Diagnostic Value of Cardiovascular Magnetic Resonance‐Derived Left Atrioventricular Coupling Index for Predicting Adverse Left Ventricular Remodeling Following ST‐Segment Elevation Myocardial Infarction

ABSTRACT Background Left atrioventricular coupling index (LACI) is a promising marker for predicting major adverse cardiac events in individuals with acute ST‐segment elevation myocardial infarction (STEMI). However, the relationship between LACI and adverse left ventricular (LV) remodeling (ALVR) in patients with STEMI remains to be fully elucidated. Methods In this retrospective study, 143 patients with STEMI who had undergone primary percutaneous coronary intervention (PCI) underwent cardiovascular magnetic resonance (CMR) imaging. The examinations were performed at 5 ± 2 days (baseline) after PCI and at 6 months after STEMI. Left atrial and LV structural and functional indicators were evaluated. ALVR was defined as an increase of ≥ 20% in LV end‐diastolic volume (LVEDV) or an increase of ≥ 15% in LV end‐systolic volume at 6 months on CMR images. The patients were divided into two groups depending on the presence or absence of ALVR, and the CMR features were compared between the two groups. Results Overall, 51 patients (mean age 57 ± 11 years; 42 men) experienced ALVR after 6 months. In the univariable regression analysis, LVEDV index and LACI were significantly correlated with ALVR (odds ratio [OR]: 0.989, 95% confidence interval [CI]: 0.979–0.999, p = 0.025; OR: 1.046, 95% CI: 1.012–1.080, p = 0.007, respectively). Following adjustment for fundamental clinical variables, multivariate logistic regression analysis showed that baseline LACI was an independent predictor of ALVR at 6 months (OR: 1.324, 95% CI: 1.055–1.662, p = 0.016). Conclusions CMR‐derived LACI in patients with acute STEMI was an independent predictor of ALVR.