N-terminal proANF in acute atrial fibrillation: a biochemical marker of atrial pressures but not a predictor for conversion to sinus rhythm. Digitalis in Acute Atrial Fibrillation (DAAF) Trial group.
BACKGROUND
Atrial filling pressures are increased in acute atrial fibrillation, which stimulates the release of atrial natriuretic factor pro-hormone, proANF.


METHODS
In a randomized trial comparing digoxin with placebo in 216 patients, we investigated whether the baseline plasma level of N-terminal proANF is a predictor for conversion to sinus rhythm and the relation among N-terminal proANF, conversion to sinus rhythm, and changes in heart rate.


RESULTS
N-terminal proANF was increased at baseline and decreased significantly in patients converting to sinus rhythm, whereas it was mainly unchanged in nonconverters. N-terminal proANF was not a predictor of conversion to sinus rhythm. A relation was found between relative changes in heart rate and N-terminal proANF in nonconverters.


CONCLUSIONS
The level of N-terminal proANF does not predict conversion to sinus rhythm, which indicates that hemodynamics per se is not important. There is a correlation between relative changes in heart rate and N-terminal proANF in nonconverters.
Hornestam
B
B
Department of Internal Medicine of Ostra University Hospital, Göteborg, Sweden.
Hall
C
C
Held
P
P
Carlsson
T
T
Falk
L
L
Karlson
B W
BW
Lundström
T
T
Peterson
M
M
D000208:Acute Disease; D001281:Atrial Fibrillation / Q000503:physiopathology*; D016275:Atrial Function; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D004077:Digoxin / Q000627:therapeutic use; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D009318:Natriuresis; D011498:Protein Precursors / Q000097:blood*
D015415:Biomarkers; D011498:Protein Precursors; D004077:Digoxin; D009320:Atrial Natriuretic Factor