Abstract 10946: Elevated Plasma Brain Natriuretic Peptide Levels Predict Left Atrial Appendage Dysfunction in Patients With Acute Ischemic Stroke
It is well known that left atrial appendage (LAA) dysfunction plays an important role in the occurrence of cardioembolic stroke. The atrium is the main source of brain natriuretic peptide (BNP) in patients with atrial fibrillation but not in those with heart failure. Therefore, we hypothesized that the plasma BNP level would be a sensitive predictor of LAA dysfunction and thrombus formation in patients with acute ischemic stroke. Transthoracic and transesophageal echocardiography were performed and plasma BNP levels were measured in 223 patients (145 males, 78 females, mean age 69 ± 14 years), within 7 days after the onset of acute ischemic stroke. None of the patients had a history of congestive heart failure. LAA thrombus was detected in 23 of 77 (30%) patients with atrial fibrillation. Plasma BNP levels were markedly higher in patients with cardioembolic stroke compared to those without (144 vs. 35 pg/ml, p<0.05). Furthermore, among patients with cardioembolic stroke, plasma BNP levels were markedly higher in patients with cardiogenic stroke, as diagnosed by transesophageal echocardiography, than in those with cryptogenic stroke (193 vs. 14 pg/ml, p<0.05). Plasma BNP levels were correlated with LAA emptying flow velocity (LAA eV) (r=−0.436, p<0.01). Multivariate logistic regression analysis showed that plasma BNP level >90 pg/ml was an independent predictor of cardiogenic stroke (odds ratio 41.39, 95% confidence interval 1.28–138; p=0.0358). In conclusion, elevated plasma BNP levels may be a reliable surrogate marker of LAA dysfunction and thrombus formation in patients with acute ischemic stroke.
- © 2010 by American Heart Association, Inc.