Association between Morphodynamic Variables by Transesophageal Echocardiography and CHA2DS2-Vasc Values
Int. j. cardiovasc. sci. (Impr.)
;
32(5): 460-470, Sept-Oct. 2019. tab, graf, graf
Article
in English
| LILACS, SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1040110
ABSTRACT
In atrial fibrillation (AF), the CHA2DS2-VASc score calculates the risk for stroke. Di Biase classified the left atrial appendage (LAA), using magnetic resonance imaging, into 4 morphological types and correlated it with cerebrovascular events. Transesophageal echocardiography (TEE) also evaluates LAA and is a more widespread technique. Objective:
To evaluate, using TEE, the possibility of characterizing LAA and to analyze its morphological aspects using the CHA2DS2VASc score.Methodology:
A total of 247 patients were divided into three groups considering the CHA2DS2-VASc score Group 1 0 and 1; Group 2 2 and 3 and, Group 3 ≥ 4 points. TEE produced the echocardiographic data. LAA was classified into thrombogenic and non-thrombogenic morphologies. In the analysis of statistical tests, a significance level of 5% was adopted.Results:
The average age was 50 and 16.2% presented AF. In Group 1, we observed normal variables with a lower prevalence of AF (8.7%, p < 0.001). In group 2, spontaneous contrast was detected in 26.7%, (p < 0.001), thrombus in 6.7% (p = 0.079) and flow velocity in LAA < 0.4 m/s in 22.7% (p < 0.001) of the cases. Group 3 presented the highest percentages of AF (31.8%, p < 0.001), stroke/TIA (77.3%, p < 0.001), EF < 55% (18.2%, p = 0.010) and higher prevalence of thrombogenic type LAA (72.7%, p = 0.014). A higher occurrence of stroke/TIA was observed in patients with thrombogenic LAA (25.2%) compared to the non-thrombogenic group (11.2%), (p = 0.005).Conclusions:
The thrombogenic morphology of LAA identified in TEE presented a higher risk of stroke regardless of the CHA2DS2VASc score. Patients with higher scores had greater abnormalities in echocardiographic variables
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Atrial Fibrillation
/
Thrombosis
/
Echocardiography, Transesophageal
/
Stroke
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Int. j. cardiovasc. sci. (Impr.)
Year:
2019
Type:
Article
Institution/Affiliation country:
A+BR
/
Instituto Dante Pazzanese de Cardiologia/BR
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