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CHA2DS2-VASc score, P-wave indexes, and echocardiographic parameters in sinus rhythm patients without valvular heart

Amanda Vanessa Demarchi1, Luciana Vidal Armaganijan1, Dalmo Antonio Ribeiro Moreira1

  • 1Instituto Dante Pazzanese de Cardiologia - São Paulo (SP), Brazil.

Revista Da Associacao Medica Brasileira (1992)
|September 20, 2023
PubMed

Insights

This study found that P-wave indexes and echocardiographic measures correlate with the CHA2DS2-VASc score in patients without atrial fibrillation or valve disease. Higher scores were linked to prolonged PR intervals, larger left atrium/ventricle dimensions, and reduced P-wave amplitude.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Imaging

Background:

  • The CHA2DS2-VASc score is crucial for assessing stroke risk in patients with atrial fibrillation.
  • Understanding predictors of this score in non-arrhythmic patients can aid risk stratification.
  • P-wave characteristics and echocardiographic parameters offer insights into cardiac structure and function.

Purpose of the Study:

  • To investigate the association between P-wave indexes, echocardiographic findings, and the CHA2DS2-VASc score.
  • To identify potential subclinical markers of cardiovascular risk in patients without known atrial fibrillation or valvular heart disease.

Main Methods:

  • Retrospective cross-sectional study of 272 patients without atrial fibrillation or valve disease.
  • Analysis of electrocardiographic parameters including P-wave duration, amplitude, and PR interval.
  • Evaluation of echocardiographic data such as left atrium and left ventricle dimensions, mass, and ejection fraction.

Main Results:

  • Positive correlations were observed between CHA2DS2-VASc score and PR interval, left atrium diameter, left ventricle diameter, left ventricle mass, and indexed left ventricle mass.
  • Negative associations were found with P-wave amplitude, P-wave voltage in lead I, and left ventricle ejection fraction.
  • The presence of the Morris index was significantly associated with a higher CHA2DS2-VASc score.

Conclusions:

  • Prolonged PR interval, Morris index, increased left atrium and left ventricle dimensions/mass, and reduced left ventricle ejection fraction correlate with higher CHA2DS2-VASc scores.
  • These findings suggest that P-wave abnormalities and cardiac structural changes may reflect underlying cardiovascular risk even in the absence of atrial fibrillation.
  • Further research could explore the prognostic implications of these correlations in diverse patient populations.
Abstract

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