title: Plasma brain natriuretic peptide levels indicating thromboembolism in very elderly patients with non-valvular atrial fibrillation.
abstract: BACKGROUND
  Assessment of left atrial (LA) function by transesophageal echocardiography is useful for detecting patients with a high risk thromboembolism secondary to atrial fibrillation (AF). A recent study showed that the atrium is the main source of brain natriuretic peptide (BNP) in AF patients without overt heart failure. The purpose of this study was to assess the possible relationship between LA function and plasma BNP levels in very elderly patients with non-valvular AF.
  
  
  RESULTS
  Seventy-four consecutive patients with chronic non-valvular AF (aged, 82+/-6 years) underwent transthoracic and transesophageal echocardiography and measurement of plasma BNP. Thirteen AF patients who had a history of cerebral embolism or echocardiographic evidence of thrombus (TE+ group) were compared with 61 AF patients who had no such complications (TE- group). The TE+ group demonstrated a lower LA appendage (LAA) velocity and higher plasma BNP level than the TE- group. Assessment of variables by multiple logistic regression analysis revealed that BNP was a significant predictor of thromboembolism. There was a significant negative correlation between the plasma BNP level and the LAA peak flow velocity.
  
  
  CONCLUSIONS
  The present findings would suggest the usefulness of measuring plasma BNP to detect very elderly non-valvular AF patients at high risk for thromboembolism.
authors.affiliation: Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan. d_wata@tokyo-med.ac.jp
authors.forename: Daisuke
authors.initials: D
authors.lastname: Watanabe
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shizuka
authors.forename: Shunichi
authors.initials: S
authors.lastname: Koyama
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000097:blood* / Q000150:complications / Q000628:therapy; D017548:Echocardiography, Transesophageal; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D020766:Intracranial Embolism / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D020097:Natriuretic Peptide, Brain