Assessment of the ability of the CHA2DS2-VASc scoring system to grade left atrial function by 2D speckle-tracking echocardiography

Abstract

Background The CHA2DS2-VASc scoring system is correlated with left atrial (LA) reservoir function in patients with atrial fibrillation (AF) rhythm or paroxysmal AF. We assessed the ability of CHA2DS2-VASc to grade LA function in patients with sinus rhythm who were candidates for coronary artery bypass grafting (CABG). Methods This cross-sectional study recruited 340 consecutive candidates for CABG and categorized them according to their CHA2DS2-VASc scores as mild-, moderate-, and high-risk score groups with 34 (10%), 83 (24%), and 223 (66%) patients, respectively. LA function was evaluated via 2D speckle-tracking echocardiography in terms of global longitudinal strain and strain rate during the reservoir, conduit, and contraction phases. In-hospital mortality, postoperative AF, prolonged intensive care unit (ICU) stay, and prolonged mechanical ventilation were assessed. Results LA strain and strain rate during the reservoir phase was statistically significantly lower in the high-risk score group than the low- and moderate-risk score groups (27.8 ± 6.9% vs 31.0 ± 5.0% vs 29.8 ± 6.1%, respectively; P = 0.004 and 2.6 ± 0.7 s−1 vs 2.9 ± 0.6 s−1 vs 2.9 ± 0.6 s−1, correspondingly; P = 0.009) and regarding LA strain and strain rate during the conduit phase (9.7 [7.1–12.5]% vs 12.9 [9.4–15.1]% vs 11.5 [9.1–13.8]%, correspondingly; P < 0.001 and 2.1 [1.6–2.7] s−1 vs 2.8 [2.4–3.6] s−1 vs 2.6 [2.2–3.0] s−1, respectively; P < 0.001). In addition, LA strain rate during the conduit phase was lower in the moderate-risk score group than the low-risk score group. After adjustments for possible confounders, these differences remained statistically significant. The risk of postoperative AF and prolonged ICU stay was highest in the high-risk score group (relative risk = 9.67 (1.31–71.43) and 8.05 (1.08–60.16), respectively; P = 0.026 and P = 0.042, respectively). Conclusions LA reservoir and conduit functions decreased in the high-risk score group, which was accompanied by an increased risk of postoperative AF and prolonged ICU stay.

Left atrial CT volume and CHA2DS2-VASc score predict pulmonary vein stump thrombus after left upper lobectomy

“…CHA 2 DS 2 -VASc score has been reported to be associated with low velocity in the LA appendage, and higher CHA 2 DS 2 -VASc score was considered to be a risk factor for LA appendage thrombus 31,32 . Furthermore, it has been reported that CHADS 2 is correlated with the amount of LA brosis, which independently predicted cerebrovascular events 33 , and is also associated with LA function 34 . LA dysfunction can cause blood ow stasis and may result in the development of PV stump thrombus after lobectomy.…”

Left atrial CT volume and CHA2DS2-VASc score predict early pulmonary vein stump thrombus after left upper lobectomy

“…CHA 2 DS 2 -VASc score has been reported to be associated with low velocity in the LA appendage, and higher CHA 2 DS 2 -VASc score was considered to be a risk factor for LA appendage thrombus 30 , 31 . Furthermore, it has been reported that CHADS 2 is correlated with the amount of LA fibrosis, which independently predicted cerebrovascular events 32 , and is also associated with LA function 33 . LA dysfunction can cause blood flow stasis and may result in the development of PV stump thrombus after lobectomy.…”

Determinants of the Volumetric Markers of Left Atrial Contraction Function in Coronary Artery Disease: A Cross-sectional Study

“… 3) The reservoir function of the LA as evaluated by volumetric or deformation study is in correlation with the occurrence of postoperative AF, increased in-hospital mortality, elevated LV diastolic pressure, and prolonged lengths of stay in the intensive care unit in patients who undergo CABG. 14) 15) 34) 35) The conduit function of the LA correlates with postoperative AF and longer stays in the intensive care unit in the aforementioned population. 35) The ability of LA contraction function to predict postoperative AF has yet to be elucidated.…”

“… 14) 15) 34) 35) The conduit function of the LA correlates with postoperative AF and longer stays in the intensive care unit in the aforementioned population. 35) The ability of LA contraction function to predict postoperative AF has yet to be elucidated. 36) Nevertheless, one of the few investigations in this regard demonstrated that postoperative LA contraction function could predict the occurrence of postoperative AF.…”