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65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f 0000000000 65535 f trailer <]>> startxref 116 %%EOF Relación entre el índice CHA2DS2-VASc y la presencia de trombo auricular en pacientes con fibrilación auricular en plan de cardioversión - Archivo PPCT

Relación entre el índice CHA2DS2-VASc y la presencia de trombo auricular en pacientes con fibrilación auricular en plan de cardioversión;
Correlation Between CHA2DS2-VASc Score and Atrial Thrombus in Patients with Atrial Fibrillation Undergoing Cardioversion

Creators:Allende, Norberto G., Barrera, Elio D., Rodríguez Pagani, Carlos, Carrasco, Eduardo, Marambio, Gerardo, López Soutric, Guillermo, Cintora, Federico, Calvo, Fanny, Pérez de la Hoz, Ricardo
2013-06-14

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Descripción

Introducción Los pacientes con fibrilación auricular representan un grupo de riesgo para el desarrollo de complicaciones tromboembólicas, con consecuencias devastadoras cuando afectan el sistema nervioso central. El rendimiento de los índices de riesgo para predecir eventos clínicos se ha evaluado en numerosas publicaciones, mientras que su relación con la presencia de trombo en la aurícula izquierda o su orejuela se ha explorado menos. Recientemente se ha propuesto la utilización del índice conocido con el acrónimo CHA2DS2-VASc para la estratificación de riesgo cardioembólico. Objetivo Evaluar la prevalencia de trombo en la aurícula izquierda y su relación con las variables del índice CHA2DS2-VASc y la función sistólica del ventrículo izquierdo en pacientes con fibrilación auricular que serán sometidos a cardioversión eléctrica. Material y métodos Se efectuó un registro prospectivo de los antecedentes clínicos de pacientes con fibrilación auricular de tiempo indeterminado o &gt; 48 horas, a los que se les realizó un eco transesofágico previo a una cardioversión eléctrica. Se analizó la relación de las variables que conforman el índice CHA2DS2-VASc y del puntaje total para predecir trombo en el eco transesofágico. Se evaluó además un modelo que resultó de sumar al CHA2DS2-VASc un puntaje según la función sistólica del ventrículo izquierdo: normal = 0, deterioro leve = 1, moderado = 2, grave = 3. Resultados Se incluyeron 129 pacientes con edad media de 70 ± 12 años, de los cuales 21 (16%) presentaron trombo. Este hallazgo fue más prevalente en pacientes con factores de riesgo, pero alcanzó nivel de significación solo para insuficiencia cardíaca y diabetes. Se observó un incremento progresivo del riesgo de trombo en relación con el CHA2DS2-VASc (3,6 ± 1,6 con trombo vs. 2,7 ± 1 sin trombo; p = 0,024, área bajo la curva ROC = 0,65). La asociación se ve reforzada cuando se incluye la función sistólica del ventrículo izquierdo (p = 0,006, área bajo la curva ROC = 0,69). Un puntaje de CHA2DS2-VASc &lt; 2 no garantizó la ausencia de trombos. Conclusiones El puntaje CHA2DS2-VASc desarrollado para predecir riesgo clínico de fenómenos embólicos también se asocia con la presencia de trombo en pacientes con fibrilación auricular de tiempo indeterminado. El agregado de la función sistólica del ventrículo izquierdo al puntaje total podría mejorar la capacidad predictiva.

Background Patients with atrial fibrillation represent a group of risk for thromboembolic complications, with catastrophic consequences when they affect the central nervous system. The performance of risk scores to predict clinical events has been evaluated by several publications; yet, its correlation with the presence of thrombi in the left atrium or left atrial appendage has been poorly investigated. The use of the CHA2DS2-VASc score has been recently proposed for stratification of thromboembolic risk. Objective To evaluate the prevalence of left atrial thrombus and its correlation with the components of the CHA2DS2-VASc score and with left ventricular systolic function in patients scheduled for electrical cardioversion. Methods A prospective registry was conducted of the medical history of patients with atrial fibrillation of unknown duration or lasting &gt; 48 hours, undergoing transesophageal echocardiography before scheduled electrical cardioversion. The correlation between the CHA2DS2-VASc score variables and the total score to predict the presence of thrombi in transesophageal echocardiography was analyzed. The result of the sum of the CHA2DS2-VASc score plus a score of left ventricular systolic function (normal = 0, mild dysfunction = 1, moderate dysfunction = 2, severe dysfunction = 3) was also evaluated. Results A total of 129 patients (mean age 70 ± 12 years) were included; 21 (16%) of which had thrombus. This finding was more prevalent in patients with risk factors, but was only statistically significant for heart failure and diabetes. The risk of thrombus in the LA/LAA progressively increased at higher CHA2DS2-VASc (3.6 ± 1.6 with thrombus vs. 2.7 ± 1 without thrombus; p = 0.024, area under the ROC curve = 0.65). This association was greater when left ventricular systolic function was included (p = 0.006, area under the ROC curve = 0.69). A CHA2DS2-VASc &lt; 2 did not warrant the absence of thrombi.Conclusions The CHA2DS2-VASc score, developed to predict the risk of thromboembolic events is also associated with the presence of thrombus in patients with atrial fibrillation of unknown duration. The addition of left ventricular systolic function to the total score might improve its predictive ability.

Metadatos destacados

Colecciones
Argentine Journal of Cardiology

Editor

Sociedad Argentina de Cardiología

Fuente

Revista Argentina de Cardiología; Vol 81, No 2 (2013); 144-150, Argentine Journal of Cardiology; Vol 81, No 2 (2013); 144-150

Citación

Allende, Norberto G. et al., “Relación entre el índice CHA2DS2-VASc y la presencia de trombo auricular en pacientes con fibrilación auricular en plan de cardioversión,” Archivo PPCT, consulta 2 de abril de 2026, http://archivoppct.caicyt.gov.ar/items/show/8183.

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Autor

Allende, Norberto G.
Barrera, Elio D.
Rodríguez Pagani, Carlos
Carrasco, Eduardo
Marambio, Gerardo
López Soutric, Guillermo
Cintora, Federico
Calvo, Fanny
Pérez de la Hoz, Ricardo

Fuente

Revista Argentina de Cardiología; Vol 81, No 2 (2013); 144-150
Argentine Journal of Cardiology; Vol 81, No 2 (2013); 144-150

Editor

Sociedad Argentina de Cardiología

Fecha

2013-06-14

Derechos

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Those signing below certify that we have full responsibility for the conduction of this study and for the design and interpretation of the information. We wrote the manuscript and are responsible for its decision. Each of us fulfills the definition of authorship as stated by the International Committee of Medical Journal Editors ( www.icmje.org). We have signed and approved the final manuscript. Neither the manuscript, nor any essential part thereof, including tables and figures, will be published or accepted for refereeing elsewhere before being published in the Journal. We have also read the "Conflict of Interest" section and would disclose any existing. We state that if our manuscript is published in the RAC, we shall transfer the copyright to the Journal.

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eng

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info:eu-repo/semantics/publishedVersion