Plasma levels of NT-pro-BNP in patients with atrial fibrillation before and after electrical cardioversion.

Autor: Shin DI; HELIOS-Klinikum Wuppertal, Universitätsklinikum der Universität Witten-Herdecke, Herzzentrum Kardiologie, Medizinische Klinik III, Arrenberger Str. 20, 42117, Wuppertal, Germany. dshin@wuppertal.helios-kliniken.de, Jaekel K, Schley P, Sause A, Müller M, Fueth R, Scheffold T, Guelker H, Horlitz M
Jazyk: angličtina
Zdroj: Zeitschrift fur Kardiologie [Z Kardiol] 2005 Dec; Vol. 94 (12), pp. 795-800.
DOI: 10.1007/s00392-005-0301-7
Abstrakt: Objective: Plasma levels of brain natriuretic peptide (BNP) have been examined in studies on patients with persistent atrial fibrillation, both before and after electrical cardioversion. Studied patients often showed a comorbidity with congestive heart failure, which complicates interpretation of measured BNP values as a natriuretic peptide. The aim of this study was to examine plasma levels of N-terminal fragment pro-brain natriuretic peptide (NT-pro-BNP), which is the more stable but inactive cleavage product of pro-BNP in patients with atrial fibrillation, but normal left ventricular ejection fraction, before and after electrical cardioversion.
Patients and Methods: NT-pro-BNP plasma levels of 34 consecutive patients were measured before, shortly after and 11 days after electrical cardioversion. All patients showed a normal ejection fraction after echocardiographic or laevocardiographic criteria.
Results: At baseline, all patients showed elevated NT-pro-BNP compared to a healthy control group (1086 vs. 66.9 pg/ml, p<0.001). After a mean follow-up time of 11 days in patients with persistent restored sinusrhythm, NT-pro-BNP decreased from 1071 pg/ml at baseline to 300 pg/ml (p<0.001). In contrast, patients with recurrence of atrial fibrillation showed increased levels from 1570.5 pg/ml at baseline to 1991 pg/ml (p=0.13; n.s.). Recurrence of atrial fibrillation was independent from height of NT-pro-BNP levels at baseline (p=0.23).
Conclusions: Atrial fibrillation in patients with a normal left ventricular ejection fraction is associated with elevated NT-pro-BNP plasma levels, which decrease when a persistent sinus-rhythm can be restored by electrical cardioversion. On the other hand, NT-pro-BNP seems to increase (n.s.) when recurrence of atrial fibrillation occurs. Finally, NT-pro-BNP is no valid predictor for long-term success of sinus-rhythm restoration by electrical cardioversion.
Databáze: MEDLINE
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