Academic journal article Iranian Journal of Public Health

Plasmatic Levels of N-Terminal Pro-BNP in Elderly Patients with Atrial Fibrillation and Heart Failure with Preserved Ejection Fraction

Academic journal article Iranian Journal of Public Health

Plasmatic Levels of N-Terminal Pro-BNP in Elderly Patients with Atrial Fibrillation and Heart Failure with Preserved Ejection Fraction

Article excerpt

Dear Editor-in-Chief

Heart failure with preserved ejection fraction has become an epidemiological problem in the last years. Mortality is similar as in patients with heart failure and reduced left ventricular ejection fraction (1). The presence of atrial fibrillation and heart failure worsens the prognosis of patients. Cardiac peptides are significant markers for the development of both conditions. We investigated the impact of atrial fibrillation on serum levels of NT-pro-BNP in elderly heart failure patients as compared to sinus rhythm patients.

The study included 101 heart failure patients with preserved ejection fraction (>50%) selected from the databases of the general practitioners in BaiaMare and Cluj-Napoca in 2015.

The selected patients were informed about the study protocol and signed informed consent was taken from them. The study was carried out in agreement with The Code of Ethics of the World Medical Association (Declaration of Helsinki) for experiments involving humans.

The patients were divided into two groups: group 1: 49 patients with atrial fibrillation (72.12+6.78 yr, 42.9% women) and group 2: 52 patients in sinus rhythm (71.68+7.69 yr, 71.2% women). When taking into account all heart failure patients, the mean NT-pro-BNP value was high: 1229.44 ± 1040.1178 pg/ml. On the contrary, mean plasmatic value of NT-pro-BNP was 843.40+938.05 pg/ml in sinus rhythm patients (group 2), significantly lower than NT-pro-BNP levels in heart failure and atrial fibrillation patients (group 1)- 1639.12+993.03 pg/ml, (P=0.0001). There was a direct correlation between NT-pro-BNP level and age: all patientscorrelation coefficient r=0.1977 (95% CI-0.0136 to 0.3794), P=0.048; group 1 correlation coefficient r=0.4432 P=0.0014 (95% CI-0.1851 to 0.6441) (Fig. 1); but not in group 2 correlation coefficient r=-0.01 (95% CI -0.2863 to 0.264), P=NS. Atrial fibrillation is associated with natriuretic hormones increase even in the absence of heart failure (2). The mean values of NT-proBNP in atrial fibrillation ranged between 800 and 1100 pg/ml and they were not associated with the duration of atrial fibrillation or with the size of the atrium (3).

In our study, there was a direct correlation between NT-pro-BNP level and age: all patientscorrelation coefficient r=0. …

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