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The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation

The association between congestive heart failure (CHF) of the CHA(2)DS(2)-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 rec...

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Autores principales: Jang, Albert Youngwoo, Kang, Woong Chol, Park, Yae Min, Ha, Kyungeun, Seo, Jeongduk, Oh, Pyung Chun, Lee, Kyounghoon, Moon, Jeonggeun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781364/
https://www.ncbi.nlm.nih.gov/pubmed/35053995
http://dx.doi.org/10.3390/jcm11020300
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author Jang, Albert Youngwoo
Kang, Woong Chol
Park, Yae Min
Ha, Kyungeun
Seo, Jeongduk
Oh, Pyung Chun
Lee, Kyounghoon
Moon, Jeonggeun
author_facet Jang, Albert Youngwoo
Kang, Woong Chol
Park, Yae Min
Ha, Kyungeun
Seo, Jeongduk
Oh, Pyung Chun
Lee, Kyounghoon
Moon, Jeonggeun
author_sort Jang, Albert Youngwoo
collection PubMed
description The association between congestive heart failure (CHF) of the CHA(2)DS(2)-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 CHA(2)DS(2)-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/m(2), and many others were tested for C criteria. Multivariate-adjusted Cox regression analysis showed that CHA(2)DS(2)-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 CHA(2)DS(2)-VASc scores.
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spelling pubmed-87813642022-01-22 The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation Jang, Albert Youngwoo Kang, Woong Chol Park, Yae Min Ha, Kyungeun Seo, Jeongduk Oh, Pyung Chun Lee, Kyounghoon Moon, Jeonggeun J Clin Med Article The association between congestive heart failure (CHF) of the CHA(2)DS(2)-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 CHA(2)DS(2)-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/m(2), and many others were tested for C criteria. Multivariate-adjusted Cox regression analysis showed that CHA(2)DS(2)-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 CHA(2)DS(2)-VASc scores. MDPI 2022-01-07 /pmc/articles/PMC8781364/ /pubmed/35053995 http://dx.doi.org/10.3390/jcm11020300 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jang, Albert Youngwoo
Kang, Woong Chol
Park, Yae Min
Ha, Kyungeun
Seo, Jeongduk
Oh, Pyung Chun
Lee, Kyounghoon
Moon, Jeonggeun
The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title_full The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title_fullStr The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title_full_unstemmed The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title_short The Thromboembolic Predictability of CHA(2)DS(2)-VASc Scores Using Different Echocardiographic Criteria for Congestive Heart Failure in Korean Patients with Nonvalvular Atrial Fibrillation
title_sort thromboembolic predictability of cha(2)ds(2)-vasc scores using different echocardiographic criteria for congestive heart failure in korean patients with nonvalvular atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8781364/
https://www.ncbi.nlm.nih.gov/pubmed/35053995
http://dx.doi.org/10.3390/jcm11020300
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