Sinus Ritmindeki Hastalarda Ekokardiyografik Aortik Sertlik Parametreleri ile CHA2DS2-VASc Skoru Arasındaki İlişki

Year 2023, Volume: 14 Issue: 2, 235 - 243, 15.08.2023

Fatih Aksoy , Ali Bağcı , İsmail Barkın Işık

https://doi.org/10.22312/sdusbed.1245816

Abstract

Amaç: CHA2DS2-VASc skoru, atriyal fibrilasyonda (AF) tromboembolik riski tahmin etmek için kullanılır. Ekokardiyografik aortik sertlik parametreleriyle ilişkisi bilinmemektedir. Mevcut çalışmada CHA2DS2-VASc skoruna göre hesaplanan risk gruplarında aortik sertlik parametrelerinin prediktif değeri araştırılması amaçlanmıştır.
Materyal-Metot: Kardiyolojik kontrol için rutin olarak başvuran toplam 272 hasta (116 kadın, 156 erkek, ort. yaş 61,76±11.5 yıl), CHA2DS2-VASc skorlarına göre iki gruba ayrıldı (skor 0 ve 1) düşük risk ve “≥2”yüksek risk olarak). 272 hastanın 153'ünde yüksek risk vardı.
Bulgular: Aortik gerilim ve aort esneyebilirliği yüksek riskli hastalarda düşük riskli bireylerde olduğundan anlamlı derecede düşüktü (8,9±3,2 ve 14,1±3,9; sırasıyla P<0,001 ve 3,4±2,3 ve 6,9±3,2; P<0,001, sırasıyla). Aortik sertlik indeksi ve elastik modulus yüksek riskli bireylerde düşük riskli bireylere göre anlamlı olarak daha yüksekti (6,5±2,9 ve 3,5±1,4; P<0,001 ve 766,6±374,5 vs. 348,4±175,9; P<0,001, sırasıyla). Aortik gerilim ve aort esneyebilirliği, yüksek risk grubuyla negatif korelasyon gösterdi. Aortik sertlik indeksi ve elastik modülus, yüksek risk grubuyla pozitif olarak korele idi. Çok değişkenli lojistik regresyon analizine göre, elastik modulus, CHA2DS2-VASc skoru açısından yüksek tromboembolik riskin bağımsız belirleyicisiydi.
Sonuç: Bulgularımız, Aort sertliği parametreleri ölçümünün, tromboembolik olaylar gibi kardiyovasküler riski değerlendirmede ek bilgi sağlayabileceğini ve aort sertliği bozuk olan kişilerin, olumsuz kardiyovasküler risk faktörlerini ve gelecekteki kardiyovasküler olayların gelişimini azaltmada daha fazla dikkat etmesi gerektiğini ortaya koymaktadır.

Keywords

CHA2DS2-VASc skoru, aortik sertlik, tromboembolik risk

Supporting Institution

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Project Number

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Thanks

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The Relation Between Echocardiographic Aortic Stiffness Parameters and CHA2DS2-VASc Score in Patients With Sinus Rhythm

Abstract

Background: The CHA2DS2-VASc score is used to estimate thromboembolic risk in atrial fibrillation (AF). Its relationship with aortic stiffness parameters is unknown.
Objective: We evaluated the predictive value of the aortic stiffness parameters in risk groups of CHA2DS2-VASc score.
Methods: A total 272 consecutive patients (116 females, 156 males, mean age 61.76±11.5 years) who admitted routinely for cardiologic control were divided into two groups according to CHA2DS2-VASc scores (a score of “0 and 1” was regarded as low risk, and “≥2” as high risk). 153 of 272 patients had high risk.
Results: Aortic strain and aortic distensibility were significantly lower in patients with in patients with high risk than in low risk subjects (8.9±3.2 vs. 14.1±3.9 respectively; P<0.001 and 3.4±2.3 vs. 6.9±3.2 respectively; P<0.001). Aortic strain ındex and elastic modulus were significantly higher in patients with high risk than in low risk subjects (6.5±2.9 vs. 3.5±1.4 respectively; P<0.001 and 766.6±374.5 vs. 348.4±175.9 respectively; P<0.001). Aortic strain and aortic distensibility were negatively correlated with high risk group. Aortic stiffness index and elastic modulus were positively correlated with high risk group. According to multivariate logistic regression analysis, elastic modulus was independent predictors of high thromboembolic risk in terms of CHA2DS2-VASc score.
Conclusion: Our findings suggest that Aortic stiffness parameters measurement could provide additional information on assessing cardiovascular risk such as thromboembolic events, and individuals with impaired aortic stiffness should receive more attention to reduce unfavorable cardiovascular risk factors and the development of future cardiovascular events.

Keywords

CHA2DS2-VASc score, aorist stiffness, thromboembolic risk

Project Number

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