Author + information
- P.A. Costa,
- D.A.R. Moreira,
- R.B.M. Barretto,
- D. Le Bihan,
- J.E. Assef,
- G.M. Mohallem,
- K.R. Serafim and
- R.G. Habib
Patients (P) with CAD and elevated CHADS2 and CHA2DS2VASc scores have been shown to be at increased risk of systemic thromboembolism (ST) independent of the documentation of AF. The addition of echocardiographic (ECHO) changes to the scores may increase its accuracy for risk stratification for ST.
To evaluate if P-CAD in sinus rhythm (SR) present ECHO alterations proportional to the CHADS2 and CHA2DS2VASc scores; and to evaluate the effect of each component of these scores on ECHO variables.
111 P-CAD in SR were stratified into two groups (CHADS2 <2 vs ≥ 2 and CHA2DS2VASc <3 vs ≥3) and submitted to TT-ECHO and TE-ECHO, with left atrial volume index (LAVi), left ventricular mass (LVMi), LVEF, presence of left ventricular diastolic dysfunction and left atrial appendage flow velocity (LAAFV).
These are presented in the tables below. The component “heart failure” is associated with a 30-fold higher risk of ECHO changes.
|ECHO parameters vs CHADS2 ≥ 2||Odds ratio||95 % CI||p|
|LAVi increased||5,1||2,2 – 12,2||< 0,001|
|LAAVF reduced||3,4||1,2 – 10,2||0,027|
|LVMi increased||2,8||1,2 – 6,8||0,019|
|LVEF reduced||18,9||2,4 – 149,2||0,005|
|Diastolic dysfunction||3,2||1,5 – 7,0||0,003|
|ECHO parameters vs CHA2DS2VASc ≥ 3||Odds ratio||95 % CI||p|
|LAVi increased||7,7||2,2 – 27,3||0,002|
|LAAVF reduced||8,6||1,1 – 67,3||0,041|
|LVMi increased||3,3||1,04 -10,4||0,042|
P-CAD with elevated scores have ECHO abnormalities, indicating a higher risk for ST, even in the absence of AF; “Heart failure” is the major determinant of ECHO changes.