Correlation between N-Terminal Pro-Brain Natriuretic Peptide and Doppler Echocardiographic Parameters of Left Ventricular Filling Pressure in Atrial Fibrillation

Abstract

BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia with a population prevalence of about 1%. Natriuretic peptide level is elevated in patients with AF with diastolic dysfunction even with a normal left ventricular (LV) ejection fraction. The N-terminal pro-brain natriuretic peptide (NT-proBNP) level and Doppler echocardiographic parameters for diastolic function have shown correlation with LV filling pressures. We aimed to evaluate the relationship between echocardiographic parameters and serum NT-proBNP in patients with AF with preserved LV ejection fraction.MethodsWe examined transthoracic echocardiography and NT-proBNP levels in the patients with AF and patients with sinus rhythm. Blood samples were taken for serum NT-proBNP measurements within 24 hours of echocardiographic examination. The group 1 was the patients with sinus rhythm (n = 30, mean age 68 ± 13 years) and the group 2 was the patients with AF (n = 33, mean age 70 ± 14 years).ResultsThe group 2 patients had significantly higher mitral E, E' (lateral annulus), E/E' (septal annulus), left atrial (LA) volume index, LA size, pulmonary vein diastolic velocity, and NT-proBNP level than those of group 1 patients (p < 0.05). The area under the receiver-operating characteristic curve showed a NT-proBNP had good diagnostic power for E/E' (septal annulus) > 15 in patients with AF at cutoff value of 433 pg/mL.ConclusionNT-proBNP level is well correlated with Doppler echocardiographic parameters of diastolic function in patients with AF and preserved LV ejection fraction. NT-proBNP level more than 433 pg/mL may suggest elevated LV filling pressure in patients with AF.

Evaluation of the Relationship between Circadian Blood Pressure Variation and Left Atrial Function Using Strain Imaging

“…In non-dippers, it has been demonstrated that target organ damages are due to the absence of night-time BP dipping, and are not the result of a higher overall BP load 5). Natriuretic peptides were reported to correlate with left ventricular (LV) diastolic function 6). Hypertensive patients were reported to have increased levels of cardiac natriuretic hormones and plasma atrial natriuretic peptide (ANP) levels were correlated with both the LV and left atrial (LA) abnormalities 7).…”

“… 5) Natriuretic peptides were reported to correlate with left ventricular (LV) diastolic function. 6) Hypertensive patients were reported to have increased levels of cardiac natriuretic hormones and plasma atrial natriuretic peptide (ANP) levels were correlated with both the LV and left atrial (LA) abnormalities. 7) Similarly, non-dippers are known to have more increased levels of cardiac natriuretic hormones.…”

A critical review on brain and heart axis response in COVID‐19 patients: Molecular mechanisms, mediators, biomarkers, and therapeutics

“…[60] In a number of possibly COVID-19-related diseases, such as pneumonia, septic shock, or acute respiratory distress syndrome, increased blood levels of cTn or NT-proBNP are similarly linked to a bad prognosis. [61] Different studies have provided an explanation for the correlation between greater NT-proBNP levels and patients with SARS-CoV-2 infection in terms of death rates, disease severity, and levels of other cardiac markers. [62,63] In COVID-19 individuals without heart failure, including severe and nonsevere instances, the concentration of NT-proBNP is markedly elevated.…”

A Real Pandora’s Box in Pandemic Times: A Narrative Review on the Acute Cardiac Injury Due to COVID-19

“…NT-proBNP is a “classical” biomarker in HF, being correlated with both elevated left ventricular filling pressures and systolic dysfunction [ 166 ]. In SARS-CoV-2 infection, the dynamic changes of NT-proBNP, CRP, and cTn concentrations are basically related to the extent of the inflammatory response, tissue injury, and functional impairment.…”