106 Determinants of B-type natriuretic peptide levels and left atrial volume in stable patients in sinus rhythm: an echocardiographic-catheterization study

Abstract

B-type natriuretic peptide (BNP) (Advia Centaur System) and left atrial volume index (LAVi) are regarded as powerful markers of global myocardial function. Several confounding factors are known to potentially influence this relation. The aim of the present study was to evaluate the determinants of BNP and LAVi in the same population of stable patients referred for catheterism. 74 consecutive patients were included. Exclusion criteria were arrhythmias, acute coronary syndrome, exacerbation of heart failure and severe left-sided valve disease. All the data were obtained within the same morning for each patient. All following variables were tested: age, gender, body mass index, systolic arterial pressure, heart rate, LV ejection fraction (LVEF), LV mass index (LVM), significant mitral regurgitation (MR), serum hemoglobin (Hb), creatinine clearance (CC), LV end-diastolic pressure (LVEDP), extent of coronary disease. Univariate determinants of BNP were age, LVEF, LVM, MR, LVEDP, extent of coronary disease, Hb and CC. By multiple regression analysis, the independant determinants of BNP were age, LVEDP and LVEF (p<0,005 for all). Univariate determinants of LAVI were age, significant MR, LVM, LVEF and LVEDP. By multiple regression analysis, the independent predictors were LVM and LVEDP (p=0,001 for all). BNP was not predicted by LAVi in the multivariate model. Our study confirms that both BNP and LAVi can be used as markers of global myocardial dysfunction in stable patients in sinus rhythm. However, age must be taken into consideration before interpreting BNP results.