Advances in rehabilitation science and practice · 2025
Predictive Value of the CHA2DS2-VASc Score on Exercise Capacity in Patients with Cardiovascular Disease.
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Yagi Eijiro, Matsumura Koichiro, Hakozaki Shohei, Uchigashima Yuki, Shiroyama Jun, Hase Mitsuki, Nanba Tomoya, Ueno Masafumi, Nakazawa Gaku
Аннотация
BACKGROUND: Cardiac rehabilitation (CR) improves exercise capacity and is strongly recommended in clinical guidelines. However, no established scoring system exists to predict improvements in exercise capacity following CR.
OBJECTIVE: This study aimed to assess whether the CHA2DS2-VASc score could serve as a predictive scoring system for improvements in exercise capacity after CR.
METHODS: Of the 99 patients with cardiovascular disease who participated in the hospital-based CR, those who were ineligible were excluded. The remaining patients were stratified into 2 groups based on the median CHA2DS2-VASc score. Changes in peak oxygen uptake (peak VO2) and clinical parameters from baseline to follow-up were compared between the groups.
RESULTS: A total of 46 patients (median age, 74 years; 72% male) were stratified according to the median CHA2DS2-VASc score of 4. Patients in the high-score group (CHA2DS2-VASc score ⩾ 4) were older, more likely to be female, and had elevated B-type natriuretic peptide levels compared with those in the low-score group (CHA2DS2-VASc score <4). The prevalence of comorbidities was similar between the groups. The low-score group showed a significantly greater improvement in peak VO2 from baseline to follow-up compared with that of the high-score group (2.8 [1.3-4.7] vs 0.4 [-1.0 to 2.4] mL/kg/min, P < 0.01). Spearman's rank correlation analysis showed a significant negative correlation between CHA2DS2-VASc scores and the change in peak VO2 between baseline and follow-up (r = -0.37, P = .01). A CHA2DS2-VASc score <4 was independently associated with an increase in peak VO2 (β = 0.50, 95% confidence interval 0.23-2.14, P = .01) in the multivariate analysis using multiple linear regression.
CONCLUSIONS: The CHA2DS2-VASc score may be a useful tool for predicting potential improvements in exercise capacity after CR.
OBJECTIVE: This study aimed to assess whether the CHA2DS2-VASc score could serve as a predictive scoring system for improvements in exercise capacity after CR.
METHODS: Of the 99 patients with cardiovascular disease who participated in the hospital-based CR, those who were ineligible were excluded. The remaining patients were stratified into 2 groups based on the median CHA2DS2-VASc score. Changes in peak oxygen uptake (peak VO2) and clinical parameters from baseline to follow-up were compared between the groups.
RESULTS: A total of 46 patients (median age, 74 years; 72% male) were stratified according to the median CHA2DS2-VASc score of 4. Patients in the high-score group (CHA2DS2-VASc score ⩾ 4) were older, more likely to be female, and had elevated B-type natriuretic peptide levels compared with those in the low-score group (CHA2DS2-VASc score <4). The prevalence of comorbidities was similar between the groups. The low-score group showed a significantly greater improvement in peak VO2 from baseline to follow-up compared with that of the high-score group (2.8 [1.3-4.7] vs 0.4 [-1.0 to 2.4] mL/kg/min, P < 0.01). Spearman's rank correlation analysis showed a significant negative correlation between CHA2DS2-VASc scores and the change in peak VO2 between baseline and follow-up (r = -0.37, P = .01). A CHA2DS2-VASc score <4 was independently associated with an increase in peak VO2 (β = 0.50, 95% confidence interval 0.23-2.14, P = .01) in the multivariate analysis using multiple linear regression.
CONCLUSIONS: The CHA2DS2-VASc score may be a useful tool for predicting potential improvements in exercise capacity after CR.