The Thromboembolic Predictability of CHA2DS2-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
- Authors
- Jang, Albert Youngwoo; Kang, Woong Chol; Park, Yae Min; Ha, Kyungeun; Seo, Jeongduk; Oh, Pyung Chun; Lee, Kyounghoon; Moon, Jeonggeun
- Issue Date
- Jan-2022
- Publisher
- MDPI
- Keywords
- Atrial fibrillation; CHA2DS2-VASc score; Congestive heart failure; Diastolic function; E/E’
- Citation
- Journal of Clinical Medicine, v.11, no.2
- Journal Title
- Journal of Clinical Medicine
- Volume
- 11
- Number
- 2
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/83390
- DOI
- 10.3390/jcm11020300
- ISSN
- 2077-0383
- Abstract
- The association between congestive heart failure (CHF) of the CHA2DS2-VASc scores and thromboembolic (TE) events in patients with atrial fibrillation (AF) is a topic of debate due to conflicting results. As the importance of diastolic impairment in the occurrence of TE events is increasingly recognized, it is crucial to evaluate the predictive power of CHA2DS2-VASc scores with C criterion integrating diastolic parameters. We analyzed 4200 Korean nonvalvular AF patients (71 years of age, 59% men) to compare multiple echocardiographic definitions of CHF. Various guideline-suggested echocardiographic parameters for systolic or diastolic impairment, including left ventricular ejection fraction (LVEF) ≤ 40%, the ratio of early diastolic mitral inflow velocity to early diastolic velocity of the mitral annulus (E/E’) ≥ 11, left atrial volume index > 34 mL/m2, and many others were tested for C criteria. Multivariate-adjusted Cox regression analysis showed that CHA2DS2-VASc score was an independent predictor for composite thromboembolic events only when CHF was defined as E/E’ ≥ 11 (hazard ratio, 1.26; p = 0.044) but not with other criteria including the original definition (hazard ratio, 1.10; p = 0.359). Our findings suggest that C criterion defined as diastolic impairment, such as E/E’ ≥ 11, may improve the predictive value of CHA2DS2-VASc scores. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - 의과대학 > 의학과 > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/83390)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.