The Changes Of Echocardiography And NT-proBNP And Their Relationship In Atrial Fibrillation Patients With Diastolic Dysfunction

BackgroundAtrial fibrillation is a common arrhythmia.Its rapid disorder of the wave replaces the orderly Diastolic and systolic activity.In China the incidence rate is increasing year by year [1].Due to atrial loses effective systolic and diastolic,atrial pump function is damage.Combined with irregular ventricular response can lead to overall cardiac insufficiency.Heart failure includs diastolic dysfunction and systolic dysfunction.Atrial fibrillation can lead to atrial remodeling,and atrial remodeling also aggravates the progression of atrial fibrillation.Studies have shown that NT-proBNP has closed relation with atrial fibrillation and left atrial structural changes [2] [3].At present,there are many studies about the changes of NT-proBNP in patients with atrial fibrillation,but there are few studies on atrial fibrillation patients with diastolic dysfunction.In this study,we regard the atrial fibrillation patients with diastolic dysfunction as the research object,by exploring changes and their correlation between the NT-proBNP and Echocardiographic index to evaluate the severity of these patients and find theoretical basis for the accurate diagnosis and treatment of these patients.ObjectiveTo explore the changes between echocardiography and NT-proBNP and their correlation in atrial fibrillation patients with diastolic dysfunction.MethodsA consecutive of 204 patients diagnosed as atrial fibrillation(87 paroxysmal cases and 117 persistent cases)with diastolic dysfunction were entrolled in our study.100 in-hospital diastolic dysfunction patients without atrial fibrillation were regarded as the control group.The data of echocardiography(left atrial dimension,left atrial volume index,E/Em,left ventricular ejection fraction,left ventricular end diastolic diameter),NT-proBNP and eGFR were collected.Comparison between the three groups used the analysis of ANOVA and any comparison between the two groups used LSD-q test.The correlation between NT-proBNP and echocardiography,eGFR was analysised by correlation analysis.P <0.05 was statistically significant.Results1.The level of left atrial dimension,left atrial volume index and NT-proBNP in the AF group(include Long-term persistent atrial fibrillation and Permanent atrial fibrillation)were significantly higher than those in the control group(P<0.05).2.The difference of left atrial dimension,left atrial volume index and NT-proBNP between the three groups is statistical significance(P<0.05).3.The difference of early diastolic mitral valve peak velocity E / Em,left ventricular ejection fraction,left ventricular end diastolic diameter between the three groups is statistical nonsignificance(P>0.05).4.NT-proBNP level has positive correlated with left atrial dimension(r=0.626,P<0.001),left atrial volume index(r=0.47,P =0.001).5.NT-proBNP level has no correlated with E/ Em(r=0.295,P =0.102),left ventricular ejection fraction(r=-0.216,P =0.158),left ventricular end diastolic diameter(r=0.153,P =0.417),eGFR(r=-0.238,P=0.146).Conclusions1.Left Atrial structure emerge pathological changes in Atrial fibrillation patients with diastolic dysfunction,and left Atrial enlargement in these patients.2.NT-proBNP level has positive correlated with left atrial dimension,left atrial volume index in Atrial fibrillation patients with diastolic dysfunction.3.We can predict the occurrence of atrial fibrillation by changes in left atrial structure and NT-proBNP.