Heart failure & cardiomyopathies
AI-Based Fully Automated Left Atrioventricular Coupling Index as a Prognostic Marker in Patients Undergoing Stress Cardiac Magnetic Resonance (CMR)
Authors' conclusion
LACI is independently associated with hospitalization for HF and cardiovascular death in patients undergoing stress CMR, with an incremental prognostic value over traditional risk factors including inducible ischemia and late gadolinium enhancement.
Study context
- Population
- Patients undergoing vasodilator stress CMR, 2016–20181:1 matched
- Participants
- 2,134 patients
- Exposure
- Left atrioventricular coupling index (LACI) and prognosis in abnormal vs normal stress CMR
- Abnormal CMRn = 1,067
- Normal CMRn = 1,067reference
- Outcome
- Hospitalization for acute heart failure (HF) or CV death
- Follow-up
- Median 5.2 years (IQR 4.8-5.5 years)
Methodological detailspropensity-score matched, consecutive patients, AI-based fully automated
- Propensity-score matched
- Consecutive patients
- AI-based fully automated
Main finding
As reported in the abstract
Association of LACI with primary outcome · median follow-up 5.2 years
LACIEstimate (95% CI)P value
Overall propensity-matched population
adjusted HR 1.18(1.13–1.24)
P < 0.001Abnormal CMR
adjusted HR per 0.1% increment 1.22(1.14–1.30)
P < 0.001Normal CMR
adjusted HR per 0.1% increment 1.12(1.05–1.20)
P < 0.001Observational data: associations, not effects.
Further findings
Incremental prognostic value of LACI ≥25% over traditional risk factors and stress CMR findings
- C-index improvement
- 0.16
- Net reclassification improvement
- 0.388
- Integrative discrimination index
- 0.153
- Likelihood ratio test
- P < 0.001
- All P < 0.001
Original publication
AI-Based Fully Automated Left Atrioventricular Coupling Index as a Prognostic Marker in Patients Undergoing Stress CMR. JACC Cardiovasc Imaging. Published 12 April 2023. doi:10.
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