Letsas Konstantinos P, Filippatos Gerasimos S, Pappas Loukas K, Mihas Constantinos C, Markou Virginia, Alexanian Ioannis P, Efremidis Michalis, Sideris Antonios, Maisel Alan S, Kardaras Fotios
Second Department of Cardiology, Evangelismos General Hospital of Athens, 10676 Athens, Greece.
Clin Res Cardiol. 2009 Feb;98(2):101-6. doi: 10.1007/s00392-008-0728-8. Epub 2008 Oct 30.
The present study aimed to investigate the clinical and echocardiographic determinants of plasma NT-pro-BNP levels in patients with atrial fibrillation (AF) and preserved left ventricular ejection fraction (LVEF).
NT-pro-BNP levels were measured in 45 patients with paroxysmal AF, 41 patients with permanent AF and 48 controls.
NT-pro-BNP levels were found significantly elevated in patients with paroxysmal (215+/-815 pg/ml) and permanent AF (1,086+/-835 pg/ml) in relation to control population (86.3+/-77.9 pg/ml) (P<0.001). According to the univariate linear regression analysis, age, hypertension, beta-blocker use, left atrial diameter (LAD), LVEF and AF status (paroxysmal or permanent or both) were significantly associated with NT-pro-BNP levels (P<0.05). In multiple linear regression analysis, LVEF (B coefficient: -53.030; CI: -95.738 to -10.322; P: 0.015) and LAD (B coefficient: 285.858; CI: 23.731-547.986; P: 0.033) were significant and independent determinants of NT-pro-BNP levels.
Plasma NT-pro-BNP levels were significantly higher in patients with paroxysmal and permanent AF compared to those with sinus rhythm in the setting of preserved left ventricular systolic function. LVEF and LAD were independent predictors of NT-pro-BNP levels.
本研究旨在调查左心室射血分数(LVEF)保留的心房颤动(AF)患者血浆N末端脑钠肽原(NT-pro-BNP)水平的临床和超声心动图决定因素。
对45例阵发性AF患者、41例持续性AF患者和48例对照者进行NT-pro-BNP水平检测。
与对照组人群(86.3±77.9 pg/ml)相比,阵发性AF患者(215±815 pg/ml)和持续性AF患者(1086±835 pg/ml)的NT-pro-BNP水平显著升高(P<0.001)。根据单变量线性回归分析,年龄、高血压、β受体阻滞剂使用情况、左心房直径(LAD)、LVEF和AF状态(阵发性或持续性或两者皆有)与NT-pro-BNP水平显著相关(P<0.05)。在多变量线性回归分析中,LVEF(B系数:-53.030;可信区间:-95.738至-10.322;P:0.015)和LAD(B系数:285.858;可信区间:23.731 - 547.986;P:0.033)是NT-pro-BNP水平的显著且独立的决定因素。
在左心室收缩功能保留的情况下,阵发性和持续性AF患者的血浆NT-pro-BNP水平显著高于窦性心律患者。LVEF和LAD是NT-pro-BNP水平的独立预测因素。