Lee Sang Hak, Jung Jae-Hun, Choi Seung-Hyuk, Lee Namho, Park Woo-Jung, Oh Dong-Jin, Rhim Chong-Yun, Lee Kwang-Hwak
Cardiology Division, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Circ J. 2006 Jan;70(1):100-4. doi: 10.1253/circj.70.100.
Although brain natriuretic peptide (BNP) is increasingly being used for screening and monitoring of congestive heart failure, its utility in patients with lone atrial fibrillation (AF) is unclear.
Plasma BNP levels were measured and comprehensive transthoracic echocardiography was performed in 96 subjects (47: sinus rhythm, 49: AF). Patients with structural heart disease were excluded. Potential determinants of BNP levels were identified by univariate and multivariate analyses. Individuals with AF had higher BNP levels than those with sinus rhythm (150 +/- 114 vs 49 +/- 61 pg/ml, p<0.001) The left atrial (LA) volume index (r=0.63, p<0.001), the pulmonary artery systolic pressure (r=0.45, p=0.006), and the early mitral inflow velocity (E)/mitral annular velocity (E') (r=0.36, p=0.04) were found to be independently correlated with BNP level. The correlations between BNP level and LA volume index (p=0.001) or E/E' (p=0.03) were unaltered when subjects with sinus rhythm were removed from the analysis.
BNP levels significantly correlated with LA volume index and E/E' in patients with lone AF, which indicates that the BNP level may reflect early left ventricular dysfunction and LA enlargement in this patient population.
尽管脑钠肽（BNP）越来越多地用于充血性心力衰竭的筛查和监测，但其在孤立性心房颤动（AF）患者中的效用尚不清楚。
对96名受试者（47名：窦性心律，49名：AF）测量血浆BNP水平并进行全面的经胸超声心动图检查。排除有结构性心脏病的患者。通过单因素和多因素分析确定BNP水平的潜在决定因素。AF患者的BNP水平高于窦性心律患者（150±114 vs 49±61 pg/ml，p<0.001）。发现左心房（LA）容积指数（r=0.63，p<0.001）、肺动脉收缩压（r=0.45，p=0.006）和二尖瓣早期血流速度（E）/二尖瓣环速度（E'）（r=0.36，p=0.04）与BNP水平独立相关。当从分析中排除窦性心律的受试者时，BNP水平与LA容积指数（p=0.001）或E/E'（p=0.03）之间的相关性未改变。
孤立性AF患者的BNP水平与LA容积指数和E/E'显著相关，这表明BNP水平可能反映该患者群体早期左心室功能障碍和LA扩大。
