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Left atrial appendage dimension predicts elevated brain natriuretic peptide in nonvalvular atrial fibrillation.
- Source :
-
Journal of Cardiovascular Electrophysiology . Jan2023, Vol. 34 Issue 1, p135-141. 7p. 1 Black and White Photograph, 2 Charts, 1 Graph. - Publication Year :
- 2023
-
Abstract
- Introduction: BNP elevation in patients with AF is observed in the absence of heart failure; however, prior mechanistic studies have not included direct left atrial pressure measurements. This study sought to understand how emptying function of the left atrial appendage (LAA) and LAA dimension contributes to brain‐natriuretic peptide elevations (BNP) in atrial fibrillation (AF) accounting for left atrial pressure (LAP). Methods: 132 patients referredfor left atrial appendage occlusion (LAAO) were prospectively enrolled in this study. BNP levels and LAP were measured just before LAAO. Statistical analysis considered BNP, rhythm at time of procedure, LAP, LAA morphology, LAA size (ostial diameter, depth, volume), LAA emptying velocity, CHADS2‐VASc score, body mass index (BMI), left ventricular ejection fraction (LVEF), estimated glomerular filtration rate (eGFR), and obstructive sleep apnea (OSA) diagnosis as covariates. Results: Bivariate statistical analysis demonstrated positive associations with age, LAA ostial diameter, depth, and volume, LAP, AF status at time of measurement, OSA, and CHADS2‐VASc score. BNP was negatively associated with LVEF, eGFR, LAA emptying velocity and BMI. With multivariate logistic regression including LAP as covariate, significant relationships between BNP and AF/AFL(OR 1.99 [1.03, 3.85]), LAP (OR 1.13 [1.06, 1.20]), LAA diameter (OR 1.14 [1.03, 1.27]), LAA depth (OR 1.14 [1.07, 1.22]), and LAA emptying velocity (OR 0.97 [0.96,0.99]) were observed; however, no significant associations were seen with LAA morphology or CHADS2‐VASc score. Conclusions: BNP elevations in AF are associated with LAA size and function, but not CHADS2‐VASc score or appendage morphology after accounting for changes in LAP. [ABSTRACT FROM AUTHOR]
- Subjects :
- *BLOOD pressure
*GLOMERULAR filtration rate
*STATISTICS
*MITRAL valve insufficiency
*VENTRICULAR ejection fraction
*MULTIPLE regression analysis
*SERUM
*MULTIVARIATE analysis
*TRANSESOPHAGEAL echocardiography
*ATRIAL fibrillation
*MANN Whitney U Test
*HEART atrium
*RESEARCH funding
*SLEEP apnea syndromes
*DESCRIPTIVE statistics
*PEPTIDE hormones
*ODDS ratio
*BODY mass index
*DATA analysis software
*DATA analysis
*STATISTICAL models
*LEFT heart atrium
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 10453873
- Volume :
- 34
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Journal of Cardiovascular Electrophysiology
- Publication Type :
- Academic Journal
- Accession number :
- 161312208
- Full Text :
- https://doi.org/10.1111/jce.15719