Dong Tian-Xin, Li Shi-Wen, Pan Xiao-Fang, Wang Chun-Feng, Liu Ying, Wu Jun, Guan Xiang-Ping, Zhang Su-Li, Zuo Peng-Fei, Liu Yi-Lin, Wang Li-Yan, Cui Lei, Liu Yan, Lai Yu-Qiong, Ding Ming-Yan, Lu Gui-Lin, Tan Jing, Yang Xin-Jian, Li Yi-Hong, Wang Yong-Huai, Zhang Xin-Tong, Ren Wei-Dong, Ma Chun-Yan
Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China.
Department of Ultrasonic Medicine, Central Hospital of Dalian University of Technology, Dalian, China.
J Am Soc Echocardiogr. 2025 Sep;38(9):794-803. doi: 10.1016/j.echo.2025.04.011. Epub 2025 Apr 24.
The left atrioventricular coupling index (LACI) and left atrial stiffness index (LASI) have recently demonstrated significant correlations with left ventricular (LV) diastolic function. However, the absence of reference values limits their widespread use. This study aimed to establish normal reference ranges for LACI and LASI.
A total of 1,648 healthy participants from 55 centers were enrolled. The LACI was defined as the ratio of left atrial (LA) minimum volume to LV end-diastolic volume. The LASI was calculated as the ratio of the average E/e' ratio to LA reservoir strain.
Both LACI and LASI increased with age in both sexes. The LACI was higher in women than in men (P < .001), whereas no significant sex difference was observed for LASI (P = .868). Age, sex, LV global longitudinal strain (GLS), and LA reservoir strain independently predicted LACI. Age, body mass index, LV GLS, and LA volume index were independently associated with LASI. Elevated LACI and LASI were observed in participants with high-normal blood pressure, overweight status, and indeterminate LV diastolic function.
Sex- and age-stratified reference values for LACI and LASI were established. Left ventricular GLS, LA reservoir strain, and LA volume index should be considered when interpreting these parameters. Hypertension, obesity, and LV diastolic dysfunction may significantly affect LACI and LASI, suggesting their potential utility in identifying early cardiac dysfunction.
左房室耦合指数（LACI）和左心房僵硬度指数（LASI）最近已证明与左心室（LV）舒张功能有显著相关性。然而，缺乏参考值限制了它们的广泛应用。本研究旨在建立LACI和LASI的正常参考范围。
共纳入了来自55个中心的1648名健康参与者。LACI定义为左心房（LA）最小容积与左心室舒张末期容积之比。LASI计算为平均E/e'比值与左心房储备应变之比。
LACI和LASI在两性中均随年龄增加。女性的LACI高于男性（P <.001），而LASI未观察到显著的性别差异（P =.868）。年龄、性别、左心室整体纵向应变（GLS）和左心房储备应变独立预测LACI。年龄、体重指数、左心室GLS和左心房容积指数与LASI独立相关。在血压高正常、超重状态和左心室舒张功能不确定的参与者中观察到LACI和LASI升高。
建立了LACI和LASI的性别和年龄分层参考值。在解释这些参数时应考虑左心室GLS、左心房储备应变和左心房容积指数。高血压、肥胖和左心室舒张功能障碍可能会显著影响LACI和LASI，表明它们在识别早期心脏功能障碍方面的潜在效用。
