Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA2DS2-VA Scores among Patients with Atrial Fibrillation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Cohort Creation
2.2. Electro-Anatomical Mapping and Ablation Procedure
2.3. Follow-Up
2.4. Statistical Analysis
3. Results
3.1. Baseline Demographics
3.2. LA LVAs According to Number of Non-Sex Category Risk Factors (CHA2DS2-VA Scores)
3.3. Sex-Related Difference of Proportion of LVAs According to CHA2DS2-VA Scores
3.4. Differential Effect of Female Sex on the Extent of LVAs
4. Discussion
4.1. Left Atrial Fibrosis in Patients with AF
4.2. Sex-Related Difference in the Extent of LA Fibrosis among Patients with AF
4.3. Female Sex as a Risk Modifier on Stroke Risk and LA Fibrosis
4.4. Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Male | Female | Total | p-Value | |
---|---|---|---|---|
(n = 444) | (n = 109) | (n = 553) | ||
Age, years | 54.9 ± 10.6 | 59.9 ± 9.6 | 55.9 ± 10.6 | <0.001 |
BMI, kg/m2 | 25.2 ± 3.0 | 24.5 ± 3.2 | 25.1 ± 3.1 | 0.022 |
CHF, n (%) | 17 (3.8) | 3 (2.8) | 20 (3.6) | 0.8 |
HTN, n (%) | 174 (39.1) | 46 (42.2) | 220 (39.8) | 0.641 |
DM, n (%) | 29 (6.5) | 8 (7.3) | 37 (6.7) | 0.929 |
MI/PAOD, n (%) | 26 (5.9) | 6 (5.5) | 32 (5.8) | 1 |
CHA2DS2-VA, n (%) | 0.176 | |||
0 | 200 (45.1) | 44 (40.4) | 244 (44.1) | |
1 | 126 (28.3) | 30 (27.5) | 156 (28.2) | |
2 | 78 (17.6) | 19 (17.4) | 97 (17.5) | |
3 | 32 (7.2) | 12 (11.0) | 44 (8.0) | |
4 | 4 (0.9) | 4 (3.7) | 8 (1.4) | |
5 | 4 (0.9) | 0 (0.0) | 4 (0.7) | |
eGFR, ml/min per 1.73 m2 | 78.1 ± 13.9 | 73.7 ± 18.2 | 77.3 ± 15.0 | 0.019 |
Non-paroxysmal AF, n (%) | 187 (42.1) | 29 (26.6) | 216 (39.1) | 0.004 |
Duration of AF, years | 3.0 (1.0–6.0) | 3.0 (1.0–7.5) | 3.0 (1.0–6.0) | 0.96 |
LA diameter, mm | 41.0 (37.5–44.5) | 40.2 (36.0–42.8) | 40.7 (37.4–44.3) | 0.056 |
LVEF, % | 57.5 (54.5–57.5) | 57.5 (54.5–57.5) | 57.5 (54.5–57.5) | 0.249 |
LA low-voltage area (%) | 9.6 (5.2–15.2) | 9.8 (5.8–20.9) | 9.7 (5.4–16.4) | 0.152 |
Univariate Analysis | Multiple Analysis Model | |||||
---|---|---|---|---|---|---|
Beta | 95% CI | p-Value | Beta | 95% CI | p-Value | |
Intercept | 7.95 | 5.96–9.95 | <0.001 | |||
Age per 10 years | 1.37 | −0.03–2.76 | 0.054 | |||
Female with CHA2DS2-VA ≥ 3 | 6.46 | −2.33–15.25 | 0.149 | 8.52 | 0.44–16.6 | 0.039 |
Non-PAF | 12.93 | 10.09–15.77 | <0.001 | 10.88 | 7.90–13.86 | <0.001 |
AF duration, years | 0.27 | 0.07–0.47 | 0.009 | 0.24 | 0.05–0.43 | 0.012 |
LA diameter ≥ 45 mm | 11.37 | 7.89–14.85 | <0.001 | 6.96 | 3.43–10.49 | <0.001 |
LVEF, % | −0.33 | −0.59–−0.07 | 0.014 | |||
eGFR < 60 mL/min per 1.73 m2 | 6.13 | 1.14–11.12 | 0.016 |
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Kim, D.Y.; Kim, Y.G.; Choi, H.Y.; Choi, Y.Y.; Boo, K.Y.; Lee, K.-N.; Roh, S.-Y.; Shim, J.; Choi, J.-I.; Kim, Y.-H. Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA2DS2-VA Scores among Patients with Atrial Fibrillation. J. Clin. Med. 2022, 11, 3111. https://doi.org/10.3390/jcm11113111
Kim DY, Kim YG, Choi HY, Choi YY, Boo KY, Lee K-N, Roh S-Y, Shim J, Choi J-I, Kim Y-H. Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA2DS2-VA Scores among Patients with Atrial Fibrillation. Journal of Clinical Medicine. 2022; 11(11):3111. https://doi.org/10.3390/jcm11113111
Chicago/Turabian StyleKim, Do Young, Yun Gi Kim, Ha Young Choi, Yun Young Choi, Ki Yung Boo, Kwang-No Lee, Seung-Young Roh, Jaemin Shim, Jong-Il Choi, and Young-Hoon Kim. 2022. "Sex-Related Differences in Left Atrial Low-Voltage Areas According to CHA2DS2-VA Scores among Patients with Atrial Fibrillation" Journal of Clinical Medicine 11, no. 11: 3111. https://doi.org/10.3390/jcm11113111