Association of CHA2DS2-VASc Score With Remodeling of Left Atrial Appendage Assessed by Cardiac Computed Tomography

Abstract

Background: CHA₂DS₂-VASc score (congestive heart failure; hypertension; ages ≥ 74 years (2 points); diabetes; stroke, transient ischemic attack, or systemic embolism (2 points); vascular disease; ages 65 - 74 years; sex (female)) is a widely used clinical scale to estimate the risk of stroke in patients with non-valvular atrial fibrillation (AF). However, the relationship between the increase in CHA₂DS₂-VASc score and atrial remodeling remains unsettled.

Methods: Twenty-five consecutive patients undergoing cardiac computed tomography (CT) were recruited. The systolic and diastolic volumes of left atrium and left atrial appendage (LAA) were measured. Risk of stroke was estimated using the CHA₂DS₂-VASc score. The relationship of the CHA₂DS₂-VASc score with morphological and functional variables was analyzed by Pearson's correlation.

Results: A positive correlation was documented between the CHA₂DS₂-VASc score and systolic (r = 0.419, P = 0.037) and diastolic (r = 0.415, P = 0.039) LAA volumes. Atrial volumes and left atrial ejection fraction showed no significant correlations with CHA₂DS₂-VASc.

Conclusions: This study shows, for the first time, a positive correlation between CHA₂DS₂-VASc score and LAA remodeling.

Keywords: Cardiac computed tomography; Embolic risk; Left atrial appendage; Remodeling.