慢性心房颤动患者血浆脑钠肽水平相关因素分析

目的 探讨影响慢性心房颤动(CAF)患者血浆B型脑钠肽(BNP)水平的相关因素。方法 采用免疫荧光定量测定法检测222例CAF患者[按左心室射血分数(LVEF)高低分为LVEF≥50％组147例,与LVEF＜50％组75例的血浆BNP含量;采用多普勒超声心动图判断LVEF;同时测定患者血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、肌酐、尿素氮、肌酸;并记录患者的高血压病史、糖尿病病史、吸烟史。结果 BNP含量在LVEF＜ 50％组较≥50％组明显升高(平均秩,158.00和87.78,Z=-7.705,P＜0.001);Logistic回归分析提示:男性(OR 13.115,95％ CI 3.382 ～50.860,P＜0.001)、高血压病史(OR 3.710,95％ CI 1.104 ～ 12.472,P=0.034)、低总胆固醇(OR 0.397,95％ CI 0.214～0.735,P=0.003)、LVEF(OR 0.791,95％ CI 0.723 ～0.867,P＜0.001)、吸烟史(OR4.660,95％ CI 1.256 ～ 17.281,P=0.021)是BNP升高的独立危险因子。结论 在CAF患者中低左心室射血分数、男性、高血压史、低总胆固醇及吸烟史是血浆BNP水平升高的独立预测因子。     

Diurnal variation of arterial stiffness and subendocardial perfusion noninvasively assessed using applanation tonometry in healthy young men

BACKGROUND: Arterial stiffness is at least partially controlled by vascular tone. Vascular tone and underlying physiological processes, e.g. sympathetic activity, have been shown to follow diurnal variations. METHODS: This study investigated whether arterial stiffness and perfusion of subendocardial myocardium relative to cardiac workload show diurnal variations under physiological conditions. The aortic augmentation index (AIx) and subendocardial viability ratio (SEVR) were measured noninvasively in 26 healthy young men (27.6 +/- 3.4 years) using applanation tonometry at three different times (8:00, 12:00, 17:00) during one day. RESULTS: Mean AIx was significantly higher and mean SEVR significantly lower at 8:00 than at the later times. No significant differences were found between mean AIx and mean SEVR at 12:00 and at 17:00. CONCLUSIONS: The observed diurnal variations of AIx and SEVR will be of value when applanation tonometry is used in human research. In order to arrive at comparable data in longitudinal investigations, measurements should be made at similar times during the course of a day. In addition, our observation should assist in studies in which novel pharmacological compounds with activity on the vasculature are investigated.     

新活素对术后肺动脉高压患者NT-proBNP及血流动力学的影响

目的观察新活素-重组人脑利钠肽(rh BNP)对临床心血管外科手术后肺动脉高压患者的治疗作用及NT-pro BNP和血流动力学的变化情况。方法将行冠状动脉旁路移植术、二尖瓣置换术后仍出现肺动脉高压患者随机分为2组,治疗组45例术后进行常规治疗,对照组45例术后给予新活素治疗。比较时间点NT-pro BNP水平及血流动力学指标,了解心脏恢复状态,判断手术预后。结果与对照组相比,治疗组术后即刻NT-pro BNP显著低于术前(P0.05),心率及肺动脉压更趋于稳定,左室舒张末直径(LVEDD)降低,射血分数(EF)增加(P0.05)。结论新活素能有效降低患者术后血浆NT-pro BNP的水平,稳定心率,降低肺动脉压。     

急性心肌梗死患者血浆BNP、ET、CRP、ANP水平变化与临床观察分析

目的　观察急性心肌梗死 (AMI)患者血浆中B型钠尿肽 (BNP)、内皮素 (ET)、C 反应蛋白 (CRP)、A型钠尿肽 (ANP)水平变化 ,为治疗及预后判断提供依据。方法　应用酶联免疫法及免疫放射分析法对 4 6例AMI患者治疗前后和 30名正常对照者血浆中BNP、ET、CRP、ANP水平进行检测。结果　AMI患者血浆中BNP、ET、CRP、ANP治疗前后比较差异有显著性 (P <0 .0 0 1) ,正常对照组与AMI治疗前比较差异有显著性 (P<0 .0 0 1) ,BNP与CRP在AMI治疗前水平呈正相关 (r =0 .874 ) ,治疗后呈明显的下降趋势 (r =0 .6 5 4 ) ,AMI治疗前后ANP与ET呈正相关 ,但AMI经溶栓和相应的支持治疗后ANP基本恢复到正常水平 (P >0 .0 5 ) ,而BNP、ET、CRP水平虽然下降明显 ,但与正常组比较差异仍有显著性 (P <0 .0 5 )。结论　AMI患者血浆中BNP、ANP、ET、CRP水平的变化说明其参与了AMI的发生、发展 ,特别是冠状动脉粥样斑块的形成和 (或 )破裂及血栓形成 ,其炎症因子是主要因素。因此 ,4项指标的观察分析对AMI治疗、预后判断具有重要意义     

急性心肌梗死患者血浆BNP、ET、CRP、ANP水平变化与临床观察分析

目的观察急性心肌梗死(AMI)患者血浆中B型钠尿肽(BNP)、内皮素(ET)、C-反应蛋白(CRP)、A型钠尿肽(ANP)水平变化,为治疗及预后判断提供依据.方法应用酶联免疫法及免疫放射分析法对46例AMI患者治疗前后和30名正常对照者血浆中BNP、ET、CRP、ANP水平进行检测.结果 AMI患者血浆中BNP、ET、CRP、ANP治疗前后比较差异有显著性(P<0.001),正常对照组与AMI治疗前比较差异有显著性(P<0.001),BNP与CRP在AMI治疗前水平呈正相关(r=0.874),治疗后呈明显的下降趋势(r=0.654),AMI治疗前后ANP与ET呈正相关,但AMI经溶栓和相应的支持治疗后ANP基本恢复到正常水平(P>0.05),而BNP、ET、CRP水平虽然下降明显,但与正常组比较差异仍有显著性(P<0.05).结论 AMI患者血浆中BNP、ANP、ET、CRP水平的变化说明其参与了AMI的发生、发展,特别是冠状动脉粥样斑块的形成和(或)破裂及血栓形成,其炎症因子是主要因素.因此,4项指标的观察分析对AMI治疗、预后判断具有重要意义.     

Immunoreactive N-terminal pro-atrial natriuretic peptide in human plasma: plasma levels and comparisons with alpha-human atrial natriuretic peptide in normal subjects, patients with essential hypertension, cardiac transplant and chronic renal failure

1. Plasma levels of immunoreactive N-terminal pro-atrial natriuretic peptide (N-terminal ANP) have been measured in 25 normal subjects, 29 patients with essential hypertension, six cardiac transplant recipients, seven patients with dialysis-independent chronic renal failure and 11 patients with haemodialysis-dependent chronic renal failure. Plasma was extracted on Sep-Pak cartridges and N-terminal ANP immunoreactivity was measured using an antibody directed against pro-ANP (1-30). 2. Plasma levels of N-terminal ANP (means +/- SEM) were 235.3 +/- 19.2 pg/ml in normal subjects and were significantly raised in patients with essential hypertension (363.6 +/- 36.3 pg/ml), in cardiac transplant recipients (1240.0 +/- 196.2 pg/ml), in patients with chronic renal failure not requiring dialysis (1636.6 +/- 488.4 pg/ml) and patients with chronic renal failure on maintenance haemodialysis (10336.1 +/- 2043.7 pg/ml). 3. There were positive and significant correlations between the plasma levels of N-terminal ANP and alpha-human ANP (alpha-hANP) with individual correlation coefficients of 0.68 within the normal subjects, 0.47 in patients with essential hypertension, 0.78 in patients with dialysis-independent chronic renal failure and 0.68 in patients with haemodialysis-dependent chronic renal failure (P less than 0.05 in every case).(ABSTRACT TRUNCATED AT 250 WORDS)     

Prognostic value of increased plasma levels of brain natriuretic peptide in patients with septic shock

Our objective was to investigate the plasma levels of brain and atrial natriuretic peptides (BNP and ANP, respectively) in patients with septic shock/severe sepsis and to study the association of BNP and ANP levels with hemodynamic parameters, severity of the disease, and prognosis of those patients. This is a prospective case series study of 22 patients with septic shock, 11 patients with severe sepsis, and 20 healthy volunteers at the Department of Emergency and Critical Care Medicine, Nara Medical University Hospital, Japan. Blood collection was performed on admission and on days 1, 2, and 4. Plasma BNP and ANP levels were measured by radioimmunoassay. Right atrial pressure, mean pulmonary arterial pressure, pulmonary arterial wedge pressure, and left ventricular stroke work index were determined using a thermodilution catheter. Acute Physiological and Chronic Health Evaluation II scores were calculated. Plasma levels of BNP and ANP were markedly elevated in patients with septic shock/severe sepsis compared with controls (BNP, 7 +/- 0.3 pg mL; ANP, 13 +/- 1 pg mL). In patients with septic shock, both BNP and ANP peaked on day 2 (BNP, 987 +/- 160 pg mL; ANP, 103 +/- 17 pg mL). Plasma levels of BNP on day 2 in patients with septic shock significantly correlated with right atrial pressure (r = 0.744, P < 0.01), mean pulmonary arterial pressure (r = 0.670, P < 0.01), pulmonary arterial wedge pressure (r = 0.709, P < 0.01), left ventricular stroke work index (r = -0.552, P < 0.05), Acute Physiological and Chronic Health Evaluation II score (r = 0.581, P < 0.01), and poor prognosis (P < 0.05). The optimal cutoff point for predicting mortality in patients with septic shock was a BNP level of 650 pg mL on day 2, in which sensitivity and specificity were 92% and 80%, respectively. Increased plasma levels of BNP may reflect not only the severity of myocardial depression but also the disease severity and could be of prognostic value in patients with septic shock.     

Analytical correlation between plasma N-terminal pro-brain natriuretic peptide and brain natriuretic peptide in patients presenting with dyspnea

OBJECTIVES: We examined the analytical correlation N-terminal pro-brain natriuretic peptide (NT-proBNP) and brain natriuretic peptide (BNP). DESIGN AND METHODS: Electrochemiluminescence and fluorescence immunoassays were used to measure NT-proBNP and BNP levels, respectively. RESULTS: The analytical correlation was satisfactory using the equation: NT-proBNP = 8.56 x BNP + 91.7 and a correlation r = 0.85. The correlation was not influenced by age, gender and BMI of patients. CONCLUSIONS: We conclude that NT-proBNP correlates with BNP.     

非瓣膜病心房纤颤患者心功能参数比较及其与血浆脑钠肽水平的相关性分析

目的探讨二尖瓣舒张早期血流速度(E)与二尖瓣环舒张早期运动速度(E′)之比(E/E′)对非瓣膜病心房纤颤患者心脏功能进行早期准确评估的可行性及其与血浆脑钠肽水平的相关性。方法将478例非瓣膜病心房纤颤患者按有无心力衰竭症状分为NYHAⅠ级组94例、NYHAⅡ级组144例、NYHAⅢ级组128例及NYHAⅣ级组112例,比较4组患者的临床资料及超声心动图参数,并分析各参数与血浆脑钠肽水平相关性。结果与NYHAⅠ级组和NYHAⅡ级组比较,NYHAⅢ级组和NYHAⅣ级组E/E′、左房收缩末期内径、左房收缩末期面积及血浆脑钠肽水平均增加(均P0.05),左室射血分数下降(P0.05)。随着心房纤颤患者心力衰竭症状的加重,E/E′逐渐增加,与NYHA分级相一致。左房收缩末期内径、左房收缩末期面积及E/E′均与血浆脑钠肽水平呈正相关,与左室射血分数呈负相关。与左房收缩末期内径、左房收缩末期面积及左室射血分数比较,E/E′与血浆脑钠肽水平相关性最强(r=0.701,P0.01)。结论 E/E′值是心房纤颤患者心力衰竭进程中评估心脏功能状态的可靠指标。     

Concentrations of atrial natriuretic peptide in plasma and urine of kidney disease patients

Concentrations of human atrial natriuretic peptide-like immunoreactivity (hANP-LI) were measured by a highly sensitive and specific radioimmunoassay (Biochem Biophys Res Commun 1986;137:231-6) in normal subjects and in renal disease patients without accompanying congestive heart failure, hypertension, edema, diabetes, or pregnancy. We attempted to clarify whether the hANP-LI concentration in plasma was increased by loss of renal mass. We found no correlation between the hANP-LI concentration in plasma and creatinine clearance (Ccr, 4.6-122.3 mL/min) in patients with renal disease (n = 63, r = -0.196), nor between hANP-LI concentrations in plasma and urine (n = 97, r = -0.207). The fractional excretion of hANP (FEhANP) correlated significantly with Ccr (n = 63, r = 0.520, P less than 0.01) and with FENa (n = 35, r = -0.503, P less than 0.01). Increased FEhANP in patients with chronic renal failure may have resulted because of an increase in single-nephron glomerular filtration rate similar to the FENa increase in these patients. The present data indicate that decreased renal function itself does not increase the concentration of hANP-LI in plasma.     

Association of plasma bone morphogenetic protein‐4 levels with arterial stiffness in hypertensive patients

BackgroundArterial stiffness interacts with hypertension, becoming an early marker of hypertension‐mediated target organ damage. This study aimed to assess the association between plasma concentrations of bone morphogenetic protein‐4 (BMP‐4) and arterial stiffness during hypertension.MethodsUsing cardio‐ankle vascular index (CAVI) to determine arterial stiffness status, 204 individuals with essential hypertension were classified into two groups, high CAVI (abnormal) group (n = 94) and low (normal) CAVI group (n = 110). Data were collected including clinical characteristics and laboratory measurements. Plasma levels of BMP‐4 were tested by using ELISA analysis.ResultsPlasma levels of BMP‐4 were substantially greater in high CAVI group than that in low CAVI group [38.51 (31.79–50.83) pg/mL vs. 31.15 (29.38–32.37) pg/mL; p < 0.001]. As shown by spearman correlation analysis, BMP‐4 concentrations were correlated with CAVI values in hypertensive individuals (r = 0.406, p < 0.001). After adjustment for potential confounders, elevated BMP‐4 levels were related with high CAVI (OR, 1.070; 95% CI, 1.003–1.108; p < 0.001). The best BMP‐4 cutoff value for identifying high CAVI, as determined by ROC curve analysis, was 33.34 pg/mL (AUC, 0.751; 95% CI, 0.683–0.818; p < 0.001).ConclusionPlasma levels of BMP‐4 are increased in hypertensive individuals with high CAVI. Elevated BMP‐4 levels are strongly correlated with higher CAVI values, implying a predictive value of BMP‐4 in arterial stiffness during hypertension.     

Correlation of the myocardial performance index with plasma B-type natriuretic peptide levels in patients with mitral regurgitation

Objective The Myocardial performance index (MPI) is an echocardiographic index of combined systolic and diastolic function, calculated as isovolumetric relaxation time plus isovolumetric contraction time divided by ejection time. The aim of this study was to define the correlation of the MPI with plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters in patients with chronic mitral regurgitation (MR). Methods About 33 patients with at least moderate MR of organic etiology were enrolled to the study. All patients undergone complete 2D and Doppler echocardiography. Plasma BNP levels were studied. Results BNP levels in NYHA classes I–III were 9.3 ± 2.2 pg/ml, 61.3 ± 12.2 pg/ml, and 199.6 ± 55.2 pg/ml, respectively (I vs. II P < 0.001, I vs. III P < 0.001 and II vs. III P = 0.004). Myocardial performance index were 0.42 ± 0.02, 0.49 ± 0.02, and 0.52 ± 0.03 in MR patients with NYHA I–III, respectively. MPI was significantly higher in patients with NYHA class III compared to NYHA I (P = 0.001) and NYHA II (P = 0.005). There were no correlations between MPI and left atrial diameter, MR jet area, MR index and systolic pulmonary artery pressure whereas left ventricle (LV) end-systolic volume (r = 0.38), LV end-diastolic volume (LVDV) (r = 0.40), LV ejection fraction (r = −0.59), NYHA class (r = 0.51) and plasma BNP levels (r = 0.67) were strongly correlated. Only independent variable affecting MPI was plasma BNP level (odds ratio [CI]: 2.18[0.002−0.098], P = 0.041). Conclusions MPI is a powerful index in assessing the severity of left ventricular function and symptom severity in patients with MR. Plasma BNP is an independent predictor of MPI where both parameters assess combined systolic and diastolic LV function, effectively.     

Ischemia-modified albumin and NT-prohormone-brain natriuretic peptide in peripheral arterial disease.

Cardiovascular disease is the leading cause of mortality and morbidity in Western countries. Despite its remarkable medical and social consequences, the prevalence of peripheral arterial disease (PAD) is often underestimated among atherosclerotic disorders. So far, little is known about the behavior of traditional and emerging markers of ischemic heart disease that should allow the reliable identification of PAD patients at increased risk of developing myocardial ischemia and heart failure or dysfunction. To investigate this topic, we measured cardiac troponin T (cTnT), ischemia-modified albumin (IMA) and NT-prohormone-brain natriuretic peptide (NT-proBNP) in 35 consecutive patients with clinically ascertained PAD (stage 2-4, according to Lériche-Fontaine) asymptomatic for chest pain and current heart failure, and 20 controls displaying moderate to high cardiovascular risk factors (hypertension, diabetes, hyperlipidemia), but with no clinical evidence of PAD. Although the concentrations of cTnT and IMA were not statistically increased in PAD patients, NT-pro-BNP values were substantially higher in PAD patients than in controls (62.6 vs. 7.4 pmol/L, p<0.0001). The percentage of subjects displaying values exceeding the specific NT-proBNP diagnostic threshold (>14.8 pmol/L) was also significantly different between PAD patients and controls (74% vs. 10%, p<0.001). After excluding PAD patients exceeding the 0.01 ng/mL cTnT cutoff value indicative of current ischemic cardiac involvement, the median concentration of NT-proBNP remained statistically increased (28.0 vs. 5.8 pmol/L, p<0.0001). Taken together, these results indicate that NT-proBNP, but not IMA, is substantially increased in PAD patients. This finding suggests that such patients, even though asymptomatic, might develop myocardial dysfunction, and thus warrant further investigation.     

瑞舒伐他汀对冠心病合并慢性心力衰竭患者临床疗效及血浆脑钠肽的影响

目的 观察瑞舒伐他汀对冠心病合并慢性心力衰竭患者(CHF)临床疗效及血浆脑钠肽(BNP)水平的影响.方法 80例冠心病并CHF患者随机分为治疗组和对照组各40例,对照组患者给予抗心力衰竭的常规治疗;治疗组在对照组基础上加用瑞舒伐他汀钙治疗,每晚餐时服用20 mg,1次/d.两组均治疗6个月.两组分别于治疗前及治疗6个月后测定左室心功能指标及血浆BNP水平.同时观察临床症状、体征及药物不良反应.结果 治疗6个月后治疗组总有效率显著高于对照组(P<0.05);治疗组的心功能指标及血浆BNP水平的改善均优于对照组(P<0.05,或P<0.01).结论 CHF患者在常规治疗同时加用瑞舒伐他汀治疗,可以显著降低血浆BNP水平,改善心功能.     

瑞舒伐他汀对冠心病合并慢性心力衰竭患者临床疗效及血浆脑钠肽的影响

目的 观察瑞舒伐他汀对冠心病合并慢性心力衰竭患者(CHF)临床疗效及血浆脑钠肽(BNP)水平的影响.方法 80例冠心病并CHF患者随机分为治疗组和对照组各40例,对照组患者给予抗心力衰竭的常规治疗;治疗组在对照组基础上加用瑞舒伐他汀钙治疗,每晚餐时服用20 mg,1次/d.两组均治疗6个月.两组分别于治疗前及治疗6个月后测定左室心功能指标及血浆BNP水平.同时观察临床症状、体征及药物不良反应.结果 治疗6个月后治疗组总有效率显著高于对照组(P<0.05);治疗组的心功能指标及血浆BNP水平的改善均优于对照组(P<0.05,或P<0.01).结论 CHF患者在常规治疗同时加用瑞舒伐他汀治疗,可以显著降低血浆BNP水平,改善心功能.     

瑞舒伐他汀对冠心病合并慢性心力衰竭患者临床疗效及血浆脑钠肽的影响

目的观察瑞舒伐他汀对冠心病合并慢性心力衰竭患者（CHF）临床疗效及血浆脑钠肽（BNP）水平的影响。方法80例冠心病并CHF患者随机分为治疗组和对照组各40例,对照组患者给予抗心力衰竭的常规治疗;治疗组在对照组基础上加用瑞舒伐他汀钙治疗,每晚餐时服用20mg,1次／d。两组均治疗6个月。两组分别于治疗前及治疗6个月后测定左室心功能指标及血浆BNP水平。同时观察临床症状、体征及药物不良反应。结果治疗6个月后治疗组总有效率显著高于对照组（P〈0．05）;治疗组的心功能指标及血浆BNP水平的改善均优于对照组（P〈0．05,或P〈0．01）。结论CHF患者在常规治疗同时加用瑞舒伐他汀治疗,可以显著降低血浆BNP水平,改善心功能。     

急性脑损伤患者血浆和脑脊液中心钠素含量的分析

目的：探讨急性脑损伤患者血浆和脑脊液中心钠素（ＡＮＰ）含量的改变及其临床意义。方法：采用放射免疫法测定９０例急性脑外伤患者（病例组）与３０例非神经系统疾病患者（对照组）血浆和脑脊液中ＡＮＰ含量，对病例组中５３例进行颅内压监护。结果：病例组伤后血浆和脑脊液中ＡＮＰ含量较对照组均降低，２４小时脑脊液中ＡＮＰ为最低，第６日血浆中ＡＮＰ最低；脑脊液中ＡＮＰ在不同类型脑损伤组间有显著性差异（Ｐ均＜０．０１），且其含量越低者，颅内压越高，当脑脊液中ＡＮＰ低于（３０１．５４±７９．６１）ｎｇ／Ｌ时提示预后不良。结论：测定脑脊液中ＡＮＰ含量较血浆能更直接、更准确地反映脑损伤的程度和范围，为监测病情和推测预后的可靠指标；及时补充外源性ＡＮＰ，可减轻脑水肿，提高救治水平。     

儿童先天性心脏病手术前后血浆脑钠肽变化的影响因素

目的通过对先天性心脏病(先心病)患儿手术前后血浆中脑钠肽(brain natriuretic peptide,BNP)的动态测定,了解不同先心病类型、手术过程等因素对BNP的影响。方法收集100例全身麻醉下进行小儿先心病手术的患儿做为研究对象,分为5种先心病类型。分别于术前、术后1天、2天、7天取患儿静脉血2ml检测BNP。结果先心病5组患儿术前BNP差异无统计学意义。术后BNP值组间差异有统计学意义。术后1天BNP与年龄(rs=-0.556,P<0.01)、体质量(rs=-0.489,P<0.01)、体外循环时间(rs=0.539,P<0.01)、机械通气时间(rs=0.354,P<0.01)存在相关关系。术后2天BNP与体外循环时间(rs=0.431,P<0.01)存在正相关关系,术后7天BNP与体外循环时间(rs=0.598,P<0.01)、术后1天乳酸水平(rs=0.357,P<0.05)存在正相关关系。结论不同先心病类型的患儿的术前BNP差异无统计学意义。术后BNP与体外循环时间存在较强的正相关性。     

持续性心房颤动导管消融前后血浆脑钠肽水平的变化

目的 观察持续性心房颤动(简称房颤)导管消融前后血浆脑钠肽(BNP)水平的变化.方法 测定68例持续性房颤且无器质性心脏病患者导管消融术前及术后90 d的血浆BNP水平.结果 在导管消融后大于3个月的随访中,12例(18%)患者复发心房扑动或房颤.导管消融后3个月血浆BNP水平由术前(80±17)ng/L降为(27±9)ng/L,与术前比较差异有统计学意义(P＜0.01).12例复发房性心律失常患者中,术后血浆BNP为(44±8)ng/L,而维持窦性心律者术后血浆BNP为(25±8)ng/L,两者差异有统计学意义(P＜0.01).结论 持续性房颤导管消融后BNP水平下降,且术后维持窦性心律组BNP水平明显低于复发房性心律失常组.     

Association of elevated plasma B-type natriuretic peptide levels with paroxysmal atrial fibrillation in patients with nonobstructive hypertrophic cardiomyopathy

OBJECTIVES: To investigate the relationship between the plasma B-type natriuretic peptide (BNP) level and the occurrence of atrial fibrillation (AF) in nonobstructive hypertrophic cardiomyopathy (HCM) patients. METHODS: Patients (n=97) were classified into chronic AF (CAF; n=14), paroxysmal AF (PAF; n=18) and normal sinus rhythm (NSR; n=65) groups. The plasma BNP values were analyzed with logarithmic transformation. RESULTS: The PAF group showed significantly higher plasma BNP levels than the NSR group [mean (range; -l SD and +1 SD); 248.3 (143.5, 429.5) vs. 78.2 (27.9, 218.8 ng/L), p<0.0001]. The CAF group also showed significantly higher plasma BNP levels than the NSR group [291.1 (161.4, 524.8 ng/L), p<0.0001]. Multivariate analysis with other clinical factors selected association of PAF as one of the factors that increased the plasma BNP level. CONCLUSIONS: The present study indicated that plasma BNP level is clinically useful for identification of nonobstructive HCM patients who have a risk of PAF.