Wozakowska-Kapłon Beata, Opolski Grzegorz, Janion Marianna, Kosior Dariusz
Department of Cardiology, Regional District Hospital, Kielce.
Kardiol Pol. 2004 Dec;61(12):513-21; discussion 522.
Plasma concentration of atrial natriuretic peptide (ANP) is elevated in patients with atrial fibrillation (AF) and in patients with chronic heart failure (CHF).Aim. To assess ANP level in patients with permanent AF and advanced CHF.
The study group consisted of 41 patients (27 males, mean age 62+/-8 years) with AF of a mean duration of 8.8 months. Twenty six (63%) patients were in NYHA class II, and 15 (37%) - in NYHA class III or IV. All patients underwent clinical and echocardiographic evaluation as well as ANP plasma concentration assessment. Multiple regression analysis was used to identify factors which determine ANP plasma concentration.
Mean ANP plasma concentration was 52.4+/-22.7 pg/ml in the whole study group; 38.6+/-10.8 pg/ml in NYHA class II patients and 74.9+/-18.7 pg/ml in NYHA class III-IV subjects (p<0.0001). Among echocardiographic parameters, patients with NYHA class III or IV had significantly lower left ventricular ejection fraction and greater left atrial volume than patients with NYHA class II (32% versus 56%, p<0.0001 and 101.0+/-23.8 cm(3) versus 83.4+/-16.1 cm(3), p<0.006, respectively). Multiple regression analysis revealed a significant negative correlation between AF duration and ANP level (p=0.0013) in a group of patients with NYHA class III or IV and identified AF duration as an independent predictor of ANP plasma concentration in this group of patients.
ANP plasma concentration in patients with persistent AF and advanced CHF is determined by AF duration - the longer the AF duration the lower the ANP level.
心房颤动（AF）患者和慢性心力衰竭（CHF）患者的血浆心房利钠肽（ANP）浓度升高。目的：评估永久性AF和晚期CHF患者的ANP水平。
研究组由41例患者（27例男性，平均年龄62±8岁）组成，AF平均持续时间为8.8个月。26例（63%）患者为纽约心脏协会（NYHA）心功能II级，15例（37%）为NYHA心功能III级或IV级。所有患者均接受了临床和超声心动图评估以及ANP血浆浓度评估。采用多元回归分析确定决定ANP血浆浓度的因素。
整个研究组的平均ANP血浆浓度为52.4±22.7 pg/ml；NYHA心功能II级患者为38.6±10.8 pg/ml，NYHA心功能III-IV级患者为74.9±18.7 pg/ml（p<0.0001）。在超声心动图参数中，NYHA心功能III级或IV级患者的左心室射血分数明显低于NYHA心功能II级患者，左心房容积明显大于NYHA心功能II级患者（分别为32%对56%，p<0.0001；101.0±23.8 cm³对83.4±16.1 cm³，p<0.006）。多元回归分析显示，在NYHA心功能III级或IV级患者组中，AF持续时间与ANP水平呈显著负相关（p=0.0013），并确定AF持续时间是该组患者ANP血浆浓度的独立预测因素。
持续性AF和晚期CHF患者的ANP血浆浓度由AF持续时间决定——AF持续时间越长，ANP水平越低。
