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A novel and easy tool to assess outcome in heart failure with reduced ejection fraction (HFrEF) : the Left Atrial Volumetric/Mechanical Coupling Index (LACI)

Read by Stefano Nistri

Main conclusion

In HFrEF, LACI is strongly, independently, and incrementally associated with excess mortality, irrespective of functional mitral regurgitation (FMR) grade and in all subsets.

Type of study

Retrospective and multivariate analysis of LACI, (calculated as left atrial volume index/tissue doppler - imaging a’) in 4 196 patients with HFrEF in sinus rhythm followed at Mayo Clinic between 2007 to 2011, to correlate it with total mortality.

Main message for clinical practice

As LACI is easy to assess with conventional echocardiography and integrates the influence of several hemodynamic determinants and displays progressive deterioration with increasing FMR severity, it seems to be a readily available approach to fully evaluate the left atrium in HFrEF and to appreciate prognosis in all subset of HfrEF.


Benfari G et al.

Left Atrial Volumetric/Mechanical Coupling Index: A Novel Predictor of Outcome in Heart Failure with Reduced Ejection Fraction. Circulation Cardiovascular Imaging. 2021; 14:e011608.