Effect of sinus rhythm restoration on plasma brain natriuretic peptide in patients with atrial fibrillation

Wożakowska−Kapłon, Beata

doi:10.1016/j.amjcard.2004.03.013

Cited by 92 publications

(75 citation statements)

References 10 publications

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“…25 The same phenomenon was found in patients with normal left ventricular function and absence of clinical heart failure. 9 These results suggest that AF itself may cause an increase in BNP levels and needs to be taken into account when interpreting BNP values in cardiac patients with AF. In PREVEND, blood was drawn on the same day as the electrocardiogram was recorded.…”

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confidence: 99%

“…7 In this regard, N-terminal pro B-type natriuretic peptide (NT-proBNP) may also be associated with future AF as NT-proBNP is secreted from cardio-myocytes, reflects haemodynamic alterations and is increased in symptomatic and asymptomatic patients with mild left ventricular dysfunction. 8 In addition, NT-proBNP has been cross-sectionally associated with AF in patients who had underlying hypertension, coronary heart disease, 9 or chronic heart failure, 10 and even in subjects with lone AF. 11 Furthermore, plasma levels of BNP have been shown to predict recurrence of AF in patients with mild heart failure 12 and postoperative AF in patients undergoing cardiac surgery.…”

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confidence: 99%

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N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

Asselbergs¹,

Berg²,

Bakker³

et al. 2008

NHJL

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Background. B-type natriuretic peptide (BNP) is secreted from cardiomyocytes and may reflect haemodynamic abnormalities predisposing to atrial fibrillation (AF). We aimed to investigate whether N-terminal pro BNP (NT-proBNP) is associated with newly detected AF in subjects obtained from the general population. Methods. From the PREVEND programme (n=8592), we selected all subjects with an available baseline and four-year electrocardiogram and NTproBNP levels at baseline. We excluded subjects with AF at baseline and subjects with a serum creatinine >2.0 mg/dl. Results. In total, 6494 subjects were eligible for the prospective analysis (aged 49±12 years, 49.7% men). At four years, AF was detected in 41 (0.6%) subjects. Median NT-proBNP levels at baseline in subjects with newly detected AF after four years was 62.2 (22.6 to 208.5) pg/ml as compared with 35.7 (15.9 to 68.7) pg/ml in those with sinus rhythm (p=0.001). Each 1 standard deviation increment in natural log transformed NT-proBNP was associated with a 54% (5% to 126%, p=0.028) increase in risk for AF after adjustment for other risk factors predisposing to AF. NT-proBNP levels above the sex-specific 80th percentile (97 pg/ml in women and 60 pg/ml in men) were associated with a multivariate odds ratio of 2.65 (1.22 to 5.76, p=0.01) for the occurrence of AF. Conclusion. Plasma levels of NT-proBNP predict newly detected AF in subjects obtained from the general population independent of cardiovascular risk factors predisposing to AF. (Neth Heart J 2008;16:73-8.)

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confidence: 99%

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confidence: 99%

N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

Asselbergs¹,

Berg²,

Bakker³

et al. 2008

NHJL

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“…Furthermore, Tuinenburg et al (25) have reported that persistent AF induced the expression of proBNP in atrial tissue but paroxysmal AF did not. However, BNP levels were comparable in paroxysmal and persistent AF patients in another study (13).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have reported that NT-proBNP levels can be associated with AF in patients with normal LV systolic function (10)(11)(12)(13)(14)(15)(16)(17)(18). These studies included the patients with paroxysmal, persistent or chronic AF.…”

Section: Introductionmentioning

confidence: 99%

Plasma renin activity and pro-B-type natriuretic peptide levels in different atrial fibrillation types

Doğan¹,

Gedikli²,

Ozaydin³

et al. 2010

Anadolu Kardiyol Derg

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Objective: Renin-angiotensin system may be activated during atrial fibrillation (AF). Our aim was to evaluate plasma renin activity (PRA) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients with different AF types who had normal left ventricular (LV) systolic function. Methods: This cross-sectional study included 97 patients with recent (≤7 days), persistent (7 days to 12 months) and permanent AF (>12 months), and age-and sex-matched 30 controls with sinus rhythm. Plasma levels of PRA and NT-pro-BNP were measured and presented as median (25 th -75 th percentiles). Echocardiographic examination was performed in all population. Variance and logistic regression analyses were also used for multiple comparisons and independent predictors, respectively. Results: Median NT-proBNP levels were higher in overall patients with AF than in controls [114 (63-165) vs 50 (38-58) pg/ml, p<0.001), but PRA level was comparable in both groups. Similarly, NT-proBNP levels were also higher in all subtypes of AF compared with controls (p<0.05). In addition, there was a significant difference in NT-proBNP level among recent, persistent and permanent AF subtypes (p=0.001). This difference mainly derived from the recent AF subtypes. Whereas PRA level was similar in all AF subtypes and controls. Age was an independent predictor of PRA level ≥1.9 ng/ml/hour (OR=1.1, 95% CI 1.01-1.23, p=0.03). With NT-proBNP level ≥52 pg/ml, independent predictors were age (OR=1.1, 95% CI 1.01-1.19, p=0.02), presence of persistent and/or permanent AF (OR=6.8, 95% CI 1.03-45.7, p=0.04) and left atrial dimension (OR=1.2, 95% CI 1.03-1.36, p=0.02). Conclusion: Plasma NT-proBNP levels can be associated with AF and its subtypes in patients with normal LV systolic function, whereas there was no association between PRA levels and AF. (Anadolu Kardiyol Derg 2010; 10: 317-22) Key words: Plasma renin activity, B-type natriuretic peptide, atrial fibrillation, logistic regression analysis ÖZET Amaç: Atriyal fibrilasyon (AF) sırasında renin-anjiyotensin sistemi (RAS) aktif olabilir. Amacımız, sol ventrikül sistolik fonksiyonu normal olan farklı AF hastalarında, plazma renin aktivitesi (PRA) ve N-terminal pro-B-tipi natriüretik peptit (NT-proBNP) düzeylerini değerlendirmektir. Yöntemler: Bu kesitsel çalışmaya, yeni (≤7 gün), persistan (7 gün ile 12 ay) ve kalıcı AF'si (>12 ay) olan 97 hasta alındı. Yaş ve cinsiyeti benzer sinüs ritimli 30 sağlıklı birey kontrol grubunu oluşturdu. Plazma PRA ve NT-pro-BNP düzeyleri ölçüldü (mediyan, 25th -75th persantil). Tüm popülasyona ekokardiyografi yapıldı. Standart testlere ek olarak, çoklu karşılaştırmalar için varyans analizi ve bağımsız prediktörler için lojistik regresyon analizi kullanıldı. Bulgular: Tüm AF grubunun ortanca NT-proBNP düzeyi, kontrol grubundan daha yüksekti [114 (63-165)'e 50 (38-58) pg/ml, p<0.001), fakat PRA düzeyi benzerdi. Benzer olarak, kontrol grubuna kıyasla, tüm AF alt-gruplarında da NT-proBNP düzeyleri daha yüksekti (p=0.001). Bu fark, başlıca yeni AF'den kaynaklandı. O...

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“…AF causes variable filling times and irregular atrial contractions, causing local stretch at a cellular level that may cause release of natriuretic peptides such as NT-proBNP. 30 Because it is known that plasma levels of NT-proBNP decrease in patients with paroxysmal or persisting AF after restoration of sinus rhythm, 31,32 and because acute paroxysms increase BNP levels, 33 these effects appear dynamic in nature.…”

Section: Tion Of Long-term Anticoagulation Therapy (Re-ly) and The Apmentioning

confidence: 99%

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

Holl

Bos

Domburg

et al. 2018

Clinical Cardiology

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BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia in the emergency department. The CHA2DS2‐VASc score helps to predict thromboembolic risk; however, the rate of other adverse cardiac events is more difficult to predict.HypothesisThe biomarker N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has prognostic value in patients presenting to the emergency department with AF.MethodsDuring a 1.5‐year period, a prospective study was performed in consecutive patients presenting to the emergency department with AF on the presenting electrocardiogram. At baseline, NT‐proBNP was measured. The primary endpoints were all‐cause death and major adverse cardiac events (MACE: all‐cause mortality, myocardial infarction, or revascularization).ResultsA total of 355 patients were included (mean age, 71 years; 55% male). The median duration of follow‐up was 2 years. After adjustment for baseline variables, the logNT‐proBNP was independently correlated with death (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.18‐1.99) and MACE (HR: 1.27, 95% CI: 1.03‐1.58). After adjustment for baseline variables, a high NT‐proBNP value (>500 pmol/L) was independently correlated with death (HR: 2.26, 95% CI: 1.19‐4.28), and for MACE a trend was seen (HR: 1.67, 95% CI: 0.96‐2.91) compared with a low value (<250 pmol/L).ConclusionsIn patients presenting to the emergency department with AF, higher NT‐proBNP values are independently associated with an increased mortality and MACE. Therefore, this biomarker may be a useful prognostic marker in the management and treatment of these patients.

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Effect of sinus rhythm restoration on plasma brain natriuretic peptide in patients with atrial fibrillation

Cited by 92 publications

References 10 publications

N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

N-terminal pro B-type natriuretic peptide levels predict newly detected atrial fibrillation in a population-based cohort

Plasma renin activity and pro-B-type natriuretic peptide levels in different atrial fibrillation types

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

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