Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
Relationship of CHA2DS2-VASc and CHADS2 score to left atrial remodeling detected by velocity vector imaging in patients with atrial fibrillation.
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房颤患者CHA2DS2-VASc和CHADS2评分与速度矢量成像检测左心房重构的关系
DOI：
10.1371/journal.pone.0077653
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Zhang W
中科院分区：
文献类型：
--
作者：
Li Y;Ding W;Wang H;Song N;Lin L;Wang Z;Zhong M;Zhang Y;Zhang W
背景CHADS 2/CHA 2DS 2-VASc评分用于预测非瓣膜性房颤（AF）患者的血栓栓塞/卒中。然而，关于房颤患者卒中风险分层与左心房（LA）重构状态之间的相关性的数据有限。本研究的目的是探讨这些评分与房颤患者超声心动图定量评估的左心房重构状态之间的相关性。方法100例房颤患者根据CHA 2DS 2-VASc/CHADS 2评分分为3组：0分（低卒中风险）、1分（中卒中风险）和≥2分（高卒中风险）。所有患者均行常规超声心动图和速度向量成像超声心动图检查。超声心动图参数：测定左心房最大容积指数（LAVImax）、左心房总排空分数（LAEFt）和左心房平均应变，定量评价左心房重构状态。结果在CHA 2DS 2-VASc分类中，与0组相比，1组LAVImax评分增加，LA平均应变评分降低（LAVImax：40.27±21.91 vs. 26.79±7.87，p=0.002; LA平均应变：15.18±6.36 vs. 22±8.54，p=0.001）。在CHADS 2评分分类时，评分≥2和1组之间观察到相似的趋势（LAVImax：43.72±13.77 vs. 31.41±9.50，p<0.001; LA平均应变：11.01±5.31 vs. 18.63±7.00，p<0.001）。采用多变量logistic回归分析，LAVImax（比值比：0.92，95% CI：0.85 - 0.98，p= 0.01）和反映LA重构的LA平均应变（比值比：1.10，95% CI：1.02 - 1.19，p=0.01）可强烈预测CHA 2DS 2-VASc评分为0。结论CHADS 2评分在识别房颤患者左心房重构方面具有一定的优势。而CHA 2DS 2-VASc评分在识别具有低卒中风险的AF患者的LA重构方面优于CHADS 2评分。
Background The CHADS2/CHA2DS2-VASc scores are used to predict thrombo-embolic/stroke in patients with nonvalvular atrial fibrillation (AF). Nevertheless, limited data are available regarding the association between these risk stratification for stroke and left atrial (LA) remodeling status of AF patients. The purpose of this study was to explore the association between these scores and LA remodeling status assessed quantificationally by echocardiography in AF patients. Methods One hundred AF patients were divided into 3 groups based on the CHA2DS2-VASc/CHADS2 score: the score of 0 (low stroke risk), the score of 1 (moderate stroke risk) and the score of ≥2 (high stroke risk). All patients were performed through conventional and velocity vector imaging echocardiography. Echocardiographic parameters: maximum LA volume index (LAVImax), LA total emptying fraction (LAEFt) and LA mean strain were obtained to assess quantificationally LA remodeling status. Results On categorizing with CHA2DS2-VASc, the score of 1 group showed augment in LAVImax and attenuation in LA mean strain derived from VVI, compared with the score of 0 group (LAVImax: 40.27±21.91 vs. 26.79±7.87, p=0.002; LA mean strain: 15.18±6.36 vs. 22±8.54, p=0.001). On categorizing with the CHADS2 score, similar trends were seen between the score of ≥2 and 1 groups (LAVImax: 43.72±13.77 vs. 31.41±9.50, p<0.001; LA mean strain: 11.01±5.31 vs. 18.63±7.00, p<0.001). With multivariate logistic regression, LAVImax (odds ratio: 0.92 , 95% C=I: 0.85 to 0.98, p= 0.01) and LA mean strain reflecting LA remodeling (odds ratio: 1.10, 95% CI: 1.02 to 1.19, p=0.01) were strongly predictive of the CHA2DS2-VASc score of 0. Conclusions The superiority of the CHADS2 score may lay in identifying LA remodeling of AF patients with high stroke risk. Whereas, the CHA2DS2-VASc score was better than the CHADS2 score at identifying LA remodeling of AF patients presenting low stroke risk.
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影响因子：
--
作者：
Wolf, PA;Mitchell, JB;D'Agostino, RB
通讯作者：
D'Agostino, RB
DOI：
10.1016/j.echo.2009.11.015
发表时间：
2010-02-01
影响因子：
6.5
作者：
Dokainish, Hisham;Nguyen, John S.;Lakkis, Nasser
通讯作者：
Lakkis, Nasser
DOI：
10.1016/s1052-3057(10)80166-1
发表时间：
1995-01-01
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
通讯作者：
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影响因子：
24
作者：
Lester, Steven J.;Tajik, A. Jamil;Oh, Jae K.
通讯作者：
Oh, Jae K.
影响因子：
39.3
作者：
Camm, A. John;Lip, Gregory Y. H.;Verheugt, Freek W. A.
通讯作者：
Verheugt, Freek W. A.