The levels of NT-pro-BNP as a predictor of recurrence of paroxysmal atrial fibrillation
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2012, Vol 29, Issue 3
Abstract
OBJECTIVE Left ventricular (LV) dysfunction has been linked with increased recurrence of atrial fibrillation (AF). The role of natriuretic peptides as a prognostic indicator of AF has not been fully clarified. This study investigated whether or not the level of NT-pro-BNP may be used as a satisfactory predictor of 6-month recurrence of paroxysmal AF in patients with preserved LV ejection fraction. In addition, the prognostic value of NT-pro-BNP levels in such cases was compared with that of the left atrial size. METHOD The study included 31 patients (54.8% male, mean age: 61.61±3.51 years), all of whom had preserved LV ejection fraction and were hospitalized because of a new episode of paroxysmal AF. These patients were followed for a period of 6 months after cardioversion to sinus rhythm. The study population was classified into 2 groups: Group A (n=15) consisted of patients that relapsed back to AF within 6 months, and Group B (n=16) patients that preserved sinus rhythm. Measurement was made of the levels of NT-pro-BNP and of the left atrial size (by transthoracic echocardiography), before and after the reversion. RESULTS Logistic regression analysis showed that NT-pro-BNP levels predicted the 6-month recurrence of AF (total prognostic value 87.1%, Nagelkerke's R2=0.664, Wald criterion: p<0.05, 95% CI: 0.990−0.999) more efficiently than the left atrial size (total prognostic value 71.1%, Nagelkerke's R2=0.364, Wald criterion: p<0.01, 95% CI: 0.004−0.0427). ROC analysis revealed that the NT-pro-BNP values above 324 pg/mL can predict the 6-month recurrence of AF with 93.3% sensitivity and 75% specificity. CONCLUSIONS The levels of NT-pro-BNP appear to be a satisfactory prognostic indicator of recurrence of paroxysmal atrial fibrillation within 6 months for patients with preserved LV ejection fraction.
Authors and Affiliations
I. MAVRODIMITRAKIS, A. MOUTSIOS-RENTZOS, N. KOUVELAS, T. ILIOPOULOS
Keywords
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