Ebru Ipek Turkoglu1,2, Emine Cigdem Kircicegi Cicekdag3. 1. Department of Cardiology, Izmir Kemalpasa State Hospital, 8 Eylul Mah, 35170, Izmir, Kırovası, Turkey. dripek73@yahoo.com. 2. Department of Cardiology, İstanbul Aydin University, Istanbul, Turkey. dripek73@yahoo.com. 3. Department of Anesthesiology, Izmir Kemalpasa State Hospital, Izmir, Turkey.
Abstract
BACKGROUND: The co-presence of atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) may cause some diagnostic difficulties, because AF itself is associated with elevated levels of N‑terminal pro-B-type natriuretic peptide (NT-proBNP). In the present study we aimed to investigate NT-proBNP levels of patients with HFpEF and AF. METHODS: This was a retrospective cohort study. Outpatient data were reviewed through the hospital data management system. Consecutive patients with the diagnosis of HFpEF and AF, who had at least one NT-proBNP measurement, were included in the study. RESULTS: The study population comprised 235 patients. Median NT-proBNP levels were 1242 pg/ml in the stable phase and 2321.5 pg/ml during decompensation. NT-proBNP was correlated positively with age, CHA2DS2 and CHA2DS2VASc scores, left atrial diameter (LAD), tricuspid annulus diameter, and systolic pulmonary artery pressure but negatively correlated with left ventricular ejection fraction (LVEF) and hemoglobin level. The change in NT-proBNP was positively correlated with heart rate and LAD. CONCLUSION: Patients with HFpEF and AF have higher levels of NT-proBNP, which may exceed the upper limits defined in guidelines. This study underlines the importance of measuring NT-proBNP levels in the stable phase and proposes a rule-in level for the decompensated phase.
BACKGROUND: The co-presence of atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) may cause some diagnostic difficulties, because AF itself is associated with elevated levels of N‑terminal pro-B-type natriuretic peptide (NT-proBNP). In the present study we aimed to investigate NT-proBNP levels of patients with HFpEF and AF. METHODS: This was a retrospective cohort study. Outpatient data were reviewed through the hospital data management system. Consecutive patients with the diagnosis of HFpEF and AF, who had at least one NT-proBNP measurement, were included in the study. RESULTS: The study population comprised 235 patients. Median NT-proBNP levels were 1242 pg/ml in the stable phase and 2321.5 pg/ml during decompensation. NT-proBNP was correlated positively with age, CHA2DS2 and CHA2DS2VASc scores, left atrial diameter (LAD), tricuspid annulus diameter, and systolic pulmonary artery pressure but negatively correlated with left ventricular ejection fraction (LVEF) and hemoglobin level. The change in NT-proBNP was positively correlated with heart rate and LAD. CONCLUSION: Patients with HFpEF and AF have higher levels of NT-proBNP, which may exceed the upper limits defined in guidelines. This study underlines the importance of measuring NT-proBNP levels in the stable phase and proposes a rule-in level for the decompensated phase.
Authors: Yogesh N V Reddy; Rickey E Carter; Masaru Obokata; Margaret M Redfield; Barry A Borlaug Journal: Circulation Date: 2018-08-28 Impact factor: 29.690
Authors: Bernadet T Santema; Mariëlle Kloosterman; Isabelle C Van Gelder; Ify Mordi; Chim C Lang; Carolyn S P Lam; Stefan D Anker; John G Cleland; Kenneth Dickstein; Gerasimos Filippatos; Pim Van der Harst; Hans L Hillege; Jozine M Ter Maaten; Marco Metra; Leong L Ng; Piotr Ponikowski; Nilesh J Samani; Dirk J Van Veldhuisen; Aeilko H Zwinderman; Faiez Zannad; Kevin Damman; Peter Van der Meer; Michiel Rienstra; Adriaan A Voors Journal: Eur Heart J Date: 2018-11-14 Impact factor: 29.983
Authors: Carolyn S P Lam; Michiel Rienstra; Wan Ting Tay; Licette C Y Liu; Yoran M Hummel; Peter van der Meer; Rudolf A de Boer; Isabelle C Van Gelder; Dirk J van Veldhuisen; Adriaan A Voors; Elke S Hoendermis Journal: JACC Heart Fail Date: 2016-12-21 Impact factor: 12.035
Authors: Barry A Borlaug; Wissam A Jaber; Steve R Ommen; Carolyn S P Lam; Margaret M Redfield; Rick A Nishimura Journal: Heart Date: 2011-04-08 Impact factor: 5.994
Authors: Dirk Westermann; Mario Kasner; Paul Steendijk; Frank Spillmann; Alexander Riad; Kerstin Weitmann; Wolfgang Hoffmann; Wolfgang Poller; Matthias Pauschinger; Heinz-Peter Schultheiss; Carsten Tschöpe Journal: Circulation Date: 2008-04-14 Impact factor: 29.690
Authors: Rosita Zakeri; Barry A Borlaug; Steven E McNulty; Selma F Mohammed; Gregory D Lewis; Marc J Semigran; Anita Deswal; Martin LeWinter; Adrian F Hernandez; Eugene Braunwald; Margaret M Redfield Journal: Circ Heart Fail Date: 2013-10-25 Impact factor: 8.790
Authors: Piotr Ponikowski; Adriaan A Voors; Stefan D Anker; Héctor Bueno; John G F Cleland; Andrew J S Coats; Volkmar Falk; José Ramón González-Juanatey; Veli-Pekka Harjola; Ewa A Jankowska; Mariell Jessup; Cecilia Linde; Petros Nihoyannopoulos; John T Parissis; Burkert Pieske; Jillian P Riley; Giuseppe M C Rosano; Luis M Ruilope; Frank Ruschitzka; Frans H Rutten; Peter van der Meer Journal: Eur Heart J Date: 2016-05-20 Impact factor: 29.983
Authors: Bernadet T Santema; Michelle M Y Chan; Jasper Tromp; Martin Dokter; Haye H van der Wal; Johanna E Emmens; Janny Takens; Nilesh J Samani; Leong L Ng; Chim C Lang; Peter van der Meer; Jozine M Ter Maaten; Kevin Damman; Kenneth Dickstein; John G Cleland; Faiez Zannad; Stefan D Anker; Marco Metra; Pim van der Harst; Rudolf A de Boer; Dirk J van Veldhuisen; Michiel Rienstra; Carolyn S P Lam; Adriaan A Voors Journal: Clin Res Cardiol Date: 2019-07-01 Impact factor: 5.460