Relationship between CHA2DS2-VASC score and p-wave indexes and echocardiographic parameters in patients without atrial fibrillation

INTRODUCTION: The CHA2DS2-VASc score has been used as a predictor of cardiovascular outcomes even in the absence of atrial fibrillation (AF). Several P wave indexes and echocardiographic parameters are associated with a higher risk of developing AF and thromboembolism; however, there are few studies in patients without AF. OBJECTIVES: Primary: Evaluate the association between P wave indexes [P wave duration, dispersion and variability, maximum and minimum P wave duration, P wave voltage in lead I, Morris index, PR interval (PRI), P/PRI ratio and P wave peak time] and CHA2DS2-VASc SCORE in patients without AF and valve disease. Secondary: To assess the relation between echocardiographic parameters [left atrium (LA) and left ventricle (LV) size, LV ejection fraction (LVEF), LV mass and LV indexed mass] and CHA2DS2-VASC score in the same population. METHODS: A cross-sectional, descriptive and analytical study in which clinical, electrocardiographic and echocardiographic data from 272 patients without AF and valve disease were collected and analyzed. For statistical analysis, the Chi-Square Test, Mann-Whitney U-Test and Spearman Correlation were used with the significance level of 5%. RESULTS: PRI, LA and LV diameter, LV mass and LV indexed mass were positively associated with CHA2DS2-VASc SCORE, while P wave amplitude, P wave voltage in lead I and LVEF were negatively associated to the same score (Table). The presence of the Morris index was related with high CHA2DS2- VASc. CONCLUSION: The study of the association between P wave indexes, echocardiographic parameters and CHA2DS2-VASc score may be useful in clinical practice to evaluate patients who trend to have a higher cardiovascular risk using clinical parameters and non-invasive methods in patients without AF.