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Eur Heart J Cardiovasc Imaging. 2018 Mar 1;19(3):245-252. doi: 10.1093/ehjci/jex322.

Rationale and design of the EACVI AFib Echo Europe Registry for assessing relationships of echocardiographic parameters with clinical thrombo-embolic and bleeding risk profile in non-valvular atrial fibrillation.

Author information

1
Department of Advanced Biomedical Sciences, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy.
2
CHU Rennes, Service de Cardiologie et Maladies Vasculaires, Université Rennes, 2 rue Henri Le Guilloux, Rennes, France.
3
Service Cardiologie, CHU Limoges, Hospital Dupuytren, 2, avenue Martin Luther King, 87042 Limoges, France.
4
Cardiothoracic Department, Echocardiography Laboratory, Clinical Cardiology Unit, San Raffaele Hospital of Milan (IRCCS), via Olgettina 60, 20132 Milano, Italy.
5
Department of Cardiology, Baskent University, Faculty of Medicine, Fevzi okmak Cad. 10. Sok. Bahcelievler, 06490 Ankara, Turkey.
6
Department of Cardiovascular Diseases, University of Siena, Policlinico 'S. Maria alle Scotte', viale M. Bracci, 16, 53100 Siena, Italy.
7
Department of Cardiology, Heart Center, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Emek HaEla St 1, Ramat Gan, Israel.
8
Cardiac Imaging Department, Hospital Da Luz, Av. Lusíada 100, 1500-650 Lisbon, Portugal.
9
CHVZ (Centrum voor Hart en Vaatziekten)-Universitair ziekenhuis and ICMI (In Vivo Cellular and Molecular Imaging) Laboratory, 101 Laarbeeklaan, 1090 Jette, Brussels, Belgium.
10
Department of Cardiology, Echokardiographie-Labore des Universitätsklinikums AöR, University of Leipzig, Liebigstr. 20, 04103 Leipzig, Germany.
11
Department of Cardiology, Clinic of Internal Medicine/Interventional Cardiology Clinical Hospital Center Zemun-Belgrade, Faculty of Medicine, University of Belgrade, Vukova 9, 11070 Beograd, Serbia.
12
Department of Cardiology, University Alcala de Henares, Hospital Ramon y Cajal, CIBERCV, Ctra. De Colmenar Viejo, km. 9100, 28034 Madrid, Spain.
13
Department of Cardiology, GIGA Cardiovascular Science, Heart Valve Clinic, Imaging Cardiology, Domaine Universitaire du Sart Tilman, Bâtiment B 35, B-4000 Liège Belgium.
14
Gruppo Villa Maria Care and Research, Anthea Hospital, via C. Rosalba, 35/37, 70124 Bari, Italy.
15
URMITE, Aix Marseille Universite, UM63, CNRS 7278, IRD 198, INSERM 1095 IHU-Méditerranée Infection, 58, bd Charles Livon, 13284 Marseille, France.
16
Cardiology Department, APHM, La Timone Hospital, 264 Rue Saint-Pierre, 13385 Marseille, France.
17
Department of Cardiology, Oslo University Hospital, Rikshospitalet, University of Oslo, 4950 Nydalen, 0424 Oslo, Norway.
18
University of Medicine and Pharmacy 'Carol Davila'-Euroecolab, Institute of Cardiovascular Diseases, Sos. Fundeni 258, Sector 2, 022328 Bucharest, Romania.

Abstract

The European Society of Cardiology (ESC) guidelines for management of atrial fibrillation (AF) recommend the use of CHA2DS2VASc risk score for assessment of thromboembolic (TE) risk, whereas the stratification of bleeding risk should be obtained by HAS-Bleed to balance the most appropriate anticoagulation (OAC) therapy. However, men with CHA2DS2VASc score = 1 and women with CHA2DS2VASc = 2, who are at intermediate TE risk, represent a grey zone where guidelines do not provide a definite OAC indication. Accordingly, implementation of risk stratification with echocardiography could be extremely useful. Both prospective and cross-sectional studies on transthoracic echocardiography (TTE) prediction of TE events and studies utilizing transoesophageal echocardiographic parameters as surrogate markers of TE events makes sustainable the hypothesis that echocardiography could improve TE prediction in non-valvular AF. Moreover, considering the close association of AF and stroke, all echo-Doppler parameters that have shown to predict AF onset and recurrence could be useful also to predict TE events in this clinical setting. Accordingly, EACVI AFib Echo Europe Registry has been designed as an observational, cross-sectional study, with the aim of evaluating: (i) left atrial (LA) size and function together with left ventricular geometry, systolic and diastolic functions in paroxysmal, persistent, and permanent AF; (ii) relationships of structural/functional parameters with clinical TE and bleeding risk profile. By the AFib Echo Europe Registry, we expect to collect data on echocardiographic phenotype of patients with AF. The large data set accumulated will be useful to test the level of agreement of different echocardiographic measurements with the available risk scores.

PMID:
29474699
DOI:
10.1093/ehjci/jex322
[Indexed for MEDLINE]

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