Heart failure & cardiomyopathiesCohort study

AI-Based Fully Automated Left Atrioventricular Coupling Index as a Prognostic Marker in Patients Undergoing Stress Cardiac Magnetic Resonance (CMR)

JACC Cardiovasc ImagingPublished

  • Retrospective cohort study
  • propensity-score matched
  • consecutive patients
  • AI-based fully automated

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)

Main finding

As reported in the abstract

Association of LACI with primary outcome · median follow-up 5.2 years
LACI vs Normal CMREstimate (95% CI)P value
overall propensity-matched population
adjusted HR 1.18(1.13–1.24)
P < 0.001
abnormal CMR
adjusted HR per 0.1% increment 1.22(1.14–1.30)
P < 0.001
normal CMR
adjusted HR per 0.1% increment 1.12(1.05–1.20)
P < 0.001

Observational 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:10.1016/j.jcmg.2023.02.015

Summarised from the published abstract; every number is checked against it