Prediction of left atrial thrombi using CHA2DS2-VASc scores in patients with nonvalvular atrial fibrillation before pulmonary vein isolation

封盼攀; 贾锋鹏; 顾俊; 高凌云; 何泉; 吕斐

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Prediction of left atrial thrombi using CHA2DS2-VASc scores in patients with nonvalvular atrial fibrillation before pulmonary vein isolation

更新时间：2026-01-09

- Prediction of left atrial thrombi using CHA2DS2-VASc scores in patients with nonvalvular atrial fibrillation before pulmonary vein isolation
- Journal of Army Medical University Vol. 35, Issue 22, Pages: 2396-2399(2013)
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  CLC： R540.46;R541.75
- Published：2013
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封盼攀,贾锋鹏,顾俊,高凌云,何泉,吕斐.CHA2DS2-VASc评分对非瓣膜病心房颤动患者射频消融前左房血栓的风险评估[J].陆军军医大学学报(原第三军医大学学报),2013,35(22):2396-2399.

　Feng Panpan,Jia Fengpeng,Gu Jun,Gao Lingyun,He Quan,Lyu Fei.Prediction of left atrial thrombi using CHA2DS2-VASc scores in patients with nonvalvular atrial fibrillation before pulmonary vein isolation[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(22):2396-2399.
封盼攀,贾锋鹏,顾俊,高凌云,何泉,吕斐.CHA2DS2-VASc评分对非瓣膜病心房颤动患者射频消融前左房血栓的风险评估[J].陆军军医大学学报(原第三军医大学学报),2013,35(22):2396-2399. DOI：

　Feng Panpan,Jia Fengpeng,Gu Jun,Gao Lingyun,He Quan,Lyu Fei.Prediction of left atrial thrombi using CHA2DS2-VASc scores in patients with nonvalvular atrial fibrillation before pulmonary vein isolation[J].J Amry Med Univ (J Third Mil Med Univ),2013,35(22):2396-2399. DOI：

摘要

目的探讨未经正规华法林抗凝的非瓣膜病心房颤动患者，射频消融术前经食道心脏超声检查左房血栓的发生率，CHA2DS2-VASc不同评分对左房血栓的预测能力。方法分析了212例未经正规华法林抗凝的非瓣膜病心房颤动（atrial fibrillation

AF）患者，经食道心脏超声(transesophageal echocardiography，TEE)检查左房血栓的发生率，左房血栓与左室射血分数、性别、年龄、高血压、糖尿病等危险因素的相关性；分析CHA2DS2-VASc不同评分与左房血栓相关性。结果左房血栓患者33例，其发生率为15.6%。CHA2DS2-VASc 评分低危患者57例，左房血栓0例；中危患者61例，左房血栓2例( 3.28%)；高危患者94例，左房血栓31例( 32.98%)。左房血栓发生率随CHA2DS2-VASc 评分增高而增加，低危、中危和高危3组间有明显差异 (P0.01)。单变量分析发现年龄≥65岁、左房内径＞40 mm、高血压、糖尿病、冠心病、卒中、CHA2DS2-VASc评分均与左房血栓相关；但多变量logistic回归分析显示，仅CHA2DS2-VASc ≥2 是预测左房血栓较好的指标(OR=7.637

95%CI：1.144～50.986

0.05)。结论未经正规华法林抗凝的非瓣膜病AF患者左房血栓发生率相对较高，CHA2DS2-VASc评分危险分层与左房血栓密切相关，提示其对AF患者射频消融前TEE检查有筛选价值，高危患者应加强抗凝治疗后仍需TEE检查。

Abstract

Objective To investigate the predictive value of the CHA2DS2-VASc scores to left atrial (LA) thrombi in the patients with nonvalvular atrial fibrillation (AF) prior to pulmonary vein isolation (PVI). Methods A total of 212 patients with nonvalvular AF were included in this study. No anticoagulation therapy was given and a

ll patients underwent transesophageal echocardiography (TEE) immediately before PVI. CHA2DS2-VASc score was calculated. Results LA thrombi were identified on TEE in 33 patients (15.6%). CHA2DS2-VASc score of 0

1 and ≥2 accounted for 26.9%

28.8%

and 44.3% of patients

respectively. The prevalence of LA thrombi was significantly increased with CHA2DS2-VASc score [score 0 (0%)

score 1 (3.28%)

and score ≥2 (32.98%)

0.001

]

. In univariate analysis

age≥65

LA≥40mm

hypertension

diabetes

coronary heart disease

stroke history and CHA2DS2-VASc score were associated with thrombi. In multivariate logistic analysis

however

only CHA2DS2-VASc ≥2 was significantly associated with the presence of LA thrombi (OR=7.637

95% CI 1.144-50.986

0.05). Conclusion The risk of LA thrombi in nonvalvular AF patients without anticoagulation is high. High CHA2DS2-VASc score (≥2) is strongly associated with LA thrombi on TEE. Our findings suggest CHA2DS2-VASc may be used for screening of TEE before PVI

and TEE needs to be performed in the high-risk patients after regular anticoagulation.

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