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Correlation between cardiac rhythm, left atrial appendage flow velocity, and CHA2 DS2 -VASc score: Study based on
Kun Zuo1, Lanlan Sun2, Xinchun Yang1
1Department of Cardiology, Chaoyang Hospital, Capital Medical University, Beijing, China.
Insights
Atrial fibrillation (AF) rhythm significantly reduces left atrial appendage flow velocity (LAA-FV), independent of the CHA2DS2-VASc score. Left atrial (LA) strain predicts LAA-FV in both AF and sinus rhythm (SR).
Area of Science:
- Cardiology
- Echocardiography
- Thrombosis
Background:
- The CHA2DS2-VASc score predicts stroke risk in atrial fibrillation (AF) patients.
- Decreased left atrial appendage flow velocity (LAA-FV) indicates blood stasis.
- Left atrial (LA) strain reflects atrial remodeling, a factor in thrombogenesis.
Purpose of the Study:
- To investigate the impact of AF rhythm and CHA2DS2-VASc score on thrombogenesis.
- To explore the correlation between AF, CHA2DS2-VASc score, LAA-FV, and LA strain.
Main Methods:
- Studied 98 patients with AF.
- Measured LAA-FV using transesophageal echocardiography.
- Assessed LA strain via transthoracic echocardiography.
Main Results:
- LAA-FV was significantly lower in the AF rhythm group compared to controls (26.22 vs 61.87 mm/s).
- In sinus rhythm (SR), LAA-FV correlated negatively with CHA2DS2-VASc score (coefficient = -0.317, P = 0.013).
- LA strain emerged as a predictor of LAA-FV in both AF and SR, with a specific strain index (<0.744) predicting decreased LAA-FV.
Conclusions:
- AF rhythm independently reduces LAA-FV, irrespective of the CHA2DS2-VASc score.
- In SR, a higher CHA2DS2-VASc score is associated with lower LAA-FV.
- LA strain is a significant predictor of LAA-FV in both AF and SR.
Background:
The CHA2 DS2 -VASc score is a classic predictor of stroke in patients with atrial fibrillation (AF). Decreased left atrial appendage flow velocity (LAA-FV) reflects the blood stasis, and left atrial (LA) strain is a manifestation of atrial remodeling. This study aimed to explore the effects of AF rhythm and CHA2 DS2 -VASc score in the development of thrombogenesis and their potential correlation with LAA-FV and LA strain.
Hypothesis:
AF rhythm and high CHA2 DS2 -VASc score correlate independently with decreased LAA-FV, which can be predicted by LA strain.
Methods:
In 98 AF patients, LAA-FV was measured by transesophageal echocardiography and LA strain was measured by transthoracic echocardiography.
Results:
LAA-FV decreased sharply in the AF rhythm group (26.22 vs 61.87 mm/s; P < 0.001), and CHA2 DS2 -VASc score did not differ between the decreased and normal LAA-FV groups in all patients (P = 0.289). However, in sinus rhythm (SR), LAA-FV was associated with CHA2 DS2 -VASc score (coefficient = -0.317, P = 0.013), and the CHA2 DS2 -VASc score differed between the normal and decreased LAA-FV groups (2 [0-7] vs 3 [0-6], respectively; P = 0.038). Moreover, LA strain was a predictor of LAA-FV in both AF rhythm and SR, whereas a peak positive systolic strain divided by LA volume index <0.744 predicted decreased LAA-FV.
Conclusions:
AF rhythm caused a sharp decrease in LAA-FV independent of CHA2 DS2 -VASc score. In SR, the CHA2 DS2 -VASc score correlated negatively with LAA-FV. LA strain was a predictor of LAA-FV in both SR and AF rhythm.
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