REN Nai-yong, SU Cen, ZHAO Kang-ren, JIN Biao, QIAN Jin-jun, XIA Hai-ping,ZHANG Min-kai, SONG Ji-dong, ZHANG Wei-fang
Value of CHA2DS2-VASc scores combined with markers of the left atrial reconstruction in predicting the risk of stroke in patients with non-valvular atrial fibrillation
(Department of Neurology, the Fourth Affiliated Hospital of Jiangsu University, Zhenjiang Jiangsu 212001, China)
Abstract：Objective: To investigate the value of CHA2DS2-VASc score combined with the markers of left atrial reconstruction in predicting the risk of stroke in patients with non-valvular atrial fibrillation(NVAF). Methods: A total of 216 cases of NVAF patients who met the criteria inclusion were selected, and according to CHA2DS2-VASc score by recording medical history and laboratory examinations, who were divided into the high-risk groups and the low-middle risk group. Echocardiography was recorded in each patient with left atrial diameter(LAD) and left atrial maximum volume(LAVmax) from left atrial volume indextime curve, in order to explore the left atrial reconstruction of the patient.According to the follow-up results, all patients were divided into the stroke group and the non-stroke group. Results: The levels of LAD and LAVmax in the high-risk group were significantly higher than those in the low-middle risk group (P<0.05).To follow-up the final stroke events as the gold standard, the ROC curve of LAD and LAVmax drawing that the area under the curve (AUC) were 0.890 and 0.891. When the LAD level≥39.9 mm or the LAVmax level≥40.35 mL, the patients with NVAF had higher risk for stroke.Then the combined score of CHA2DS2-VASc-LAD-LAVmax was formed that the AUC was 0.878 with the ROC curve analysis, while the AUC of CHA2DS2-VASc score was only 0.810. The patients with NVAF were more prone to suffer with stroke when CHA2DS2-VASc-LAD-LAVmax score was greater than 2. Conclusion: CHA2DS2-VASc score combined with LAD and LAVmax level had higher predictive value for the risk of stroke in NVAF patients. ［Key words］non-valvular atrial fibrillation; stroke; CHA2DS2-VASc score; left atrial diameter; left atrial maximum volume
收稿日期: 2017-08-28
基金资助:
镇江市社会发展项目(SH2015027，SH2013089)
通讯作者:
赵康仁(通讯作者)，主任医师，E-mail: zhaokr@aliyum.com
作者简介: 任乃勇(1966—)，男，江苏如东人，主任医师，主要从事脑血管病和帕金森疾病的防治；
引用本文:
任乃勇, 苏岑, 赵康仁, 靳彪, 钱进军, 夏海平, 张民凯, 宋继东, 张渭芳. CHA2DS2-VASc评分结合左心房重构指标对非瓣膜性房颤脑卒中的预测价值[J]. 江苏大学学报:医学版, 2017, 27(06): 509-512,521.
REN Nai-Yong, Su-Cen, Zhao-Kang-Ren, Jin-Biao, Qian-Jin-Jun, Xia-Hai-Ping, Zhang-Min-Kai, Song-Ji-Dong, Zhang-Wei-Fang. Value of CHA2DS2-VASc scores combined with markers of the left atrial reconstruction in predicting the risk of stroke in patients with non-valvular atrial fibrillation. Journal of Jiangsu University(Medicine Edition), 2017, 27(06): 509-512,521.
2017, Vol. 27 
