Serum N-terminal-pro-brain natriuretic peptide level and its clinical implications in patients with atrial fibrillation

Abstract

Background: Brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure. However, the role of BNP in patients with atrial fibrillation (AF) and normal left ventricular function has not been determined. This study investigates serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level and its clinical implications in patientswith AF. Methods: Serum NT-proBNP levels were measured by enzyme-linked immunosorbent assay (ELISA) and transthoracic echocardiography was performed in 136 subjects (90 cases with AF and 46 cases with sinus rhythm [SR]). Subjects were excluded if they had a history of myocardial infarction, cardiomyopathy, rheumatic heart disease, or hyperthyroidism that preceded the onset of AF. Controls (n = 30) were from a healthy outpatientprimary care population.Potentialdeterminantsof serumNT-proBNP levelswere identified by univariate and multivariate analyses. Results: Individuals with AF had higher serum NT-proBNP levels (689.56±251.87 fmol/ml) than those with SR (456.11±148.14 fmol/ml, <0.01) and control subjects (415.83±62.02 fmol/ml, P <0.01). Individuals with SR and control subjects did not show significant difference at serum NT-proBNP levels (P>0.05). The regression model of serum NT-proBNP levels and clinical predictors showed that presence of AF, older age, and larger right atrial diameter were independently predictive of higher serumNT-proBNP values. Conclusions: Patientswith AF were associatedwith increased serumNT-proBNP levels. Examining the change of serumNT-proBNP levels is helpful to evaluate the cardiac function in patients with AF. © 2009 Wiley Periodicals, Inc.