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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

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Relationship between CHA2DS2-VASc score and atrial electromechanical function in patients with paroxysmal atrial

Mehmet Bülent Vatan1, Sabiye Yılmaz1, Mustafa Tarık Ağaç1

  • 1Department of Cardiology, Sakarya University Training and Research Hospital, Sakarya, Turkey.

Journal of Cardiology
|March 31, 2015
PubMed

Insights

Left atrial mechanical function, assessed via echocardiography, can identify high-risk patients with atrial fibrillation. This method shows promise in predicting stroke risk beyond traditional scoring systems.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Atrial Fibrillation Research

Background:

  • The CHA2DS2-VASc score is the standard for predicting stroke risk in atrial fibrillation patients.
  • This study investigates if atrial remodeling, reflected by echocardiographic measures, correlates with stroke risk.
  • Left atrial electromechanical remodeling is explored as a potential indicator of high stroke risk.

Purpose of the Study:

  • To determine if echocardiographic evaluation of left atrial electromechanical function can identify high-risk patients with paroxysmal atrial fibrillation (PAF).
  • To assess the correlation between left atrial mechanical function parameters and the CHA2DS2-VASc score.
  • To evaluate the predictive value of specific echocardiographic parameters for high stroke risk.

Main Methods:

  • Sixty-five patients with PAF were stratified into low (CHA2DS2-VASc=0), moderate (score=1), and high (score ≥2) risk groups.
  • Atrial electromechanical intervals and left atrial mechanical functions were compared across risk groups.
  • Correlation and ROC analyses were performed to assess the relationship between echocardiographic parameters and CHA2DS2-VASc score.

Main Results:

  • Atrial electromechanical intervals did not differ significantly between risk groups.
  • Parameters of left atrial mechanical function, including LA phasic volumes (Vmax, Vmin, Vp) and LA passive emptying volume (LATEV), were significantly higher in moderate and high-risk groups.
  • Vmin ≥11ml/m² demonstrated high predictive value for CHA2DS2-VASc score ≥2 (88% sensitivity, 89% specificity; ROC area 0.88).

Conclusions:

  • Echocardiographic assessment of left atrial mechanical function, particularly Vmin, can effectively identify patients at high risk of stroke.
  • These findings suggest that left atrial electromechanical function evaluation may serve as a valuable tool for risk stratification in atrial fibrillation.
  • This approach offers a potential adjunct to the CHA2DS2-VASc score for identifying high-risk individuals.
Abstract

Keywords:
Atrial fibrillationEchocardiographyRemodelingRisk stratification

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