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CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation

 Jeong-Eun Yi  ;  Young Soo Lee  ;  Eue-Keun Choi  ;  Myung-Jin Cha  ;  Tae-Hoon Kim  ;  Jin-Kyu Park  ;  Jung-Myung Lee  ;  Ki-Woon Kang  ;  Jaemin Shim  ;  Jae-Sun Uhm  ;  Jun Kim  ;  Changsoo Kim  ;  Jin-Bae Kim  ;  Hyung Wook Park  ;  Boyoung Joung  ;  Junbeom Park 
 SCIENTIFIC REPORTS, Vol.8(1) : e18039, 2018 
Journal Title
Issue Date
Adult ; Age Factors ; Aged ; Asymptomatic Diseases ; Atrial Fibrillation/diagnosis* ; Atrial Fibrillation/pathology ; Atrial Fibrillation/physiopathology* ; Cardiorespiratory Fitness/physiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/pathology ; Diagnostic Techniques, Cardiovascular* ; Exercise Tolerance/physiology* ; Heart Failure/complications ; Heart Failure/diagnosis ; Heart Failure/pathology ; Humans ; Hypertension/complications ; Hypertension/diagnosis ; Hypertension/pathology ; Ischemic Attack, Transient/complications ; Ischemic Attack, Transient/diagnosis ; Ischemic Attack, Transient/pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Research Design ; Risk Assessment ; Risk Factors ; Sex Factors ; Stroke/complications ; Stroke/diagnosis ; Stroke/pathology ; Vascular Diseases/complications ; Vascular Diseases/diagnosis ; Vascular Diseases/pathology ; Young Adult
Exercise intolerance among the clinical symptoms in patients with atrial fibrillation (AF) has usually been masked by their adjusted life style. We sought to assess the role of CHA2DS2-VASc score to predict exercise intolerance in asymptomatic AF patients, and further examine whether the relationship differs by age and gender. Among the 6,275 participants of the prospective Korean registry of the Comparison study of Drugs for symptom control and complication prevention of Atrial Fibrillation (CODE-AF), 1,080 AF patients who underwent exercise treadmill testing were studied. Exercise intolerance was defined as a peak exercise capacity of 7 metabolic equivalents (METs) or less, and the patients were divided into two groups for the analysis: ≤7 METs (n = 131) and >7 METs (n = 949). Patients with exercise intolerance had a significantly higher CHA2DS2-VASc score than those without (3.1 ± 1.3 vs. 2.0 ± 1.5, p < 0.0001). In the multivariate analysis, a higher CHA2DS2-VASc score (OR 1.54, 95% CI 1.31-1.81, p < 0.0001), corrected QT interval (OR 1.01, 95% CI 1.00-1.02, p = 0.026), and increased left atrial volume index (OR 1.02, 95% CI 1.01-1.03, p = 0.001) were found to be independent predictors of exercise intolerance. The impact of the CHA2DS2-VASc score on exercise intolerance was significant only in male patients aged <65 years (OR 3.30, 95% CI 1.76-6.19, p < 0.0001). The CHA2DS2-VASc score may be a feasible risk assessment tool to predict exercise intolerance, especially in young and middle-aged male patients with asymptomatic AF.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Chang Soo(김창수) ORCID logo https://orcid.org/0000-0002-5940-5649
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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