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

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    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.

    Original languageEnglish
    Article number18039
    JournalScientific reports
    Issue number1
    Publication statusPublished - 2018 Dec 1

    Bibliographical note

    Funding Information:
    This study was supported by a grant from the Korean Healthcare Technology R & D project funded by the Ministry of Health & Welfare (H15C1200), and by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2017R1E1A1A01078382).

    Publisher Copyright:
    © 2018, The Author(s).

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