Division of Cardiac and Vascular Sciences, St George's University of London, London SW17 0RE, UK.
Europace. 2012 Sep;14(9):1302-10. doi: 10.1093/europace/eus088. Epub 2012 May 31.
We propose to assess the value of exercise-induced change in N-terminal-pro atrial natriuretic peptide (NT-proANP) and left atrial expansion index (LAEI) in predicting AFR after cardioversion and their effect on AF-free survival.
Fifty-five patients with persistent AF of <18 months duration needing cardioversion were recruited for the study. Fifty-four patients were successfully cardioverted. At 3 months 28/54 (51%) were in SR and at 12 months 21/53 (39%). On multivariate analysis, only exercise-induced change in NT-proANP and LAEI were found to be predictive of AFR up to 12 months post-cardioversion and had an effect on AF-free survival. N-terminal-pro brain natriuretic peptide was elevated in all persistent AF patients but did not predict recurrent AF.
Left atrial expansion index and exercise-induced atrial natriuretic peptide change show promise as predictors of AFR after cardioversion. These predictors may identify patients at an early stage in their disease with intact neurohumoral feedback systems and less advanced atrial remodelling. Further studies are required to confirm these findings.
我们旨在评估运动诱导的 N 末端脑利钠肽前体（NT-proANP）和左心房扩张指数（LAEI）变化在预测电复律后复律后心房颤动（AFR）中的价值，以及它们对无 AF 生存的影响。
本研究纳入了 55 例持续时间<18 个月的需要电复律的持续性 AF 患者。54 例患者成功进行了电复律。3 个月时，28/54（51%）患者恢复窦性节律，12 个月时，21/53（39%）患者恢复窦性节律。多变量分析显示，只有运动诱导的 NT-proANP 和 LAEI 变化可预测电复律后 12 个月的 AFR，并对无 AF 生存有影响。所有持续性 AF 患者的脑利钠肽前体 N 端升高，但不能预测复发性 AF。
左心房扩张指数和运动诱导的心房利钠肽变化有望成为电复律后 AFR 的预测指标。这些预测因子可能可以识别出疾病早期、神经激素反馈系统完整、心房重构程度较低的患者。需要进一步研究来证实这些发现。
