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

Research output: Contribution to journalArticle

Abstract

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
Volume8
Issue number1
DOIs
Publication statusPublished - 2018 Dec 1

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Atrial Fibrillation
Exercise
Metabolic Equivalent
Drug and Narcotic Control
Registries
Life Style
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • General

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Yi, Jeong Eun ; Lee, Young Soo ; Choi, Eue Keun ; Cha, Myung Jin ; Kim, Tae Hoon ; Park, Jin Kyu ; Lee, Jung Myung ; Kang, Ki Woon ; Shim, Jaemin ; Uhm, Jae Sun ; Kim, Jun ; Kim, Changsoo ; Kim, Jin Bae ; Park, Hyung Wook ; Joung, Boyoung ; Park, Junbeom. / CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation. In: Scientific reports. 2018 ; Vol. 8, No. 1.
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title = "CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation",
abstract = "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.",
author = "Yi, {Jeong Eun} and Lee, {Young Soo} and Choi, {Eue Keun} and Cha, {Myung Jin} and Kim, {Tae Hoon} and Park, {Jin Kyu} and Lee, {Jung Myung} and Kang, {Ki Woon} and Jaemin Shim and Uhm, {Jae Sun} and Jun Kim and Changsoo Kim and Kim, {Jin Bae} and Park, {Hyung Wook} and Boyoung Joung and Junbeom Park",
year = "2018",
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Yi, JE, Lee, YS, Choi, EK, Cha, MJ, Kim, TH, Park, JK, Lee, JM, Kang, KW, Shim, J, Uhm, JS, Kim, J, Kim, C, Kim, JB, Park, HW, Joung, B & Park, J 2018, 'CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation', Scientific reports, vol. 8, no. 1, 18039. https://doi.org/10.1038/s41598-018-36185-7

CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation. / Yi, Jeong Eun; Lee, Young Soo; Choi, Eue Keun; Cha, Myung Jin; Kim, Tae Hoon; Park, Jin Kyu; Lee, Jung Myung; Kang, Ki Woon; Shim, Jaemin; Uhm, Jae Sun; Kim, Jun; Kim, Changsoo; Kim, Jin Bae; Park, Hyung Wook; Joung, Boyoung; Park, Junbeom.

In: Scientific reports, Vol. 8, No. 1, 18039, 01.12.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - CHA2DS2-VASc score predicts exercise intolerance in young and middle-aged male patients with asymptomatic atrial fibrillation

AU - Yi, Jeong Eun

AU - Lee, Young Soo

AU - Choi, Eue Keun

AU - Cha, Myung Jin

AU - Kim, Tae Hoon

AU - Park, Jin Kyu

AU - Lee, Jung Myung

AU - Kang, Ki Woon

AU - Shim, Jaemin

AU - Uhm, Jae Sun

AU - Kim, Jun

AU - Kim, Changsoo

AU - Kim, Jin Bae

AU - Park, Hyung Wook

AU - Joung, Boyoung

AU - Park, Junbeom

PY - 2018/12/1

Y1 - 2018/12/1

N2 - 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.

AB - 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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