Left atrial minimum volume is more strongly associated with N-terminal pro-B-type natriuretic peptide than the left atrial maximum volume in a community-based sample.
Previous data have demonstrated that left atrial (LA) minimum volume indexed for body surface area (LAVImin) is more strongly associated with the Doppler echocardiographic E/e' ratio than LA maximum volume index (LAVImax). We sought to explore if LAVImin was more closely related to serum levels of NT-proBNP than LAVImax and E/e' in the community. A community-based sample of 730 subjects underwent echocardiographic examinations and NT-proBNP measurements. The mean age of the participants was 66.3 years (range 38-86) and 72% were men. Age (Spearman correlation [rho] 0.533), LAVImin (rho 0.460), LAVImax (rho 0.360), estimated glomerular filtration rate (rho -0.349), and E/e' (rho 0.301; all P < 0.001) were strongly correlated with log-NT-proBNP. In a multiple linear regression model with log-NT-proBNP as dependent variable and LAVImin, LAVImax, E/e' ratio, and potential confounders as predictors, an adjusted R(2) of 44.9% was obtained. When excluding either of LAVImin (R(2) 42.6%, P < 0.001) or E/e' (R(2) 44.6%, P = 0.019) the model fit was significantly reduced. In contrast, when LAVImax was excluded the model fit was preserved (R(2) 45.0%, P = 0.69). To detect an NT-proBNP level of >125 ng/L, LAVImin yielded a significantly larger area under the receiver operating characteristic curve (AUC) of 0.749 than LAVImax (AUC 0.701; P < 0.001) and E/e' (AUC 0.661; P < 0.001). In our community-based sample, LAVImin was more strongly associated with NT-proBNP than LAVImax. Moreover, the discriminatory power to detect an elevated NT-proBNP level was stronger in LAVImin than in LAVImax and E/e'. Our findings support previous data that LAVImin may be more closely related to LV filling function than LAVImax.
Department of Clinical Physiology, Västmanland County Hospital, 721 89, Västerås, Sweden. par.o.hedberg@ltv.se.|Centre for Clinical Research, Västmanland County Hospital, Uppsala University, Västerås, Sweden. par.o.hedberg@ltv.se.
Pär
http://orcid.org/0000-0001-5731-966X
P
Hedberg
Department of Clinical Physiology, Västmanland County Hospital, 721 89, Västerås, Sweden.
Jonas
J
Selmeryd
Centre for Clinical Research, Västmanland County Hospital, Uppsala University, Västerås, Sweden.
Jerzy
J
Leppert
Department of Clinical Physiology, Västmanland County Hospital, 721 89, Västerås, Sweden.
Egil
E
Henriksen
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D016279:Atrial Function, Left; D015415:Biomarkers / Q000097:blood; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006331:Heart Diseases / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015854:Up-Regulation; D016277:Ventricular Function, Left
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
Doppler echocardiography; General population; Left atrial volumes; NT-proBNP