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SCI 발표논문

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Sci Rep. 2020;10(1):18765.

CHA2DS2-VASc score, cerebral small vessel disease, and frailty in older patients with atrial fibrillation.

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제1저자 최정연 · 교신저자 김광일, 김철호

소속 (7)
  1. Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Seongnam-si, Kyeongi-do, 13620, Republic of Korea.
  2. Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
  3. Department of Radiology, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Seongnam-si, Kyeongi-do, 13620, Republic of Korea.
  4. Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Seongnam-si, Kyeongi-do, 13620, Republic of Korea. kikim907@snu.ac.kr.
  5. Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. kikim907@snu.ac.kr.
  6. Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173beon-gil, Seongnam-si, Kyeongi-do, 13620, Republic of Korea. cheolkim@snubh.org.
  7. Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea. cheolkim@snubh.org.

Abstract

The CHA2DS2-VASc score is a validated predictor of ischemic stroke in atrial fibrillation (AF) patients. However, data are limited on whether the CHA2DS2-VASc score is associated with subclinical brain structural changes or physical frailty among older AF patients. We assessed the relationship between CHA2DS2-VASc scores and brain structural changes or physical frailty in AF patients without history of stroke. Overall, 117 patients completed a comprehensive geriatric assessment for physical frailty. In brain magnetic resonance imaging sub-study (n = 49), brain volume and white matter hyperintensity lesion burden were automatically quantified using the LESIONQUANT software program. Patients with high risk of CHA2DS2-VASc scores (≥ 2 in men or ≥ 3 in women) tended to be older and had more comorbidities, higher frailty index, and slower gait speed. Total white matter hyperintensity lesion burden was higher in those with high risk of CHA2DS2-VASc score than in those with intermediate risk (score of 1 in men or 2 in women) of CHA2DS2-VASc score (1.67 [interquartile range: 0.70-3.45] vs. 0.64 [0.19-1.44], p = 0.036). Cognitive function was associated with brain volume, but gait speed was related with white matter hyperintensity lesion burden. In conclusion, we showed a positive relationship between CHA2DS2-VASc scores, white matter hyperintensity lesion burden, and physical frailty in older AF patients. Subclinical brain changes associated with high CHA2DS2-VASc scores may predict physical frailty risk.

Figures

Figure 1
Figure 1 Relationship between the CHA2DS2-VASc score, brain white matter hyperintensity lesion, brain volume, and frailty. The CHA2DS2-VASc score, physical frailty, and white matter hyperintensity lesion/brain volume have a significant ( +) interrelationship.
Figure 2
Figure 2 Relationship between the CHA2DS2-VASc score and brain white matter hyperintensity according to gait speed. The trend of higher white matter hyperintensity lesion burden in higher CHA2DS2-VASc score group was more prominent in slow gait speed group (right column) than the fast gait speed group (left column).

그림 출처: PubMed Central 공개 논문 (PMC7603394)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article, Research Support, Non-U.S. Gov't
저널
Scientific reports · eISSN 2045-2322
전자 출판
2020-10-30
MeSH
Aged · Anticoagulants / therapeutic use · Atrial Fibrillation / drug therapy / pathology / physiopathology · Cardiology · Cerebral Small Vessel Diseases / drug therapy / pathology / physiopathology · Female · Frailty / drug therapy / pathology / physiopathology · Humans · Male · Risk Assessment · Risk Factors · Stroke / drug therapy / pathology / physiopathology
Substances
Anticoagulants
참고문헌
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