Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.

BACKGROUND:The CHADS2/CHA2DS2-VASc scores are used to predict thrombo-embolic/stroke in patients with nonvalvular atrial fibrillation (AF). Nevertheless, limited data are available regarding the association between these risk stratification for stroke and left atrial (LA) remodeling status of AF pat...

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Main Authors: Yihui Li, Wenyuan Ding, Hua Wang, Nianpeng Song, Leyu Lin, Zhihao Wang, Ming Zhong, Yun Zhang, Wei Zhang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3798687?pdf=render
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author Yihui Li
Wenyuan Ding
Hua Wang
Nianpeng Song
Leyu Lin
Zhihao Wang
Ming Zhong
Yun Zhang
Wei Zhang
author_facet Yihui Li
Wenyuan Ding
Hua Wang
Nianpeng Song
Leyu Lin
Zhihao Wang
Ming Zhong
Yun Zhang
Wei Zhang
author_sort Yihui Li
collection DOAJ
description BACKGROUND:The CHADS2/CHA2DS2-VASc scores are used to predict thrombo-embolic/stroke in patients with nonvalvular atrial fibrillation (AF). Nevertheless, limited data are available regarding the association between these risk stratification for stroke and left atrial (LA) remodeling status of AF patients. The purpose of this study was to explore the association between these scores and LA remodeling status assessed quantificationally by echocardiography in AF patients. METHODS:One hundred AF patients were divided into 3 groups based on the CHA2DS2-VASc/CHADS2 score: the score of 0 (low stroke risk), the score of 1 (moderate stroke risk) and the score of ≥2 (high stroke risk). All patients were performed through conventional and velocity vector imaging echocardiography. Echocardiographic parameters: maximum LA volume index (LAVImax), LA total emptying fraction (LAEFt) and LA mean strain were obtained to assess quantificationally LA remodeling status. RESULTS:On categorizing with CHA2DS2-VASc, the score of 1 group showed augment in LAVImax and attenuation in LA mean strain derived from VVI, compared with the score of 0 group (LAVImax: 40.27±21.91 vs. 26.79±7.87, p=0.002; LA mean strain: 15.18±6.36 vs. 22±8.54, p=0.001). On categorizing with the CHADS2 score, similar trends were seen between the score of ≥2 and 1 groups (LAVImax: 43.72±13.77 vs. 31.41±9.50, p<0.001; LA mean strain: 11.01±5.31 vs. 18.63±7.00, p<0.001). With multivariate logistic regression, LAVImax (odds ratio: 0.92 , 95% C=I: 0.85 to 0.98, p= 0.01) and LA mean strain reflecting LA remodeling (odds ratio: 1.10, 95% CI: 1.02 to 1.19, p=0.01) were strongly predictive of the CHA2DS2-VASc score of 0. CONCLUSIONS:The superiority of the CHADS2 score may lay in identifying LA remodeling of AF patients with high stroke risk. Whereas, the CHA2DS2-VASc score was better than the CHADS2 score at identifying LA remodeling of AF patients presenting low stroke risk.
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spelling doaj.art-0797dcbc6ab74bbb802151ab67ae8a712022-12-22T02:45:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-01810e7765310.1371/journal.pone.0077653Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.Yihui LiWenyuan DingHua WangNianpeng SongLeyu LinZhihao WangMing ZhongYun ZhangWei ZhangBACKGROUND:The CHADS2/CHA2DS2-VASc scores are used to predict thrombo-embolic/stroke in patients with nonvalvular atrial fibrillation (AF). Nevertheless, limited data are available regarding the association between these risk stratification for stroke and left atrial (LA) remodeling status of AF patients. The purpose of this study was to explore the association between these scores and LA remodeling status assessed quantificationally by echocardiography in AF patients. METHODS:One hundred AF patients were divided into 3 groups based on the CHA2DS2-VASc/CHADS2 score: the score of 0 (low stroke risk), the score of 1 (moderate stroke risk) and the score of ≥2 (high stroke risk). All patients were performed through conventional and velocity vector imaging echocardiography. Echocardiographic parameters: maximum LA volume index (LAVImax), LA total emptying fraction (LAEFt) and LA mean strain were obtained to assess quantificationally LA remodeling status. RESULTS:On categorizing with CHA2DS2-VASc, the score of 1 group showed augment in LAVImax and attenuation in LA mean strain derived from VVI, compared with the score of 0 group (LAVImax: 40.27±21.91 vs. 26.79±7.87, p=0.002; LA mean strain: 15.18±6.36 vs. 22±8.54, p=0.001). On categorizing with the CHADS2 score, similar trends were seen between the score of ≥2 and 1 groups (LAVImax: 43.72±13.77 vs. 31.41±9.50, p<0.001; LA mean strain: 11.01±5.31 vs. 18.63±7.00, p<0.001). With multivariate logistic regression, LAVImax (odds ratio: 0.92 , 95% C=I: 0.85 to 0.98, p= 0.01) and LA mean strain reflecting LA remodeling (odds ratio: 1.10, 95% CI: 1.02 to 1.19, p=0.01) were strongly predictive of the CHA2DS2-VASc score of 0. CONCLUSIONS:The superiority of the CHADS2 score may lay in identifying LA remodeling of AF patients with high stroke risk. Whereas, the CHA2DS2-VASc score was better than the CHADS2 score at identifying LA remodeling of AF patients presenting low stroke risk.http://europepmc.org/articles/PMC3798687?pdf=render
spellingShingle Yihui Li
Wenyuan Ding
Hua Wang
Nianpeng Song
Leyu Lin
Zhihao Wang
Ming Zhong
Yun Zhang
Wei Zhang
Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
PLoS ONE
title Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
title_full Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
title_fullStr Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
title_full_unstemmed Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
title_short Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
title_sort relationship of cha2ds2 vasc and chads2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation
url http://europepmc.org/articles/PMC3798687?pdf=render
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