Kim Min, Yu Hee Tae, Kim Tae-Hoon, Lee Dae-In, Uhm Jae-Sun, Kim Young Dae, Nam Hyo Suk, Joung Boyoung, Lee Moon-Hyoung, Heo Ji Hoe, Pak Hui-Nam
Division of Cardiology, Chungbuk National University Hospital, Cheongju, South Korea.
Division of Cardiology, Yonsei University Health System, Seoul, South Korea.
Front Cardiovasc Med. 2022 Feb 8;8:791112. doi: 10.3389/fcvm.2021.791112. eCollection 2021.
Ischemic strokes (ISs) can appear even in non-gender-related CHADS-VA scores 01 patients with atrial fibrillation (AF). We explored the determinants associated with IS development among the patients with non-gender-related CHADS-VA score 01 AF.
In this single-center retrospective registry data for AF catheter ablation (AFCA), we included 1,353 patients with AF (24.7% female, median age 56 years, and paroxysmal AF 72.6%) who had non-gender-related CHADS-VA score 01, normal left ventricular (LV) systolic function, and available HFPEF score. Among those patients, 113 experienced IS despite a non-gender-related CHADS-VA score of 01. All included patients underwent AFCA, and we evaluated the associated factors with IS in non-gender-related CHADS-VA score 0~1 AF. Patients with ISs in this study had a lower estimated glomerular filtration rate (eGFR) ( < 0.001) and LV ejection fraction (LVEF; = 0.017), larger LA diameter ( < 0.001), reduced LA appendage peak velocity ( < 0.001), and a higher baseline HFPEF score ( = 0.018) relative to those without ISs. Age [odds ratio (OR) 1.11 (1.07-1.17), < 0.001, Model 1] and HFPEF score as continuous [ 1.31 (1.03-1.67), = 0.028, Model 2] variable were independently associated with ISs by multivariate analysis. Moreover, the eGFR was independently associated with IS at low CHADS-VA scores in both Models 1 and 2. AF recurrence was significantly higher in patients with IS (log-rank < 0.001) but not in those with high HFPEF scores (log-rank = 0.079), respectively.
Among the patients with normal LVEF and non-gender-related CHADS-VA score 0~1 AF, the high HFPEF score, and increasing age were independently associated with IS development (ClinicalTrials.gov Identifier: NCT02138695).
即使在非性别相关CHADS-VA评分为01的房颤（AF）患者中也可能出现缺血性卒中（IS）。我们探讨了非性别相关CHADS-VA评分为01的AF患者中与IS发生相关的决定因素。
在这项关于AF导管消融（AFCA）的单中心回顾性登记数据中，我们纳入了1353例非性别相关CHADS-VA评分为01、左心室（LV）收缩功能正常且有可用HFPEF评分的AF患者（24.7%为女性，中位年龄56岁，阵发性AF占72.6%）。在这些患者中，113例尽管非性别相关CHADS-VA评分为01但仍发生了IS。所有纳入患者均接受了AFCA，我们评估了非性别相关CHADS-VA评分为01的AF中与IS相关的因素。与未发生IS的患者相比，本研究中发生IS的患者估计肾小球滤过率（eGFR）更低（<0.001）、LV射血分数（LVEF；=0.017）更低、左心房（LA）直径更大（<0.001）、LA附件峰值速度降低（<0.001）且基线HFPEF评分更高（=0.018）。通过多变量分析，年龄[比值比（OR）1.11（1.071.17），<0.001，模型1]和作为连续变量的HFPEF评分[1.31（1.03~1.67），=0.028，模型2]与IS独立相关。此外，在模型1和模型2中，eGFR在低CHADS-VA评分时均与IS独立相关。IS患者的AF复发率显著更高（对数秩检验<0.001），但HFPEF评分高的患者AF复发率无显著差异（对数秩检验=0.079）。
在LVEF正常且非性别相关CHADS-VA评分为0~1的AF患者中，高HFPEF评分和年龄增长与IS发生独立相关（ClinicalTrials.gov标识符：NCT02138695）。
