Lin Y Chen1, Bee C Tai2, David C Foo3, Raymond C Wong4, A Selcuk Adabag5, David G Benditt6, Lieng H Ling7. 1. Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA; Department of Medicine, Cardiovascular Division, National University of Singapore, Singapore. 2. Department of Epidemiology and Public Health, National University of Singapore, Singapore. 3. Cardiology Department, Tan Tock Seng Hospital, Singapore. 4. Cardiac Department, National University Hospital, Singapore. 5. Division of Cardiology, Veterans Affairs Medical Centre, Minneapolis, Minnesota, USA. 6. Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA. 7. Department of Medicine, Cardiovascular Division, National University of Singapore, Singapore.
Abstract
OBJECTIVE: To determine the extent to which conduit artery stiffness is associated with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF). DESIGN: Cross-sectional study. SETTING: National University Hospital, Singapore. PATIENTS: Cases (n=117) were patients with AF onset <65 years of age without heart failure or structural heart disease. Controls (n=274) were patients without AF who were seen at the general cardiology clinic. INTERVENTIONS: Transthoracic echocardiography, carotid-femoral pulse wave velocity (CFPWV) measured using applanation tonometry and blood draw for plasma NT-proBNP at enrolment for all patients. MAIN OUTCOME MEASURES: Plasma NT-proBNP. RESULTS: In patients with AF, CFPWV was associated with NT-proBNP after adjusting for hypertension and factors that were univariately associated with NT-proBNP: age at enrolment, type of AF, body mass index, left ventricular mass index, left atrial volume index, mitral E/E', mitral deceleration time and use of β-blockers (β=0.234; 95% CI 0.100 to 0.367; p=0.001). In contrast, CFPWV was not associated with NT-proBNP in controls. In patients with AF, the adjusted mean NT-proBNP level in the highest quartile of CFPWV (350 pg/ml; 95% CI 237 to 517 pg/ml) was fivefold higher than the lowest quartile (69 pg/ml; 95% CI 47 to 103 pg/ml) (p=0.001). CONCLUSIONS: CFPWV is associated with NT-proBNP level in AF. Since elevated NT-proBNP is a marker of adverse cardiovascular outcomes, arterial stiffness may be associated with worse prognosis in patients with AF.
OBJECTIVE: To determine the extent to which conduit artery stiffness is associated with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF). DESIGN: Cross-sectional study. SETTING: National University Hospital, Singapore. PATIENTS: Cases (n=117) were patients with AF onset <65 years of age without heart failure or structural heart disease. Controls (n=274) were patients without AF who were seen at the general cardiology clinic. INTERVENTIONS: Transthoracic echocardiography, carotid-femoral pulse wave velocity (CFPWV) measured using applanation tonometry and blood draw for plasma NT-proBNP at enrolment for all patients. MAIN OUTCOME MEASURES: Plasma NT-proBNP. RESULTS: In patients with AF, CFPWV was associated with NT-proBNP after adjusting for hypertension and factors that were univariately associated with NT-proBNP: age at enrolment, type of AF, body mass index, left ventricular mass index, left atrial volume index, mitral E/E', mitral deceleration time and use of β-blockers (β=0.234; 95% CI 0.100 to 0.367; p=0.001). In contrast, CFPWV was not associated with NT-proBNP in controls. In patients with AF, the adjusted mean NT-proBNP level in the highest quartile of CFPWV (350 pg/ml; 95% CI 237 to 517 pg/ml) was fivefold higher than the lowest quartile (69 pg/ml; 95% CI 47 to 103 pg/ml) (p=0.001). CONCLUSIONS:CFPWV is associated with NT-proBNP level in AF. Since elevated NT-proBNP is a marker of adverse cardiovascular outcomes, arterial stiffness may be associated with worse prognosis in patients with AF.
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