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26.07.2018 | Original Paper

Independent effect of atrial fibrillation on natriuretic peptide release

verfasst von: Marek Sramko, Dan Wichterle, Vojtech Melenovsky, Janka Franekova, Marcell Clemens, Masato Fukunaga, Josef Kautzner

Erschienen in: Clinical Research in Cardiology | Ausgabe 2/2019

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Abstract

Background

We investigated whether the increase of plasma natriuretic peptides (NPs) in atrial fibrillation (AF) is independent of the effect of AF on the left atrial (LA) hemodynamics.

Methods

Hemodynamically stable patients scheduled for AF ablation underwent assessment of B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP), echocardiography, and direct measurement of left atrial (LA) pressure. Concentrations of the NPs were compared between patients in AF (n = 31) and controls in sinus rhythm (SR; n = 31) who were matched for age, gender, heart rate, left ventricular ejection fraction, LA volume index, and directly measured mean LA pressure. Eighteen patients underwent serial measurement of NPs and LA pressure during native SR and after 20 min of pacing-induced AF.

Results

Compared to the patients in SR, the patients in AF had 2.6 times higher unadjusted BNP [median (inter-quartile range), 101 (63, 129) vs. 38 (26, 79) ng/L] and two times higher unadjusted MR-proANP [183 (140, 230) vs. 91 (67, 135) pmol/L; both p < 0.001]. Concentrations of both NPs correlated with mean LA pressure in the patients in SR (r = 0.75 for BNP and 0.62 for MR-proANP, both p < 0.001) but not in the patients in AF (r = 0.18 and 0.04, respectively, both p > 0.3). Both NPs increased significantly during induced AF [adjusted median (IQR) relative change, BNP: 27 (22; 40)%, MR-proANP: 75 (64; 99)%, both p < 0.001] without a significant change in the LA pressure.

Conclusions

The increase of NPs in AF was independent of its effect on the LA hemodynamics.

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Titel: Independent effect of atrial fibrillation on natriuretic peptide release
verfasst von: Marek Sramko
Dan Wichterle
Vojtech Melenovsky
Janka Franekova
Marcell Clemens
Masato Fukunaga
Josef Kautzner
Publikationsdatum: 26.07.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 2/2019
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1332-1

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Independent effect of atrial fibrillation on natriuretic peptide release