HELT-E₂S₂ score is a promising marker for predicting left atrial appendage dysfunction in patients with ischemic...

The HELT-E₂S₂ score, replacing diabetes mellitus and heart failure and adding extreme elderly (≥ 85 years), type of atrial fibrillation (AF), and low body mass index (BMI), has been proposed as a new measure for stratifying the risk of stroke in Japanese patients with AF. However, the association of the HELT-E₂S₂ score with left atrial appendage (LAA) dysfunction in patients with ischemic stroke remains unclear. We performed transthoracic and transesophageal echocardiography and evaluated the HELT-E₂S₂ scores in 593 patients with acute ischemic stroke and 296 patients without acute ischemic stroke as the control group. LAA dysfunction, defined as the presence of an LAA thrombus and/or severe spontaneous echo contrast, was identified in 182 patients. In a receiver operating characteristic curve analysis, the area under the curve of the HELT-E₂S₂ score for predicting LAA dysfunction was significantly higher than those of the CHADS₂ score (0.74 vs. 0.67, P < 0.001) and the CHA₂DS₂-VA score (0.74 vs. 0.67, P < 0.001). Multivariate logistic regression analysis showed that the HELT-E₂S₂ score was an independent predictor of LAA dysfunction after adjusting for conventional risk factors. The HELT-E₂S₂ score is a promising marker for predicting LAA dysfunction in patients with ischemic stroke.