Cor Vasa 2019, 61(4):e397-e402 | DOI: 10.33678/cor.2019.044

NT-proBNP as predictive factor for the conversion of paroxysmal atrial fibrillation of heart to sinus rhythm in non-diabetic and diabetic populations

Jarmila Harvanová^a, Roman Beňačka^b, Alexander Hudák^c

^a I. Internal Clinic, University Hospital L. Pasteur Košice, Košice, Slovak Republic

^b Institute of Pathological Physiology, Faculty of Medicine, P.J. Šafarik, University in Košice, Košice, Slovak Republic

^c Department of Chemistry, Biochemistry and Biophysics,University of Veterinary Medicine and Pharmacy in Košice, Košice, Slovak Republic

Introduction: Atrial fibrillation is considered today as the most common arrhythmia. The NT-proBNP level is provably elevated in patients with atrial fibrillation in atrium of heart, even without documented heart failure. The association between NT-proBNP level and the conversion of atrial fibrillation to sinus rhythm has not been proved so far, and it is unclear whether such a link exists at all.

Objective: The aim of the study is to analyze the relationship between NT-proBNP levels and the conversion of atrial fibrillation and to point to the possible predictive value of this marker in relation to rhythm conversion.

Material and methods: A total number of 96 patients (50% of diabetics) with no documented cardiac failure, with paroxysmal atrial fibrillation lasting up to 24 hours, were monitored. In all patients, venous blood was collected to determine the level of NT-proBNP. Subsequently, the patients were divided into two groups (diabetics and non-diabetic patients), with mean NT-proBNP values recorded in each group in which the rhythm conversion occurred. In the follow-up examination all participants of the study were evaluated, regardless of the presence of diabetes.

Results: Low NT-proBNP values have a positive predictive value in rhythm conversion prediction (mean value of 678.8 ± 936.6 ng/l in successful conversion), and a further increase in NT-proBNP is associated with a lower probability of conversion (mean value 2 597.5 ± 2 300.4 ng/l in unsuccessful conversion). In 45 patients spontaneous conversion to sinus rhythm was recorded, in 51 patients there was no rhythm conversion. In this observation, we achieved statistical significance in the prediction of conversion based on NT-proBNP values (p < 0.001). There was no evidence of dependence between NT-proBNP level and rhythm conversion in diabetics. In 37.5% of patients suffering from diabetes with the mean value of NT-proBNP 824.1 ± 1 338.0 ng/l rhythm conversion occurred, in 62.5% of patients-diabetics with an average value of 1 807.3 ± 1 875.3 ng/l atrial fibrillation in atrium of heart persisted (p = 0.149)., Conclusion: The results indicate the potential prognostic aspect of NT-proBNP levels for rhythm conversion in patients with paroxysmal atrial fibrillation. However, further studies are needed to clarify the mechanisms of these phenomena and to find further use in clinical research.

Keywords: Atrial fibrillation, Diabetic, NT-proBNP value, Rhythm conversion

Received: December 2, 2018; Accepted: March 2, 2019; Published: August 11, 2019  Show citation