Abstract 504: Significant Association Between Atrial and Ventricular Echocardiographic Findings and Cardiac Circulating Biomarkers in Patients With a History of Atrial Fibrillation: Data From the GISSI-AF Trial
Objective: Patients with atrial fibrillation (AF) may present with remodeling of atrial and left ventricular chambers and activation of neurohormonal systems. We evaluated the association between these two compensatory mechanisms in pts with a history of AF.
Methods: Echocardiographic parameters [left atrial diameter (LAD/BSA) and volume (LAV/BSA), left ventricular end diastolic volume (LVEDV/BSA) and ejection fraction (LVEF)] and plasma biomarkers [mid-regional proatrial natriuretic peptide (MR-proANP), N-terminal proBNP (NT-proBNP) and high sensitive troponin T (hsTnT)] were measured at baseline in central core labs in 306 pts with a history of AF enrolled in the multicenter GISSI-AF trial. The association between echo variables and biomarkers was tested with ANOVA, adjusting for age, gender and creatinine.
Results: Pts presented with abnormal LAV (median = 42.2 mL/m2, more than half with severely abnormal), but normal LVEF (median = 63%), and modestly elevated circulating biomarkers (MR-proANP = 161 pmol/L [112–229], NT-proBNP 191 pg/mL [91–331], hsTnT 8.2 pg/mL [5.6 –13.0]). There was a strong association between the three cardiac markers and LA volume (Figure⇓) or diameter (all p<0.0001), somewhat weaker with LV morphology and function. Such associations were not observed for a marker of inflammation (CRP, p = ns).
Conclusion: We observed for the first time in a multicenter setting and in a large number of pts in sinus rhythm with a history of AF, a strong and specific association between novel circulating cardiac biomarkers and the morphology of the left atrium.
Association between circulating cardiac biomarkers (by tertiles) and LAV/BSA. P for adjusted ANOVA.