Authors

• Snezana Lazic — Faculty of Medical Science University of Priština, Kosovska Mitrovica, Kosovo — ORCID: 0000-0001-6362-3713
• Sanja Markovic — Clinical Hospital Center Pristina, Kosovo — ORCID: 0000-0003-2819-9018
• Maja Sipic — Faculty of Medical Science University of Priština, Kosovska Mitrovica, Kosovo — ORCID: 0000-0003-4173-1224
• Bratislav Lazic — Faculty of Medical Science University of Priština, Kosovska Mitrovica, Kosovo — ORCID: 0000-0002-1186-140X

Abstract

Objectives: It is considered that atrial fibrillation (AF) is present among 0.4% of adult population. CHA2DS2-VASc score is used for stratification of thromboembolic risk. Systolic heart failure has significant thrombogenic potential in atrial fibrillation. (1) Data from the literature on causal relationship between enlarged left atrium and thromboembolic risk in patients with AF are controversial. Patients and Methods: The study analyzed 90 patients with atrial fibrillation. Exclusion criterion was AF in sepsis, acute myocarditis and pericarditis, in acute myocardial infarction, and postoperative AF. Methods used were standard 12-lead ECG, transthoracic echocardiogram and laboratory tests. The first group included 12 (13.3%) patients with valvular AF, while the second group included 78 (86.7%) patients with non-valvular AF. Results: Anteroposterior diameter of the left atrium was 55.6±11.5 mm vs. 46.3±6.2 mm in the second group; p<0.001. Ejection fraction (EF, %) was 37.1±10.1% in the first group vs. 43.0±11.6% in the second group; p=0.102. CHA2DS2-VASc score was 4.0 (1.0-6.0) in the first group vs. 3.0 (0.0-7.0) in the second group; p=0.132. The correlation between CHA2DS2-VASc score and anteroposterior diameter of the left atrium among all patients (n=90) was not statistically significant (r=1.0; p=0.346). Significant negative correlation was found between CHA2DS2-VASc score and EF among all patients (r=-0.420; p<0.001). Conclusions: In our study, the anteroposterior diameter of left atrium was not a determining factor of thromboembolic risk. However, with increase of CHA2DS2-VASc score, there was a reduction of EF which favors AF and increase in thromboembolic risk.

Keywords

atrial fibrillation, tromboembolic risk, transthoracic echocardiography

DOI

Literature

1. Colonna P. Echocardiography for embolic risk stratification in atrial fibrillation: improvement of CHA2DS2-VASc in the era of new oral anticoagulants. Rev Argent Cardiol. 2013;81:102–6. https://doi.org/10.7775/rac.es.v81.i2.2522