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KMID : 0882420090760030311
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Korean Journal of Medicine
2009 Volume.76 No. 3 p.311 ~ p.320
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Role of B-type natriuretic peptide in the recurrence of atrial fibrillation after electrical cardioversion
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Lee Su-Hee
Hong Young-Ho
Kim Do-Yi
Won Hyun-Sun
Yang Moon-Seok
Kim Tae-Sun
Seo Yun-Yong
Park Jeong-Bae
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Abstract
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Background/Aims: No studies have conclusively determined whether the B-type natriuretic peptide (BNP) level measured before electrical cardioversion for atrial fibrillation (AF) is associated with the maintenance of sinus rhythm after the procedure. Therefore, we investigated whether the plasma BNP can predict AF recurrence in the short-term.
Methods: We prospectively recruited 20 consecutive patients with persistent AF, without symptomatic congestive heart failure. The plasma BNP was measured before and after electrical cardioversion.
Results: In all patients, AF was converted to normal sinus rhythm (NSR) after the procedure. NSR was maintained in 70.0% of the patients at 1 week and in 52.6% of the patients at 4 weeks. Of the patients with NSR at 1 week, five patients had relapsed by 4 weeks (4-week relapse group, 4WRG). The log BNP levels after cardioversion decreased significantly in all patients, except for the failed group at 1 week and the 4WRG. Multivariate analysis revealed that the maintenance of sinus rhythm was associated with body mass index at 1 week, and left atrial diameter (LAD) and left ventricular mass index (LVMI) at 4 weeks. 4WRG had a significantly higher baseline BNP. The baseline BNP was associated with the LVMI (R2=0.241, p=0.028) and tissue Doppler imaging (TDI) E’ (R2=0.432, p=0.002).
Conclusion: A higher plasma BNP at baseline in AF patients may help to predict the failure to maintain sinus rhythm 4 weeks after electrical cardioversion, but not the early recurrence at 1 week.
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KEYWORD
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Atrial fibrillation, B-type natriuretic peptide, Cardioversion
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