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<p>Hypertrophic cardiomyopathy (HCM) can lead to various complications, such as arrhythmias, systemic thromboembolism, and heart failure. In addition to atrial fibrillation (AF), factors like an enlarged left atrial diameter, heart failure, and older age are associated with a higher risk of thromboembolic events in HCM patients. The left atrioventricular coupling index (LACI) is a new echocardiographic measure with promising potential to predict patient outcomes across different clinical scenarios. This study aimed to investigate the relationship between ischemic cerebrovascular events (CE) and the LACI in patients with HCM who do not have AF. This retrospective study examined 250 patients diagnosed with HCM, excluding those with AF. After applying exclusion criteria, 195 patients were included in the final analysis. Each participant underwent transthoracic echocardiography prior to the procedure, and LACIs were calculated for all patients. LACI was defined by the ratio of left atrial (LA) end-diastolic volume divided by left ventricular (LV) enddiastolic volume. Patients were monitored for 24 months to identify any occurrences of ischemic cerebrovascular events (CE). During a median follow-up of 24 months, the study’s primary outcome—ischemic CE + in HCM patients without AF—was significantly higher in those with higher LACI (%) (48 ± 12 vs. 66 ± 23, <i>p</i> = 0.042). Univariate logistic regression analysis revealed significant correlations between ischemic CE + in HCM patients without AF with smoking and LACI. Further analysis of these variables using the multivariate logistic regression analysis indicated that LACI (OR: 1.842, 95% CI: 1.332–2.548; <i>p</i> &lt; 0.001) and smoking were independent predictors for the development of ischemic CE + in HCM patients without AF. In the ROC analysis, the LACI optimal cut-off value of &gt; 0.61 (61%) predicted ischemic CE + in patients with HCM without AF, showing 62.5% sensitivity and 90.4% specificity. This study demonstrates the significance of LACI in predicting ischemic CE for patients with HCM without AF.</p> Graphical Abstract <p></p>

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The relationship between left atrioventricular coupling index and ischemic cerebrovascular events in patients with hypertrophic cardiomyopathy without atrial fibrillation

  • 期刊论文

  • 发表日期：

    2026年1月19日

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  • Yusuf Demir,
  • Samet Sevinc,
  • Arda Guler,
  • Ahmet Anil Baskurt,
  • Oktay Senoz,
  • Eren Ozan Bakir,
  • Cesur Samanci

摘要

Hypertrophic cardiomyopathy (HCM) can lead to various complications, such as arrhythmias, systemic thromboembolism, and heart failure. In addition to atrial fibrillation (AF), factors like an enlarged left atrial diameter, heart failure, and older age are associated with a higher risk of thromboembolic events in HCM patients. The left atrioventricular coupling index (LACI) is a new echocardiographic measure with promising potential to predict patient outcomes across different clinical scenarios. This study aimed to investigate the relationship between ischemic cerebrovascular events (CE) and the LACI in patients with HCM who do not have AF. This retrospective study examined 250 patients diagnosed with HCM, excluding those with AF. After applying exclusion criteria, 195 patients were included in the final analysis. Each participant underwent transthoracic echocardiography prior to the procedure, and LACIs were calculated for all patients. LACI was defined by the ratio of left atrial (LA) end-diastolic volume divided by left ventricular (LV) enddiastolic volume. Patients were monitored for 24 months to identify any occurrences of ischemic cerebrovascular events (CE). During a median follow-up of 24 months, the study’s primary outcome—ischemic CE + in HCM patients without AF—was significantly higher in those with higher LACI (%) (48 ± 12 vs. 66 ± 23, p = 0.042). Univariate logistic regression analysis revealed significant correlations between ischemic CE + in HCM patients without AF with smoking and LACI. Further analysis of these variables using the multivariate logistic regression analysis indicated that LACI (OR: 1.842, 95% CI: 1.332–2.548; p < 0.001) and smoking were independent predictors for the development of ischemic CE + in HCM patients without AF. In the ROC analysis, the LACI optimal cut-off value of > 0.61 (61%) predicted ischemic CE + in patients with HCM without AF, showing 62.5% sensitivity and 90.4% specificity. This study demonstrates the significance of LACI in predicting ischemic CE for patients with HCM without AF.

Graphical Abstract