First Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine, Mannheim, University of Heidelberg, Mannheim, Germany.
Central Laboratory, University Hospital Erlangen, Erlangen, Germany.
Sci Rep. 2017 Aug 22;7(1):9028. doi: 10.1038/s41598-017-08999-4.
The left atrial appendage (LAA) represents both a predisposing source of thrombus formation and of neuro-humoral haemostasis. This study aims to evaluate changes of biomarker expression before and after successful percutaneous closure of the LAA. Patients with atrial fibrillation and contraindication for oral anticoagulant therapy were enrolled. Blood samples were taken within 24 hours before (T1) and at least 6 months (mid-term) (T2) after successful implantation of LAA occlusion devices. Blood levels of high sensitivity troponin I and T (hsTnI, hsTnT), aminoterminal pro-brain natriuretic peptide (NT-proBNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) were evaluated at both time points. A total of 42 patients with successful percutaneous LAA closure were included. Median mid-term follow-up was of 183 days. HsTnT, hsTnI and NT-proBNP did not show any significant differences over time. Serum levels of MR-proANP increased significantly between immediate pre-intervention (T1: median = 245.7 pmol/l, IQR 155.8-361.3 pmol/l) and at mid-term follow-up (T2: median = 254 pmol/l, IQR 183.4-396.4 pmol/l) (p = 0.037). These results indicate, that percutaneous LAA closure affects neuro-humoral haemostasis by increasing MR-proANP serum levels at mid-term follow-up.
左心耳（LAA）既是血栓形成的倾向部位，也是神经体液止血的倾向部位。本研究旨在评估 LAA 成功经皮封堵前后生物标志物表达的变化。入选有房颤且口服抗凝治疗禁忌证的患者。在 LAA 闭塞装置成功植入前 24 小时内（T1）和至少 6 个月（中期）（T2）采血。在两个时间点评估高敏肌钙蛋白 I 和 T（hsTnI、hsTnT）、氨基末端脑利钠肽前体（NT-proBNP）和中区利钠肽前体（MR-proANP）的血液水平。共纳入 42 例 LAA 成功经皮封堵的患者。中位中期随访时间为 183 天。hsTnT、hsTnI 和 NT-proBNP 随时间无明显差异。MR-proANP 血清水平在即刻术前（T1：中位数=245.7pmol/L，IQR 155.8-361.3pmol/L）和中期随访时（T2：中位数=254pmol/L，IQR 183.4-396.4pmol/L）显著升高（p=0.037）。这些结果表明，经皮 LAA 封堵通过增加中期随访时的 MR-proANP 血清水平来影响神经体液止血。
