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.
Highlights
Exercise intolerance among the clinical symptoms in patients with atrial fibrillation (AF) has usually been masked by their adjusted life style
The mean peak exercise capacity was 10.5 ± 2.7 metabolic equivalents (METs), and the patients were divided into two groups according to the exercise capacity: ≤7 METs (n = 131) and >7 METs (n = 949)
There were no significant differences in the proportion of subjects with a stroke or TIA, peripheral artery disease, dyslipidemia, or Variables Age Age
Summary
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. 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). 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. Some patients with AF are asymptomatic[6] and their adjusted life style may mask the exercise intolerance. We tested the hypothesis that the CHA2DS2-VASc score could predict exercise intolerance in asymptomatic AF patients. We further examined whether the relationship differs by age and gender, because age and gender were very important risk factors which influence on exercise intolerance
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