A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: comparisons of sympathetic activity and left atrial size
Purpose Development 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 progr...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2013-11, Vol.38 (2), p.79-84 |
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| creator | Akutsu, Yasushi Kaneko, Kyouichi Kodama, Yusuke Miyoshi, Fumito Li, Hui-Ling Watanabe, Norikazu Asano, Taku Tanno, Kaoru Suyama, Jumpei Namiki, Atsuo Gokan, Takehiko Kobayashi, Youichi |
| description | Purpose
Development 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.
Methods
P 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.
Results
Over 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
|
| doi_str_mv | 10.1007/s10840-013-9818-2 |
| format | Article |
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Development 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.
Methods
P 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.
Results
Over 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].
Conclusion
The wide MPWD with elevated BNP level was associated with the progression to persistent AF.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-013-9818-2</identifier><identifier>PMID: 24026966</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Aged ; Atrial Fibrillation - blood ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - epidemiology ; Biomarkers - blood ; Cardiology ; Chronic Disease ; Disease Progression ; Disease-Free Survival ; Echocardiography - statistics & numerical data ; Electrocardiography - statistics & numerical data ; Female ; Follow-Up Studies ; Heart Atria - diagnostic imaging ; Humans ; Incidence ; Japan - epidemiology ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Organ Size ; Prevalence ; Reproducibility of Results ; Risk Assessment ; Sensitivity and Specificity ; Stroke Volume</subject><ispartof>Journal of interventional cardiac electrophysiology, 2013-11, Vol.38 (2), p.79-84</ispartof><rights>Springer Science+Business Media New York 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-b268fda00e14349c257b1ecc1dadf61fe6136adfd5d18e1b43296d9bb56dbcd93</citedby><cites>FETCH-LOGICAL-c438t-b268fda00e14349c257b1ecc1dadf61fe6136adfd5d18e1b43296d9bb56dbcd93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-013-9818-2$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-013-9818-2$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24026966$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Akutsu, Yasushi</creatorcontrib><creatorcontrib>Kaneko, Kyouichi</creatorcontrib><creatorcontrib>Kodama, Yusuke</creatorcontrib><creatorcontrib>Miyoshi, Fumito</creatorcontrib><creatorcontrib>Li, Hui-Ling</creatorcontrib><creatorcontrib>Watanabe, Norikazu</creatorcontrib><creatorcontrib>Asano, Taku</creatorcontrib><creatorcontrib>Tanno, Kaoru</creatorcontrib><creatorcontrib>Suyama, Jumpei</creatorcontrib><creatorcontrib>Namiki, Atsuo</creatorcontrib><creatorcontrib>Gokan, Takehiko</creatorcontrib><creatorcontrib>Kobayashi, Youichi</creatorcontrib><title>A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: comparisons of sympathetic activity and left atrial size</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><addtitle>J Interv Card Electrophysiol</addtitle><description>Purpose
Development 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.
Methods
P 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.
Results
Over 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].
Conclusion
The wide MPWD with elevated BNP level was associated with the progression to persistent AF.</description><subject>Aged</subject><subject>Atrial Fibrillation - blood</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Biomarkers - blood</subject><subject>Cardiology</subject><subject>Chronic Disease</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Echocardiography - statistics & numerical data</subject><subject>Electrocardiography - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Atria - diagnostic imaging</subject><subject>Humans</subject><subject>Incidence</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Organ Size</subject><subject>Prevalence</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>Sensitivity and Specificity</subject><subject>Stroke Volume</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1u1TAQhSMEoqXwAGyQJTZsQu38OuyqCgpSpbIoErvIP5NbV4kdPM5Fl7fkjTppSoWQWM2MfOabY50sey34e8F5e4qCy4rnXJR5J4XMiyfZsajbIpd1Vz-lvpRlLtv6-1H2AvGWc97xonmeHRUV1a5pjrPfZ8yESTuvkguehYF9ZT_VHhiMYFIMRkXrwi6q-ebAlLdsHhVOiumonGe0Fd0SITnDZpiTs8BG2MPIhhDZHME6k5zfsXQDNBIHENc7KZA-osMEPrGVomjH6ejG8d7Jh9XWrKLD4HG1hQcaCbOeUgTdu7QZGmF4JKD7BS-zZ4MaEV491JPs26eP1-ef88uriy_nZ5e5qUqZcl00crCKcxBVWXWmqFstwBhhlR0aMUAjyoZaW1shQeiqLLrGdlrXjdXGduVJ9m7j0r9-LICpnxwaIP8ewoK9qIgreM1rkr79R3oblujJ3aoSbVdxuQLFpjIxIEYY-jm6ScVDL3i_5t1vefeUd7_m3Re08-aBvOgJ7OPGn4BJUGwCpCe_g_jX6f9S7wAG0bzK</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Akutsu, Yasushi</creator><creator>Kaneko, Kyouichi</creator><creator>Kodama, Yusuke</creator><creator>Miyoshi, Fumito</creator><creator>Li, Hui-Ling</creator><creator>Watanabe, Norikazu</creator><creator>Asano, Taku</creator><creator>Tanno, Kaoru</creator><creator>Suyama, Jumpei</creator><creator>Namiki, Atsuo</creator><creator>Gokan, Takehiko</creator><creator>Kobayashi, Youichi</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20131101</creationdate><title>A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: comparisons of sympathetic activity and left atrial size</title><author>Akutsu, Yasushi ; Kaneko, Kyouichi ; Kodama, Yusuke ; Miyoshi, Fumito ; Li, Hui-Ling ; Watanabe, Norikazu ; Asano, Taku ; Tanno, Kaoru ; Suyama, Jumpei ; Namiki, Atsuo ; Gokan, Takehiko ; Kobayashi, Youichi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-b268fda00e14349c257b1ecc1dadf61fe6136adfd5d18e1b43296d9bb56dbcd93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Atrial Fibrillation - blood</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Biomarkers - blood</topic><topic>Cardiology</topic><topic>Chronic Disease</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Echocardiography - statistics & numerical data</topic><topic>Electrocardiography - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Atria - diagnostic imaging</topic><topic>Humans</topic><topic>Incidence</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Organ Size</topic><topic>Prevalence</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment</topic><topic>Sensitivity and Specificity</topic><topic>Stroke Volume</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akutsu, Yasushi</creatorcontrib><creatorcontrib>Kaneko, Kyouichi</creatorcontrib><creatorcontrib>Kodama, Yusuke</creatorcontrib><creatorcontrib>Miyoshi, Fumito</creatorcontrib><creatorcontrib>Li, Hui-Ling</creatorcontrib><creatorcontrib>Watanabe, Norikazu</creatorcontrib><creatorcontrib>Asano, Taku</creatorcontrib><creatorcontrib>Tanno, Kaoru</creatorcontrib><creatorcontrib>Suyama, Jumpei</creatorcontrib><creatorcontrib>Namiki, Atsuo</creatorcontrib><creatorcontrib>Gokan, Takehiko</creatorcontrib><creatorcontrib>Kobayashi, Youichi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akutsu, Yasushi</au><au>Kaneko, Kyouichi</au><au>Kodama, Yusuke</au><au>Miyoshi, Fumito</au><au>Li, Hui-Ling</au><au>Watanabe, Norikazu</au><au>Asano, Taku</au><au>Tanno, Kaoru</au><au>Suyama, Jumpei</au><au>Namiki, Atsuo</au><au>Gokan, Takehiko</au><au>Kobayashi, Youichi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: comparisons of sympathetic activity and left atrial size</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><addtitle>J Interv Card Electrophysiol</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>38</volume><issue>2</issue><spage>79</spage><epage>84</epage><pages>79-84</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><abstract>Purpose
Development 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.
Methods
P 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.
Results
Over 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].
Conclusion
The wide MPWD with elevated BNP level was associated with the progression to persistent AF.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>24026966</pmid><doi>10.1007/s10840-013-9818-2</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of interventional cardiac electrophysiology, 2013-11, Vol.38 (2), p.79-84 |
| issn | 1383-875X 1572-8595 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Aged Atrial Fibrillation - blood Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Biomarkers - blood Cardiology Chronic Disease Disease Progression Disease-Free Survival Echocardiography - statistics & numerical data Electrocardiography - statistics & numerical data Female Follow-Up Studies Heart Atria - diagnostic imaging Humans Incidence Japan - epidemiology Male Medicine Medicine & Public Health Middle Aged Natriuretic Peptide, Brain - blood Organ Size Prevalence Reproducibility of Results Risk Assessment Sensitivity and Specificity Stroke Volume |
| title | A combination of P wave electrocardiography and plasma brain natriuretic peptide level for predicting the progression to persistent atrial fibrillation: comparisons of sympathetic activity and left atrial size |
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