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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Cardiac Structural or Functional Changes Associated with CHA2DS2-VASc Scores in Nonvalvular Atrial Fibrillation: A

Albert Youngwoo Jang1, Jongwook Yu1, Ye Min Park1

  • 1Division of Cardiology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.

Journal of Cardiovascular Imaging
|October 13, 2018
PubMed

Insights

Higher CHA2DS2-VASc scores in atrial fibrillation patients correlate with impaired diastolic function and increased left ventricular mass. These cardiac changes may indicate higher left atrial pressure, increasing stroke risk.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Imaging

Background:

  • CHA2DS2-VASc scoring is standard for atrial fibrillation (AF) stroke risk assessment.
  • Cardiac structural and functional changes associated with CHA2DS2-VASc scores are not well understood.

Purpose of the Study:

  • To investigate cardiac functional and structural changes in relation to CHA2DS2-VASc scores in nonvalvular AF patients.
  • To identify echocardiographic parameters associated with elevated stroke risk scores.

Main Methods:

  • Echocardiography was used to assess cardiac structure and function in 4,204 nonvalvular AF patients.
  • Patients were stratified into four groups based on CHA2DS2-VASc scores (0-1, 2-3, 4-6, 7-9).

Main Results:

  • Left ventricular mass index and left ventricular hypertrophy (LVH) prevalence increased with higher CHA2DS2-VASc scores (p < 0.05).
  • Left atrial volume index (LAVI) and E/E' (diastolic function parameter) significantly increased with higher scores (p < 0.001), independent of hypertension.
  • LVH and E/E' were independent risk factors for CHA2DS2-VASc scores ≥ 2.

Conclusions:

  • Increasing CHA2DS2-VASc scores are linked to impaired diastolic function.
  • These diastolic impairments may reflect elevated left atrial pressure, potentially increasing thrombogenic risk in AF patients.
Abstract

Keywords:
Atrial fibrillationCHA2DS2-VASc scoreDiastolic dysfunctionHypertensionLeft ventricular hypertrophy

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