Association between CHA2DS2-VASc Score and Left Atrial Function by Speckle Tracking Echocardiography in Patients with Sinus Rhythm

Background The CHA ₂ DS ₂ -VASc score is an established tool for thromboembolic risk assessment in atrial fibrillation (AF). Individual components of the score may affect left atrial function. Speckle-tracking echocardiography (STE) enables detection of early, subtle changes in the left atrium. Aim This study aimed to test whether left atrial function, as assessed by speckle-tracking echocardiography, differs among patients with sinus rhythm according to their CHA ₂ DS ₂ -VASc score. Methods This study included 150 patients with sinus rhythm. They were grouped by CHA ₂ DS ₂ -VASc score: low (1 for females, 0 for males), moderate (2 for females, 1 for males), and high (≥ 3 for females, ≥ 2 for males), with 50 patients per group. All participants gave written consent, provided medical histories, underwent a 12-lead ECG, and received standard and STE echocardiography. Results The high-risk group had significantly lower left atrial strain during both the reservoir (33.2 ± 7.1) and conduit phases (20.3 ± 5.7) compared to the moderate-risk group (36.9 ± 6.1, 23.5 ± 4.8) and low-risk group (40.6 ± 5.6, 26.9 ± 3.9), with all p-values < 0.01. Moderate-risk patients also showed lower strain values than low-risk patients. In contrast, left atrial maximal volume index did not differ among the groups (p = 0.536). Conclusion Increased CHA ₂ DS ₂ -VASc scores correlated with reduced left atrial strain in reservoir and conduit phases, suggesting early atrial dysfunction prior to enlargement. Further research should assess the clinical relevance of these echocardiographic findings for risk stratification in patients with high CHA ₂ DS ₂ -VASc score.