Atrial Fibrillation, Heart Failure with Impaired Ejection Fraction and Natriuretic Peptides
Journal Title: E Journal of Cardiovascular Medicine - Year 2020, Vol 8, Issue 2
Abstract
Objectives: Atrial fibrillation (AF) is frequent in clinical practice and its relationship with heart failure (HF) is well known. The present study investigated clinical and biochemical characteristics and N-terminal pro-B type natriuretic peptide (NT-proBNP) levels of patients with AF and HF with impaired left ventricle ejection fraction in a closed cohort. Materials and Methods: Patients who had AF, left ventricle ejection fraction (LVEF) <50% and who had a NT-proBNP measurement in the stable phase of HF, who applied to the İzmir Kemalpaşa State Hospital’s cardiology clinic between January and June 2018 were enrolled. Characteristics of 137 patients and the correlation of the change in creatine, glomerular filtration rate (GFR), and NT-proBNP to the clinical factors were investigated. Results: Mean age, LVEF, CHA2DS2 and CHA2DS2VASc scores were 71.8±9.1 years, 46.9±5.3%, 3.2±1.3 and 4.7±1.3 respectively in the study group. The median NT-proBNP was 1553.00 pg/mL in stable phase of HF. Elevated NT-proBNP in decompensated phase was present in 32 patients and the median was 2944.50 pg/mL. Initial GFR was correlated positively with hemoglobin but strongly negatively with age, CHA2DS2 and CHA2DS2VASc scores. NT-proBNP was correlated strongly positively with CHA2DS2VASc and systolic pulmonary artery pressure and negatively with LVEF as expected. Conclusion: Both of AF and HF are related to an increase of NT-proBNP level. Present study suggests a median 92.05% increase compared to stable phase level in NT-proBNP is related to decompensation. This finding emphasizes the importance of level of stable phase-NT-proBNP in patients with AF for the diagnosis of decompensation, because of no consensus on upper limit of NT-proBNP in patients with AF while the knowledge of higher levels is not new. Also, the relationship between GFR and CHA2DS2, CHA2DS2VASc scores implicates careful GFR monitoring in patients with higher scores to avoid improper drug doses such as NOAC’s.
Authors and Affiliations
Ebru İpek Türkoğlu, Emine Çiğdem Kırçiçeği Çiçekdağ
Keywords
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- EP ID EP685163
- DOI 10.32596/ejcm.galenos.2020.03.014
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