A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2013-09-13

AUTHORS

Yasushi Akutsu, Kyouichi Kaneko, Yusuke Kodama, Fumito Miyoshi, Hui-Ling Li, Norikazu Watanabe, Taku Asano, Kaoru Tanno, Jumpei Suyama, Atsuo Namiki, Takehiko Gokan, Youichi Kobayashi

ABSTRACT

PurposeDevelopment of atrial fibrillation (AF) is complexly associated with electrical and structural remodeling and other factors every stage of AF development. We hypothesized that P wave electrocardiography with an elevated brain natriuretic peptide (BNP) level would be associated with the progression to persistence from paroxysmal AF.MethodsP wave electrocardiography such as a maximum P wave duration (MPWD) and dispersion by 12-leads ECG, heart/mediastinum (H/M) ratio by delayed iodine-123 metaiodobenzylguanidine scintigraphic imaging, left ventricular ejection fraction (LVEF), and left atrial dimension (LAD) by echocardiography, and plasma BNP level were measured to evaluate the electrical and structural properties and sympathetic activity in 71 patients (mean ± standard deviation, age: 67 ± 13 years, 63.4 % males) with idiopathic paroxysmal AF.ResultsOver a 12.9-year follow-up period, AF developed into persistent AF in 30 patients. A wider MPWD (>129 ms) (p = 0.001), wider P wave dispersion (>60 ms) (p = 0.001), LAD enlargement (>40 mm) (p = 0.001), higher BNP level (>72 pg/mL) (p = 0.002), lower H/M ratio (≤2.7) (p = 0.025), and lower LVEF (≤60 %) (p = 0.035) were associated with the progression to persistent AF, and the wide MPWD was an independently powerful predictor of the progression to persistent AF with a hazard ratio (HR) of 5.49 [95 % confidence interval (CI) 2.38–12.7, p < 0.0001] after adjusting for potential confounding variables, such as age and sex. The combination of wide MPWD and elevated BNP level was additive and incremental prognostic power with 13.3 [2.16–13, p < 0.0001].ConclusionThe wide MPWD with elevated BNP level was associated with the progression to persistent AF. More... »

PAGES

79-84

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10840-013-9818-2

DOI

http://dx.doi.org/10.1007/s10840-013-9818-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1021281697

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24026966


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30 schema:description PurposeDevelopment of atrial fibrillation (AF) is complexly associated with electrical and structural remodeling and other factors every stage of AF development. We hypothesized that P wave electrocardiography with an elevated brain natriuretic peptide (BNP) level would be associated with the progression to persistence from paroxysmal AF.MethodsP wave electrocardiography such as a maximum P wave duration (MPWD) and dispersion by 12-leads ECG, heart/mediastinum (H/M) ratio by delayed iodine-123 metaiodobenzylguanidine scintigraphic imaging, left ventricular ejection fraction (LVEF), and left atrial dimension (LAD) by echocardiography, and plasma BNP level were measured to evaluate the electrical and structural properties and sympathetic activity in 71 patients (mean ± standard deviation, age: 67 ± 13 years, 63.4 % males) with idiopathic paroxysmal AF.ResultsOver a 12.9-year follow-up period, AF developed into persistent AF in 30 patients. A wider MPWD (>129 ms) (p = 0.001), wider P wave dispersion (>60 ms) (p = 0.001), LAD enlargement (>40 mm) (p = 0.001), higher BNP level (>72 pg/mL) (p = 0.002), lower H/M ratio (≤2.7) (p = 0.025), and lower LVEF (≤60 %) (p = 0.035) were associated with the progression to persistent AF, and the wide MPWD was an independently powerful predictor of the progression to persistent AF with a hazard ratio (HR) of 5.49 [95 % confidence interval (CI) 2.38–12.7, p < 0.0001] after adjusting for potential confounding variables, such as age and sex. The combination of wide MPWD and elevated BNP level was additive and incremental prognostic power with 13.3 [2.16–13, p < 0.0001].ConclusionThe wide MPWD with elevated BNP level was associated with the progression to persistent AF.
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36 schema:keywords AF development
37 BNP levels
38 ECG
39 LAD enlargement
40 LVEF
41 M ratio
42 P-wave dispersion
43 P-wave duration
44 PurposeDevelopment
45 ResultsOver
46 activity
47 age
48 atrial dimension
49 atrial fibrillation
50 atrial size
51 brain natriuretic peptide levels
52 combination
53 comparison
54 complexly
55 confounding variables
56 development
57 dimensions
58 dispersion
59 duration
60 echocardiography
61 ejection fraction
62 electrocardiography
63 elevated BNP levels
64 elevated brain natriuretic peptide levels
65 enlargement
66 factors
67 fibrillation
68 follow
69 fraction
70 hazard ratio
71 heart/mediastinum ratio
72 higher BNP levels
73 idiopathic paroxysmal atrial fibrillation
74 imaging
75 incremental prognostic power
76 levels
77 lower LVEF
78 maximum P-wave duration
79 mediastinum ratio
80 natriuretic peptide levels
81 paroxysmal atrial fibrillation
82 patients
83 peptide levels
84 period
85 persistence
86 persistent atrial fibrillation
87 plasma BNP levels
88 plasma brain natriuretic peptide levels
89 potential confounding variables
90 power
91 powerful predictor
92 predictors
93 prognostic power
94 progression
95 properties
96 ratio
97 remodeling
98 scintigraphic imaging
99 sex
100 size
101 stage
102 structural properties
103 structural remodeling
104 sympathetic activity
105 variables
106 ventricular ejection fraction
107 wave dispersion
108 wave duration
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