This scoring system allocates 1 point to each factor except for stroke, transient ischemic attack, and thromboembolism (2 points for each), and age (2 points allocated to age ≥ 75 years and 1 point to 65 < age < 74 years). The factors evaluated are such clinical factors as congestive heart failure, left ventricular (LV) dysfunction (LV ejection fraction < 40%), hypertension, age, diabetes, stroke, transient ischemic attack, thromboembolism, sex (female), and vascular diseases including a prior myocardial infarction aortic plaque and peripheral arterial disease. The CHA 2DS 2-VASc score is a scoring system that was first used for the risk assessment of cerebrovascular or thromboembolic events in patients with atrial fibrillation (AF). LA reservoir and conduit functions decreased in the high-risk score group, which was accompanied by an increased risk of postoperative AF and prolonged ICU stay. The risk of postoperative AF and prolonged ICU stay was highest in the high-risk score group (relative risk = 9.67 (1.31–71.43) and 8.05 (1.08–60.16), respectively P = 0.026 and P = 0.042, respectively).
After adjustments for possible confounders, these differences remained statistically significant. In addition, LA strain rate during the conduit phase was lower in the moderate-risk score group than the low-risk score group. LA strain and strain rate during the reservoir phase was statistically significantly lower in the high-risk score group than the low- and moderate-risk score groups (27.8 ± 6.9% vs 31.0 ± 5.0% vs 29.8 ± 6.1%, respectively P = 0.004 and 2.6 ± 0.7 s −1 vs 2.9 ± 0.6 s −1 vs 2.9 ± 0.6 s −1, correspondingly P = 0.009) and regarding LA strain and strain rate during the conduit phase (9.7 % vs 12.9 % vs 11.5 %, correspondingly P < 0.001 and 2.1 s −1 vs 2.8 s −1 vs 2.6 s −1, respectively P < 0.001). In-hospital mortality, postoperative AF, prolonged intensive care unit (ICU) stay, and prolonged mechanical ventilation were assessed. LA function was evaluated via 2D speckle-tracking echocardiography in terms of global longitudinal strain and strain rate during the reservoir, conduit, and contraction phases. This cross-sectional study recruited 340 consecutive candidates for CABG and categorized them according to their CHA 2DS 2-VASc scores as mild-, moderate-, and high-risk score groups with 34 (10%), 83 (24%), and 223 (66%) patients, respectively. We assessed the ability of CHA 2DS 2-VASc to grade LA function in patients with sinus rhythm who were candidates for coronary artery bypass grafting (CABG). The CHA 2DS 2-VASc scoring system is correlated with left atrial (LA) reservoir function in patients with atrial fibrillation (AF) rhythm or paroxysmal AF.
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