Natriuretic peptides in patients with atrial fibrillation.

BACKGROUND The aim of the study was to evaluate plasma natriuretic peptides (NPs): atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations in patients with paroxysmal, persistent and permanent atrial fibrillation (AF). METHODS AND RESULTS The study groups consisted of 23 patients with paroxysmal AF, 42 patients with permanent AF and 77 patients with persistent AF with normal left ventricular function. The mean ANP level was increased in AF patients in the paroxysmal, persistent and permanent groups: 249 +/- 88.3 pg/mL; 258 +/- 89.7 pg/mL; 208 +/- 76.7 pg/mL, respectively, vs. 67 +/- 21.2 pg/mL in the control subjects (p < 0.001). The mean BNP level was increased in AF patients in the paroxysmal, persistent and permanent groups: 99.6 +/- 29.8 pg/mL; 82.3 +/- 33 pg/mL; 95.6 +/- 46.4 pg/mL, respectively, vs. 37.5 +/- 13 pg/mL in the control group. Multivariate logistic regression analysis revealed a positive correlation between ANP levels, maximal left atrial volume, heart rate and New York Heart Association (NYHA) classification, in the persistent AF patients. A positive correlation between plasma BNP levels and heart failure stage according to NYHA classification in this group was found. Baseline ANP concentrations were positively correlated with baseline BNP concentrations in AF patients. CONCLUSIONS Plasma NPs levels are increased in patients with paroxysmal, persistent and permanent AF and normal left ventricle function, and positively correlated with left atrial volume, heart rate and heart failure stage according to NYHA classification. Neurohormonal assessment does not distinguish the type of arrhythmia.