Drop in plasma brain natriuretic peptide levels after successful direct current cardioversion in chronic atrial fibrillation.
Drop in plasma brain natriuretic peptide levels after successful direct current cardioversion in chronic atrial fibrillation.
复制标题
慢性心房颤动成功直流电复律后血浆脑钠肽水平下降。
DOI：
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发表时间：
2001
期刊：
影响因子：
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通讯作者：
Y. Ishibashi
中科院分区：
文献类型：
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作者：
Y. Ohta;T. Shimada;H. Yoshitomi;S. Inoue;Y. Murakami;H. Shimizu;K. Nakamura;T. Ohta;H. Katoh;Y. Ishibashi
背景
根据以往的报道，心房颤动（AF）时血浆心钠素水平升高，直流电（DC）复律成功后降低，但血浆脑钠素（BNP）未见报道。
目的
确定慢性房颤患者成功直流电复律后血浆BNP水平是否降低。
患者和方法
20例患者在心脏复律后保持窦性心律至少7天，20名正常对照受试者，进行了研究。A组10例，包括扩张型心肌病2例，肥厚型心肌病1例，二尖瓣病变3例，高血压性心脏病3例，房间隔封堵术后1例。B组为单纯房颤患者10例，C组为正常窦性心律、无危险因素者20例。
结果
复律前A组（176.7 ± 128.1 ng/mL）和B组（96.8 ± 51.7 ng/ml）血浆BNP水平均高于C组（6.3 ± 3.8 ng/ml）（均P<0.01）。成功复律后，A组和B组的平均血浆BNP水平从136.8 ± 105.5 ng/mL降至46.4 ± 44.2 ng/mL（P<0.01）。A组血浆BNP水平从176.7 ± 128.1 ng/mL降至62.5 ± 54.6 ng/mL（P<0.01），B组血浆BNP水平从96.8 ± 51.7 ng/mL降至30.3 ± 23.8 ng/mL（P<0.01）。
结论
孤立性房颤会升高血浆BNP水平，如果存在潜在的结构性心脏病，则会更加明显，心脏复律会降低血浆BNP水平。因此，慢性AF患者的高血浆BNP水平可能是由AF引起的，反映了与基础心脏病相关的心脏超负荷，尽管部分原因是基础心脏病。
BACKGROUND
According to previous reports, plasma atrial natriuretic peptide levels increase in atrial fibrillation (AF) and decrease after successful direct current (DC) cardioversion, but there have been no reports on plasma brain natriuretic peptide (BNP).
OBJECTIVE
To determine whether plasma BNP levels decrease after successful direct DC cardioversion in patients with chronic AF.
PATIENTS AND METHODS
Twenty patients who remained in sinus rhythm for at least seven days after cardioversion, and 20 normal control subjects, were studied. Group A consisted of 10 patients with underlying heart disease, including dilated cardiomyopathy (n=2), hypertrophic cardiomyopathy (n=1), mitral valve disease (n=3), hypertensive heart disease (n=3) and status after atrial septal closure (n=1). Group B consisted of 10 patients with just AF. Group C (serving as controls) comprised 20 subjects with normal sinus rhythm and no risk factors.
RESULTS
Before cardioversion, plasma BNP levels were higher in group A (176.7+/-128.1 ng/mL) and in group B (96.8+/-51.7 ng/ml) than in group C (6.3+/-3.8 ng/ml) (P<0.01 for all). After successful cardioversion, mean plasma BNP levels in groups A and B decreased from 136.8+/-105.5 ng/mL to 46.4+/-44.2 ng/mL (P<0.01). In group A, plasma BNP levels decreased from 176.7+/-128.1 ng/mL to 62.5+/-54.6 ng/mL (P<0.01), and in group B, plasma BNP levels decreased from 96.8+/-51.7 ng/mL to 30.3+/-23.8 ng/mL (P<0.01).
CONCLUSIONS
Lone AF raises plasma BNP levels, which is more marked if there is underlying structural heart disease present, and cardioversion reduces plasma BNP levels. Therefore, high plasma BNP levels in patients with chronic AF are likely to be caused by AF and reflect cardiac overloading associated with, although contributed to in part by, underlying heart diseases.