P-597: Brain natriuretic peptide and left ventricular geometry in hypertensive patients predisposed to paroxysmal atrial fibrillation

Abstract

BNP is a cardiac neurohormone secreted from the ventricles in response to ventricular volume expansion and and pressure overload. BNP levels may also reflect diastolic dysfunction. We assessed the hypothesis that BNP plasma levels may be of prognostic value in hypertensive patients predisposed to AF.

For this purpose, BNP levels were measured in 30 hypertensive patients with history of paroxysmal atrial fibrillation (PAF) (group A) and 30 hypertensive patients without previous history of PAF (group B).In 8 patients from group A the BNP levels were measured during the paroxysm of AF and after the reversion to sinus rhythm.

There were no differences among the two groups regarding the clinical data (age, sex, body mass index, office blood pressure, duration of hypertension, EF: 65%vs67%, p=NS for all cases). The left ventricular mass index and left atrial dimensions were significantly higher in group A (135±27gr/m² vs 105±19 gr/m², p<0.0001 and 3.77±0.3 vs 3.51±0.4 cm, respectively). BNP levels were significantly higher in group A (49.04±53.8 vs 12.24±14.21 pg/dl, p=0.006). In addition, BNP levels were significantly higher during PAF comparing with the levels after reversion to sinus rhythm (144.03 vs 36.49 pg/dl). By applied a multivariate model it was revealed that BNP levels were higher in hypertensive patients with LVH than in the absence of LVH.

In conclusion, there were also good correlation between plasma BNP levels and left ventricular mass index. BNP could be a significant and reliable predictive index for the detection of patient prone to the development of PAF in essential hypertensive patients while in sinus rhythm.

Brain Natriuretic Peptide, Hypertension, Left Ventricluar Mass Index