Association between the N-terminal plasma brain natriuretic peptide levels or elevated left ventricular filling pressure and thromboembolic risk in patients with non-valvular atrial fibrillation

Abstract Background We aimed to investigate the role of brain natriuretic peptide (BNP) levels and left ventricular (LV) filling pressures in thromboembolic risk in patients with non-valvular atrial fibrillation (AF). Methods Among 327 patients with non-valvular AF, the ratio of peak early filling velocity to mitral annulus velocity (E/Ea) and N-terminal proBNP (NT-proBNP) was compared according to the presence of left atrial appendage (LAA) dysfunction [presence of spontaneous echo contrast (SEC) ≥ grade 3 and/or reduced LAA emptying flow velocity 249.7 pg/ml (odds ratio, OR 6.79, 95% confidence interval, CI 3.16–15.55, p < 0.001) and E/Ea >10 (OR 4.41, 95% CI 2.39–8.15, p < 0.001) were independent predictors of LAA dysfunction after adjustment of known thromboembolic risk factors. Conclusion Elevated plasma NT-proBNP concentrations and LV filling pressures represented by LAA dysfunction may be reliable surrogate markers for predicting thromboembolic risk in patients with AF.