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Purpose of Review <p>The aim of this review paper is to explore the clinical utility of left atrial coupling indices—LACI-v/m (volumetric/mechanical) and LACI-av (atrioventricular volumetric)—as emerging predictors of atrial fibrillation (AF) and heart failure (HF). It emphasizes their relevance in the context of diastolic dysfunction and left heart remodeling.</p> Recent Findings <p>LACI-v/m, calculated by dividing indexed left atrial volume by a′ velocity, has been independently associated with incident AF and HF across diverse populations. LACI-av, defined as the ratio of left atrium (LA) to left ventricular (LV) end-diastolic volumes, is applicable in AF and has demonstrated predictive value for AF, HF, and mortality using echocardiography, cardiac MRI, and CT. A meta-analysis confirmed a significant association between elevated LACI and AF risk.</p> Summary <p> Given the interdependence of LA and LV function, both LACI-v/m and LACI-av enhance cardiovascular risk stratification by integrating left atrial structure and function. Future prospective studies are needed to validate standardized thresholds and guide LACI-based management strategies.</p>

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Left Atrial Coupling Index for the Prediction of Atrial Fibrillation and Heart Failure: Current Evidence and Clinical Implications

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Tea Gegenava,
  • Stephan Milhorini Pio,
  • Koen Nieman

摘要

Purpose of Review

The aim of this review paper is to explore the clinical utility of left atrial coupling indices—LACI-v/m (volumetric/mechanical) and LACI-av (atrioventricular volumetric)—as emerging predictors of atrial fibrillation (AF) and heart failure (HF). It emphasizes their relevance in the context of diastolic dysfunction and left heart remodeling.

Recent Findings

LACI-v/m, calculated by dividing indexed left atrial volume by a′ velocity, has been independently associated with incident AF and HF across diverse populations. LACI-av, defined as the ratio of left atrium (LA) to left ventricular (LV) end-diastolic volumes, is applicable in AF and has demonstrated predictive value for AF, HF, and mortality using echocardiography, cardiac MRI, and CT. A meta-analysis confirmed a significant association between elevated LACI and AF risk.

Summary

Given the interdependence of LA and LV function, both LACI-v/m and LACI-av enhance cardiovascular risk stratification by integrating left atrial structure and function. Future prospective studies are needed to validate standardized thresholds and guide LACI-based management strategies.