房颤对利钠肽释放的独立影响。
Independent effect of atrial fibrillation on natriuretic peptide release.
机构信息
Department of Cardiology, Institute for Clinical and Experimental Medicine (IKEM), Videnska 1958/9, 14021, Prague, Czech Republic.
Department of Laboratory Methods, Institute for Clinical and Experimental Medicine (IKEM), Prague, Czech Republic.
出版信息
Clin Res Cardiol. 2019 Feb;108(2):142-149. doi: 10.1007/s00392-018-1332-1. Epub 2018 Jul 26.
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.
背景
我们研究了在心房颤动（AF）中，血浆利钠肽（NPs）的增加是否独立于 AF 对左心房（LA）血流动力学的影响。
方法
血流动力学稳定的拟行 AF 消融的患者接受了 B 型利钠肽（BNP）和中段 pro-心房利钠肽（MR-proANP）评估、超声心动图和直接测量左心房（LA）压力。将 31 例 AF 患者（AF 组）和 31 例窦性心律（SR）匹配的对照者（SR 组）的 NP 浓度进行比较，两组在年龄、性别、心率、左心室射血分数、LA 容积指数和直接测量的平均 LA 压力方面相匹配。18 例患者在自然 SR 和起搏诱导的 AF 后 20 分钟进行了 NP 和 LA 压力的连续测量。
结果
与 SR 组患者相比，AF 组患者的未校正 BNP 高 2.6 倍[中位数（四分位距），101（63，129）比 38（26，79）ng/L]，未校正 MR-proANP 高 2 倍[183（140，230）比 91（67，135）pmol/L；均 P<0.001]。在 SR 组患者中，两种 NP 浓度与平均 LA 压力相关（BNP：r=0.75，MR-proANP：r=0.62，均 P<0.001），但在 AF 组患者中无相关性（r=0.18 和 0.04，均 P>0.3）。在诱导的 AF 中，两种 NP 均显著升高[调整后的中位数（IQR）相对变化，BNP：27（22；40）%，MR-proANP：75（64；99）%，均 P<0.001]，而 LA 压力无明显变化。
结论
AF 中 NPs 的增加独立于其对 LA 血流动力学的影响。
Zotero 插件