Carotid-femoral pulse wave velocity is associated with N-terminal pro-B-type natriuretic peptide level in patients with atrial fibrillation.
OBJECTIVE
To determine the extent to which conduit artery stiffness is associated with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF).


METHODS
Cross-sectional study.


METHODS
National University Hospital, Singapore.


METHODS
Cases (n=117) were patients with AF onset <65 years of age without heart failure or structural heart disease. Controls (n=274) were patients without AF who were seen at the general cardiology clinic.


METHODS
Transthoracic echocardiography, carotid-femoral pulse wave velocity (CFPWV) measured using applanation tonometry and blood draw for plasma NT-proBNP at enrolment for all patients.


METHODS
Plasma NT-proBNP.


RESULTS
In patients with AF, CFPWV was associated with NT-proBNP after adjusting for hypertension and factors that were univariately associated with NT-proBNP: age at enrolment, type of AF, body mass index, left ventricular mass index, left atrial volume index, mitral E/E', mitral deceleration time and use of β-blockers (β=0.234; 95% CI 0.100 to 0.367; p=0.001). In contrast, CFPWV was not associated with NT-proBNP in controls. In patients with AF, the adjusted mean NT-proBNP level in the highest quartile of CFPWV (350 pg/ml; 95% CI 237 to 517 pg/ml) was fivefold higher than the lowest quartile (69 pg/ml; 95% CI 47 to 103 pg/ml) (p=0.001).


CONCLUSIONS
CFPWV is associated with NT-proBNP level in AF. Since elevated NT-proBNP is a marker of adverse cardiovascular outcomes, arterial stiffness may be associated with worse prognosis in patients with AF.
Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA; Department of Medicine, Cardiovascular Division, National University of Singapore, Singapore.
Lin Y
LY
Chen
Department of Epidemiology and Public Health, National University of Singapore, Singapore.
Bee C
BC
Tai
Cardiology Department, Tan Tock Seng Hospital, Singapore.
David C
DC
Foo
Cardiac Department, National University Hospital, Singapore.
Raymond C
RC
Wong
Division of Cardiology, Veterans Affairs Medical Centre, Minneapolis, Minnesota, USA.
A Selcuk
AS
Adabag
Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA.
David G
DG
Benditt
Department of Medicine, Cardiovascular Division, National University of Singapore, Singapore.
Lieng H
LH
Ling
Atrial fibrillation; N-terminal pro-B-type natriuretic peptide; arterial stiffness; carotid-femoral pulse wave velocity