Natriuretic peptide levels predict recurrence of atrial fibrillation after radiofrequency catheter ablation
Natriuretic peptide levels predict recurrence of atrial fibrillation after radiofrequency catheter ablation
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DOI：
10.1016/j.ahj.2010.09.031
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发表时间：
2011-01-01
影响因子：
4.8
通讯作者：
Bax, Jeroen J.
中科院分区：
文献类型：
--
作者：
den Uijl, Dennis W.;Delgado, Victoria;Bax, Jeroen J.
背景心房颤动（AF）的发生与利钠肽水平升高有关。此外，利钠肽水平升高可预测AF的发生。然而，目的探讨利钠肽对房颤射频消融术（RFCA）后房颤复发的预测作用。方法术前测定心房利钠肽氨基末端前体（AEP），并与术后12个月的随访结果进行比较。在87例接受RFCA治疗的症状性药物难治性AF患者中测定了NT-proANP和氨基末端-pro-B型利钠肽（NT-proBNP）血浆水平。此外，在基线时进行了全面的临床和超声心动图评估。评估左心房容积、左心室容积和功能（收缩和舒张）。在6个月的随访期间，监测AF复发，并将其定义为心电图上的任何AF记录或24小时霍尔特监测中AF发作时间超过30秒。结果在随访期间，66例（76%）患者维持窦性心律，而21例（24%）患者有AF复发。AF复发患者的基线利钠肽水平高于维持窦性心律的患者（NT-proANP 3.19 nmol/L [2.55 - 4.28] vs 2.52 nmol/L [1.69 - 3.55]，P = 0.030; NT-proBNP 156.4 pg/mL [64.1 - 345.3] vs 84.6 pg/mL [43.3 - 142.7]，P = 0.036）。然而，NT-proBNP是AF复发的独立预测因子，而NT-proANP不是。结论基线血浆NT-proBNP水平是RFCA术后房颤复发的独立预测指标。(Am Heart J 2011; 161：197 - 203.）
Background The presence of atrial fibrillation (AF) is related to increased levels of natriuretic peptides. In addition, increased natriuretic peptide levels are predictive of the development of AF. However, the role of natriuretic peptides to predict recurrence of AF after radiofrequency catheter ablation (RFCA) is controversial.Objective The study aimed to investigate the role of natriuretic peptides in the prediction of AF recurrence after RFCA for AF.Methods Pre-procedural amino-terminal pro-atrial natriuretic peptide (NT-proANP) and amino-terminal-pro-B-type natriuretic peptide (NT-proBNP) plasma levels were determined in 87 patients undergoing RFCA for symptomatic drug-refractory AF. In addition, a comprehensive clinical and echocardiographic evaluation was performed at baseline. Left atrial volumes, left ventricular volumes, and function (systolic and diastolic) were assessed. During a 6-month follow-up period, AF recurrence was monitored and defined as any registration of AF on electrocardiogram or an episode of AF longer than 30 seconds on 24-hour Holter monitoring. The role of natriuretic peptide plasma levels to predict AF recurrence after RFCA was studied.Results During follow-up, 66 patients (76%) maintained sinus rhythm, whereas 21 patients (24%) had AF recurrence. Patients with AF recurrence had higher baseline natriuretic peptide levels than patients who maintained sinus rhythm (NT-proANP 3.19 nmol/L [2.55-4.28] vs 2.52 nmol/L [1.69-3.55], P = .030; NT-proBNP 156.4 pg/mL [64.1-345.3] vs 84.6 pg/mL [43.3-142.7], P = .036). However, NT-proBNP was an independent predictor of AF recurrence, whereas NT-proANP was not. Moreover, NT-proBNP had an incremental value over echocardiographic characteristics to predict AF recurrence after RFCA.Conclusion Baseline NT-proBNP plasma level is an independent predictor of AF recurrence after RFCA. (Am Heart J 2011;161:197-203.)