Comparison of Patients with Atrial Fibrillation Without Structural Heart Disease and Normal Population In Terms of Urine Catecholamines

OBJECTIVE
This study aimed to compare the sympathetic nervous system activity of atrial fibrillation patients without structural heart disease and the normal population in terms of urinary metanephrine levels.


METHODS
Our study was conducted with 40 paroxysmal or persistent patients without structural heart disease and CHA2DS2VASc score of 0 or 1 and 40 healthy controls. Laboratory parameters, demographic characteristics, and 24-hour urine metanephrine levels were compared between the 2 groups included in the study.


RESULTS
Metanephrine value in urine was found to be significantly higher in the atrial fibrillation group (atrial fibrillation group 97.50 ± 17.19 µg/day vs. control group 74.27 ± 15.55 µg/day; P < 0.001). The body mass index of the atrial fibrillation group was found to be significantly higher than the control group (atrial fibrillation group 27.26 ± 2.97 kg/m2 vs. control group 24.05 ± 2.24 kg/m2; P < 0.001). In multivariate linear regression analysis, body mass index (beta: 0.266, P =.02) and urinary metanephrine level (beta: 0.522, P = 0.002) were found to be independent risk factors. According to receiver operating characteristic analysis, it was determined that urinary metanephrine value (area under the curve = 0.834, P < 0.001) and body mass index (area under the curve = 0.803, P < 0.001) predicted the development of atrial fibrillation.


CONCLUSION
Our study found that urinary metanephrine levels were higher in patients with atrial fibrillation without structural heart disease than those without atrial fibrillation, and metanephrine values predicted the development of atrial fibrillation.