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Carotid-femoral pulse wave velocity is associated with N-terminal pro-B-type natriuretic peptide level in patients with atrial fibrillation
  1. Lin Y Chen1,2,
  2. Bee C Tai3,
  3. David C Foo4,
  4. Raymond C Wong5,
  5. A Selcuk Adabag6,
  6. David G Benditt1,
  7. Lieng H Ling2
  1. 1Department of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2Department of Medicine, Cardiovascular Division, National University of Singapore, Singapore
  3. 3Department of Epidemiology and Public Health, National University of Singapore, Singapore
  4. 4Cardiology Department, Tan Tock Seng Hospital, Singapore
  5. 5Cardiac Department, National University Hospital, Singapore
  6. 6Division of Cardiology, Veterans Affairs Medical Centre, Minneapolis, Minnesota, USA
  1. Correspondence to Lin Y Chen, Department of Medicine, Cardiovascular Division, University of Minnesota Medical School, 420 Delaware Street SE, MMC 508, Minneapolis, MN 55455, USA; chenx484{at}


Objective To determine the extent to which conduit artery stiffness is associated with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with atrial fibrillation (AF).

Design Cross-sectional study.

Setting National University Hospital, Singapore.

Patients Cases (n=117) were patients with AF onset <65 years of age without heart failure or structural heart disease. Controls (n=274) were patients without AF who were seen at the general cardiology clinic.

Interventions Transthoracic echocardiography, carotid-femoral pulse wave velocity (CFPWV) measured using applanation tonometry and blood draw for plasma NT-proBNP at enrolment for all patients.

Main outcome measures Plasma NT-proBNP.

Results In patients with AF, CFPWV was associated with NT-proBNP after adjusting for hypertension and factors that were univariately associated with NT-proBNP: age at enrolment, type of AF, body mass index, left ventricular mass index, left atrial volume index, mitral E/E′, mitral deceleration time and use of β-blockers (β=0.234; 95% CI 0.100 to 0.367; p=0.001). In contrast, CFPWV was not associated with NT-proBNP in controls. In patients with AF, the adjusted mean NT-proBNP level in the highest quartile of CFPWV (350 pg/ml; 95% CI 237 to 517 pg/ml) was fivefold higher than the lowest quartile (69 pg/ml; 95% CI 47 to 103 pg/ml) (p=0.001).

Conclusions CFPWV is associated with NT-proBNP level in AF. Since elevated NT-proBNP is a marker of adverse cardiovascular outcomes, arterial stiffness may be associated with worse prognosis in patients with AF.

  • Atrial fibrillation
  • N-terminal pro-B-type natriuretic peptide
  • arterial stiffness
  • carotid-femoral pulse wave velocity

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  • Funding This work was supported by a research grant NMRC/1141/2007 from the National Medical Research Council of Singapore (awarded to LYC).

  • Competing interests None

  • Ethics approval This study was conducted with the approval of the National University of Singapore Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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