Predictive Value of Blood and Echocardiographic Indicators for Nonvalvular Atrial Fibrillation in Postmenopausal Women

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS

Annals of Noninvasive Electrocardiology Pub Date : 2025-02-25 DOI:10.1111/anec.70053

Lei Song, Xiao-Ping Shen, Jian-Rong Cai, Hong-Lei Zhang, Gui-Ru Li, Jing Shi

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引用次数: 0

Abstract

Objective

To evaluate the association and predictive value of midregional pro-atrial natriuretic peptide (MR-proANP), bone morphogenetic protein (BMP-7), and left atrial diameter (LAD) with nonvalvular atrial fibrillation (NVAF) in postmenopausal women.

Methods

This retrospective study included 288 postmenopausal women treated at Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences from January 2022 to October 2024. Patients were categorized into the NVAF and control groups based on electrocardiogram findings. Observation indicators were LAD, MR-proANP, BMP-7, homocysteine (Hcy), and free thyroxine (FT4). Echocardiography excluded valvular disease and measured LAD. Serum biomarkers were quantified using ELISA. Logistic regression identified independent risk factors, and ROC curves assessed predictive value.

Results

Of the 288 participants, 175 (61%) had NVAF. MR-proANP (425.8 vs. 289.4 nmol/L, p < 0.001), and LAD (38.4 vs. 32.5 mm, p < 0.001) were significantly higher in the NVAF group, whereas BMP-7 levels were lower (2.22 vs. 2.67 pg/L, p < 0.001). Additionally, Hcy (13.59 vs. 11.64 nmol/L, p = 0.023) and FT4 (16.91 vs. 15.85 nmol/L, p = 0.014) levels were also significantly elevated in the NVAF group. Multivariate logistic regression showed MR-proANP (OR 1.005, 95% CI 1.001–1.008), BMP-7 (OR 0.338, 95% CI 0.226–0.504), and LAD (OR 1.291, 95% CI 1.205–1.383) as independent risk factors for NVAF. Combined ROC analysis for MR-proANP, BMP-7, and LAD demonstrated an area under the curve (AUC) of 0.803, indicating superior predictive sensitivity and specificity than one indicator alone.

Conclusion

MR-proANP, BMP-7, and LAD are independent risk factors for NVAF in postmenopausal women. Their combined measurement provides valuable predictive insights, aiding in clinical decision-making.

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血液和超声心动图指标对绝经后妇女非瓣膜性心房颤动的预测价值

目的探讨中区域前房利钠肽（MR-proANP）、骨形态发生蛋白（BMP-7）、左房内径（LAD）与绝经后妇女非瓣膜性房颤（NVAF）的相关性及预测价值。方法对2022年1月至2024年10月在上海医科大学附属崇明医院接受治疗的绝经后妇女288例进行回顾性研究。根据心电图结果将患者分为非瓣膜性房颤组和对照组。观察指标为LAD、MR-proANP、BMP-7、同型半胱氨酸（Hcy）、游离甲状腺素（FT4）。超声心动图排除瓣膜疾病并测量LAD。采用ELISA对血清生物标志物进行定量分析。Logistic回归识别独立危险因素，ROC曲线评估预测价值。结果288名参与者中，175名（61%）患有非瓣膜性房颤。NVAF组MR-proANP （425.8 vs. 289.4 nmol/L, p < 0.001）和LAD （38.4 vs. 32.5 mm, p < 0.001）水平显著升高，而BMP-7水平较低（2.22 vs. 2.67 pg/L, p < 0.001）。此外，NVAF组Hcy （13.59 vs. 11.64 nmol/L, p = 0.023）和FT4 （16.91 vs. 15.85 nmol/L, p = 0.014）水平也显著升高。多因素logistic回归显示MR-proANP （OR 1.005, 95% CI 1.001-1.008）、BMP-7 （OR 0.338, 95% CI 0.226-0.504）和LAD （OR 1.291, 95% CI 1.205-1.383）为非瓣瓣性房颤的独立危险因素。MR-proANP、BMP-7和LAD的联合ROC分析显示，曲线下面积（AUC）为0.803，表明预测敏感性和特异性优于单独使用一项指标。结论MR-proANP、BMP-7、LAD是绝经后妇女非瓣瓣性房颤的独立危险因素。他们的综合测量提供了有价值的预测见解，有助于临床决策。

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来源期刊

Annals of Noninvasive Electrocardiology 医学-心血管系统

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The ANNALS OF NONINVASIVE ELECTROCARDIOLOGY (A.N.E) is an online only journal that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. ANE is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation. ANE publishes peer-reviewed articles of interest to clinicians and researchers in the field of noninvasive electrocardiology. Original research, clinical studies, state-of-the-art reviews, case reports, technical notes, and letters to the editors will be published to meet future demands in this field.