Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.
Svante, G., Judith, G., Alexander, S., Eric, B.B., Miriam, P., Gerd, H., Andreas, S., Constanze, S., Karl, T., & Torben, L. (2026). Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.. Eur Heart J Imaging Methods Pract. https://doi.org/10.1093/ehjimp/qyag061
Svante G, Judith G, Alexander S, Eric BB, Miriam P, Gerd H, et al. Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.. Eur Heart J Imaging Methods Pract. 2026; doi: 10.1093/ehjimp/qyag061
Svante G, Judith G, Alexander S, et al. Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.[J]. Eur Heart J Imaging Methods Pract. 2026. DOI: 10.1093/ehjimp/qyag061.
@article{svante2026,
author = {Gersch Svante and Gronwald Judith and Schulz Alexander and Beuthner Bo Eric and Puls Miriam and Hasenfuß Gerd and Schuster Andreas and Schmidt Constanze and Toischer Karl and Lange Torben},
title = {Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement.},
journal = {Eur Heart J Imaging Methods Pract},
year = {2026},
doi = {10.1093/ehjimp/qyag061},
note = {PMID: 42040888},
}
TY - JOUR AU - Gersch Svante AU - Gronwald Judith AU - Schulz Alexander AU - Beuthner Bo Eric AU - Puls Miriam AU - Hasenfuß Gerd AU - Schuster Andreas AU - Schmidt Constanze AU - Toischer Karl AU - Lange Torben TI - Prognostic impact of cardiovascular magnetic resonance-derived left atrioventricular coupling Index in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement. T2 - Eur Heart J Imaging Methods Pract PY - 2026 DO - 10.1093/ehjimp/qyag061 AN - PMID:42040888 ER -
Transcatheter aortic valve replacement (TAVR) is an established therapy improving outcome in patients with severe aortic stenosis (AS). Cardiovascular magnetic resonance (CMR)-derived left atrioventricular coupling index (LACI) has demonstrated prognostic value, however, its prognostic utility in severe AS remains unknown. Between January 2017 and September 2023 138 consecutive patients with severe AS (80 years (70-83), 62% male) referred for TAVR were prospectively recruited for pre-procedural CMR imaging. LACI was defined as the ratio of the left atrial (LA) end-diastolic volume index (LA EDVi) and left ventricular (LV) end-diastolic volume index (LV EDVi). The primary endpoint was cardiovascular (CV)-mortality. The cohort was dichotomized at a median of 44.1% (high vs. low LACI). Patients with increased LACI (≥44.1%) had higher symptom burden (NYHA III/IV prevalence (68.1% vs. 44.9%; P = 0.047)), more frequently atrial fibrillation (50.7% vs. 14.5%; P < 0.001), and elevated NT-proBNP (2017 ng/L vs. 1012 ng/L; P = 0.007). Over a median follow-up of 2.7 years (IQR 1.7-3.6), high LACI was associated with higher CV mortality (log-rank P = 0.016). In exploratory multivariable Cox regression models, LACI remained associated with CV-mortality after adjustment for established parameters of left atrial or ventricular function (LA reservoir strain: HR 2.19, 95% CI 1.05-4.57, P = 0.036; LV GLS: HR 2.21 95% CI 1.00-4.9, P = 0.049). In patients with severe aortic stenosis, CMR-derived LACI was associated with cardiovascular mortality and may serve as a structural marker of advanced atrioventricular remodelling. Given its simplicity and routine availability in standard CMR workflows, LACI may serve as a clinically practical risk marker for baseline stratification.