Tags

Type your tag names separated by a space and hit enter

The influence of left ventricle diastolic function on natriuretic peptides levels in patients with atrial fibrillation.
Pacing Clin Electrophysiol. 2009 Jun; 32(6):745-52.PC

Abstract

BACKGROUND

The diagnosis of the impaired left ventricle (LV) diastolic function during atrial fibrillation (AF) using traditional methods is very difficult. Natriuretic peptides seem to be useful for assessment of diastolic function in patients with AF.

AIM

To evaluate the influence of LV diastolic dysfunction on natriuretic peptides concentrations and to assess the diagnostic value of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with AF and impaired LV diastolic function.

METHODS

The study included 42 patients (23 males, 19 females), aged 58.6 +/- 8.2 years with nonvalvular persistent AF with preserved LV systolic function who were converted into sinus rhythm by DC cardioversion (CV) and maintained sinus rhythm for at least 30 days. Echocardiography (ECG), ANP, and BNP level measurements were taken at baseline 24 hours before CV and 24 hours and 30 days after CV. On the 30th day following CV in patients with sinus rhythm, Doppler ECG was performed to assess LV diastolic function.

RESULTS

Thirty days after CV, normal LV diastolic function in 15 patients and impaired diastolic function in 27 patients was diagnosed: 20 with impaired LV relaxation and seven with impaired LV compliance. During AF and 24 hours, and 30 days after sinus rhythm restoration, significantly higher ANP and BNP levels were observed in patients with LV diastolic dysfunction as compared to the subgroup with normal LV diastolic function. The average values of ANP during AF in patients with normal and impaired diastolic function were 167.3 +/- 70.1 pg/mL and 298.7 +/- 83.6 pg/mL, respectively (P < 0.001), and the average values of BNP in the above mentioned subgroups were 49.5 +/- 14.7 pg/mL and 145.6 +/- 49.6 pg/mL respectively (P < 0.001). While comparing the diagnostic value of both natriuretic peptides it was noted that BNP was a more specific and sensitive marker of impaired LV diastolic function. ANP value >220.7 pg/mL measured during AF identified patients with impaired LV diastolic function with 85% sensitivity and 90% specificity. BNP value >74.7 pg/mL proved 95% sensitive and 100% specific in the diagnosing of such a group.

CONCLUSIONS

The increase of ANP/BNP concentration in patients with AF results not only from the presence of AF, but also reflects the impaired LV diastolic function. Natriuretic peptides, especially BNP, may be useful in diagnosing LV diastolic dysfunction in patients with AF.

Authors+Show Affiliations

Swietokrzyskie Centrum Kardiologii, Clinical Cardiology Department, Kielce, Poland. bakowski@mp.plNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19545336

Citation

Bakowski, Dawid, et al. "The Influence of Left Ventricle Diastolic Function On Natriuretic Peptides Levels in Patients With Atrial Fibrillation." Pacing and Clinical Electrophysiology : PACE, vol. 32, no. 6, 2009, pp. 745-52.
Bakowski D, Wozakowska-Kaplon B, Opolski G. The influence of left ventricle diastolic function on natriuretic peptides levels in patients with atrial fibrillation. Pacing Clin Electrophysiol. 2009;32(6):745-52.
Bakowski, D., Wozakowska-Kaplon, B., & Opolski, G. (2009). The influence of left ventricle diastolic function on natriuretic peptides levels in patients with atrial fibrillation. Pacing and Clinical Electrophysiology : PACE, 32(6), 745-52. https://doi.org/10.1111/j.1540-8159.2009.02360.x
Bakowski D, Wozakowska-Kaplon B, Opolski G. The Influence of Left Ventricle Diastolic Function On Natriuretic Peptides Levels in Patients With Atrial Fibrillation. Pacing Clin Electrophysiol. 2009;32(6):745-52. PubMed PMID: 19545336.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The influence of left ventricle diastolic function on natriuretic peptides levels in patients with atrial fibrillation. AU - Bakowski,Dawid, AU - Wozakowska-Kaplon,Beata, AU - Opolski,Grzegorz, PY - 2009/6/24/entrez PY - 2009/6/24/pubmed PY - 2009/9/3/medline SP - 745 EP - 52 JF - Pacing and clinical electrophysiology : PACE JO - Pacing Clin Electrophysiol VL - 32 IS - 6 N2 - BACKGROUND: The diagnosis of the impaired left ventricle (LV) diastolic function during atrial fibrillation (AF) using traditional methods is very difficult. Natriuretic peptides seem to be useful for assessment of diastolic function in patients with AF. AIM: To evaluate the influence of LV diastolic dysfunction on natriuretic peptides concentrations and to assess the diagnostic value of atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with AF and impaired LV diastolic function. METHODS: The study included 42 patients (23 males, 19 females), aged 58.6 +/- 8.2 years with nonvalvular persistent AF with preserved LV systolic function who were converted into sinus rhythm by DC cardioversion (CV) and maintained sinus rhythm for at least 30 days. Echocardiography (ECG), ANP, and BNP level measurements were taken at baseline 24 hours before CV and 24 hours and 30 days after CV. On the 30th day following CV in patients with sinus rhythm, Doppler ECG was performed to assess LV diastolic function. RESULTS: Thirty days after CV, normal LV diastolic function in 15 patients and impaired diastolic function in 27 patients was diagnosed: 20 with impaired LV relaxation and seven with impaired LV compliance. During AF and 24 hours, and 30 days after sinus rhythm restoration, significantly higher ANP and BNP levels were observed in patients with LV diastolic dysfunction as compared to the subgroup with normal LV diastolic function. The average values of ANP during AF in patients with normal and impaired diastolic function were 167.3 +/- 70.1 pg/mL and 298.7 +/- 83.6 pg/mL, respectively (P < 0.001), and the average values of BNP in the above mentioned subgroups were 49.5 +/- 14.7 pg/mL and 145.6 +/- 49.6 pg/mL respectively (P < 0.001). While comparing the diagnostic value of both natriuretic peptides it was noted that BNP was a more specific and sensitive marker of impaired LV diastolic function. ANP value >220.7 pg/mL measured during AF identified patients with impaired LV diastolic function with 85% sensitivity and 90% specificity. BNP value >74.7 pg/mL proved 95% sensitive and 100% specific in the diagnosing of such a group. CONCLUSIONS: The increase of ANP/BNP concentration in patients with AF results not only from the presence of AF, but also reflects the impaired LV diastolic function. Natriuretic peptides, especially BNP, may be useful in diagnosing LV diastolic dysfunction in patients with AF. SN - 1540-8159 UR - https://www.unboundmedicine.com/medline/citation/19545336/The_influence_of_left_ventricle_diastolic_function_on_natriuretic_peptides_levels_in_patients_with_atrial_fibrillation_ L2 - https://doi.org/10.1111/j.1540-8159.2009.02360.x DB - PRIME DP - Unbound Medicine ER -