文献类型：期刊文献

英文题名：Left atrioventricular coupling index by 2D and 3D echocardiography: association with exercise capacity in chronic kidney disease

作者：Wang, Ruonan[1];Zhao, Fan[2];Shi, Wenjia[1];Sun, Hanliang[3];Tang, Haiyang[3];Hua, Jing[4];Chu, Aiai[1,2]

第一作者：Wang, Ruonan

通信作者：Chu, A[1];Chu, A[2];Hua, J[3]

机构：[1]Gansu Univ Chinese Med, Gansu Prov Hosp, Clin Med Sch 1, Dept Echocardiog, Lanzhou, Peoples R China;[2]Lanzhou Univ, Gansu Prov Hosp, Dept Echocardiog, Hosp 3,Gansu Univ Chinese Med,Clin Med Sch 1, 204 West Donggang Rd, Lanzhou 730000, Peoples R China;[3]Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou Inst Resp Hlth, Dept Clin Lab,Natl Clin Res Ctr Resp Dis,State Key, Guangzhou, Peoples R China;[4]Tongji Univ, Shanghai East Hosp, Sch Med, Dept Pulm & Crit Care Med, 150 Jimo Rd, Shanghai 200120, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Gansu Prov Hosp, Clin Med Sch 1, Dept Echocardiog, Lanzhou, Peoples R China;[2]corresponding author), Lanzhou Univ, Gansu Prov Hosp, Dept Echocardiog, Hosp 3,Gansu Univ Chinese Med,Clin Med Sch 1, 204 West Donggang Rd, Lanzhou 730000, Peoples R China;[3]corresponding author), Tongji Univ, Shanghai East Hosp, Sch Med, Dept Pulm & Crit Care Med, 150 Jimo Rd, Shanghai 200120, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

外文期刊名：QUANTITATIVE IMAGING IN MEDICINE AND SURGERY

收录：;WOS:【SCI-EXPANDED(收录号:WOS:001752018400001)】；

基金：This work was supported by the Central Guidance Fund for Local Science and Technology Development Reserve Project (grant No. 24ZYQA029) ; the Lanzhou Municipal Science and Technology Plan Project (grant No. 2025-2-102) ; the Key Research and Development Program - International Cooperation Project of the Gansu Provincial Department of Science and Technology (grant No. 25YFWA027) ; and The Key Specialty Construction Project of Shanghai Pudong New Area Health Commission (grant No. PWZzk2022-07) .

语种：英文

外文关键词：Chronic kidney disease (CKD); left atrioventricular coupling index (LACI); exercise capacity; three-dimensional echocardiography (3DE)

摘要：Background: The left atrioventricular coupling index (LACI) quantifies the relationship between left atrial (LA) and left ventricular (LV) volumes at end-diastole, and a higher LACI has been associated with worse prognosis and adverse clinical outcomes across various cardiovascular conditions. However, the relationship between LACI and exercise capacity remains unknown. The objective of this study was to evaluate the association between resting LACI, as measured by two-dimensional echocardiography (2DE) and three-dimensional echocardiography (3DE), and exercise capacity in individuals diagnosed with chronic kidney disease (CKD). Methods: A total of 122 patients with CKD underwent resting echocardiography and treadmill training in the study at a single tertiary care center. LACI, the ratio of the LA to LV volume at end-diastole, was calculated offline using EchoPAC 204. Exercise capacity was evaluated as metabolic equivalents (METs) and reduced exercise capacity was defined as METs of <= 7. Results: Patients in the highest tertile of exercise capacity (METs >7.20) exhibited significantly lower LACI compared with those in the lower tertiles. Both 2D-LACI {beta, -0.266 [95% confidence interval (CI): -4.964, -0.635]; P=0.010} and 3D-LACI [beta, -0.333 (95% CI: -5.388, -0.181); P=0.003] were independent predictors of reduced exercise capacity in patients with CKD after adjustment for confounders. The 3D-LACI demonstrated the higher diagnostic accuracy [the area under the curve (AUC) =0.8105; optimal cutoff: 0.2850], outperforming 2D-LACI (AUC =0.7718; cutoff: 0.2097) (DeLong test: P=0.014). Conclusions: LACI, a marker of deteriorated atrioventricular interaction, is an independent predictor of exercise capacity in patients with CKD. Moreover, 3D-LACI offers superior prediction performance compared to 2D-LACI, potentially enhancing early detection of exercise capacity intolerance.