Yamada Takumi, Murakami Yoshimasa, Okada Taro, Yoshida Naoki, Toyama Junji, Yoshida Yukihiko, Tsuboi Naoya, Inden Yasuya, Hirai Makoto, Murohara Toyoaki
Cardiac Rhythm Management Laboratory, Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, AL 35294-0019, USA.
Europace. 2007 Sep;9(9):770-4. doi: 10.1093/europace/eum157. Epub 2007 Aug 1.
The aim of this study was to investigate the change in plasma brain natriuretic peptide (BNP) level after pulmonary vein isolation (PVI) in paroxysmal (PAF), persistent (Pers-AF), and permanent atrial fibrillation (AF) (Perm-AF) patients.
In 96 lone AF patients (PAF=65, Pers-AF=17, and Perm-AF=14), BNP was measured before and 3 months after successful PVIs. At baseline, in all patients, BNP was elevated and was significantly greater in Pers-AF and Perm-AF patients than PAF patients (P<0.05). After 3 months of follow-up following multiple PVIs, AF recurred in 12 (18%) PAF, 7 (41%) Pers-AF, and 8 (57%) Perm-AF patients. In Pers-AF and Perm-AF patients, BNP at baseline did not predict AF recurrence. After the PVIs, BNP significantly decreased in PAF and Pers-AF patients (P=0.005) but not in Perm-AF patients. An elevated BNP at baseline decreased to within-normal limits in all Pers-AF and Perm-AF patients without AF recurrences. In all seven (23%) patients, whose AF type improved after the PVIs, BNP decreased.
The reduction in the BNP level after the PVI seemed to be a marker for a good outcome in AF post-ablation patients.
本研究旨在调查阵发性房颤(PAF)、持续性房颤(Pers-AF)和永久性房颤(Perm-AF)患者肺静脉隔离(PVI)后血浆脑钠肽(BNP)水平的变化。
在96例孤立性房颤患者(PAF = 65例、Pers-AF = 17例、Perm-AF = 14例)中,在成功进行肺静脉隔离术前和术后3个月测量BNP。基线时,所有患者的BNP均升高,Pers-AF和Perm-AF患者的BNP显著高于PAF患者(P<0.05)。在多次肺静脉隔离术后3个月的随访中,12例(18%)PAF、7例(41%)Pers-AF和8例(57%)Perm-AF患者房颤复发。在Pers-AF和Perm-AF患者中,基线时的BNP不能预测房颤复发。肺静脉隔离术后,PAF和Pers-AF患者的BNP显著降低(P = 0.005),但Perm-AF患者未降低。所有未复发房颤的Pers-AF和Perm-AF患者基线时升高的BNP均降至正常范围内。在所有7例(23%)肺静脉隔离术后房颤类型改善的患者中,BNP降低。
肺静脉隔离术后BNP水平的降低似乎是房颤消融术后患者预后良好的一个标志物。