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电复律后 1 个月内持续性心房颤动患者心钠肽与左心房结构和功能的关系。

Relationship of Natriuretic Peptides with Left Atrial Structure and Function within 1 Month after Electrical Cardioversion in Patients with Persistent Atrial Fibrillation.

机构信息

Laboratory of Behavioral Medicine, Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas LT-50161, Lithuania.

Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas LT-50161, Lithuania.

出版信息

Biomed Res Int. 2019 Mar 17;2019:7636195. doi: 10.1155/2019/7636195. eCollection 2019.

Abstract

Atrial fibrillation (AF) despite the absence of heart failure is related to increased levels of natriuretic peptides (NPs). NPs have not been widely investigated in relation to left atrium (LA) function after sinus rhythm (SR) restoration and duration of AF. The aim of the study was to determine the changes of NPs levels and to define their relation with LA phasic function after electrical cardioversion (ECV). . The study included 48 persistent AF patients with restored SR after ECV. NT-proANP and NT-proBNP were measured for all patients before the ECV. LA phasic function (, , and phases) was assessed using echocardiographic volumetric analysis within the first 24 hours after ECV. Patients were repeatedly tested after 1 month in case of SR maintenance. . After 1 month, SR was maintained in 26 (54%) patients. For those patients, NT-proBNP decreased significantly (p=0.0001), whereas NT-proANP tended to decrease (p=0.13). Following 1 month after SR restoration, LA indexed volume decreased (p=0.0001) and all phases of LA function improved (p=<0.01). Patients with AF duration < 3 months had lower NT-proANP compared to patients with AF duration from 6 to 12 months (p = 0.005). Higher NT-proANP concentration before ECV was associated with lower LA function during the first day after SR restoration (R=-0.456, p=0.005), whereas higher NT-proBNP concentration after 1 month in SR was significantly related to lower LA function (R=-0.429, p=0.047). . LA indexed volume, all phases of LA function, and NT-proBNP levels improved significantly following 1 month of SR restoration. Preliminary results suggest that higher baseline NT-proANP levels and higher NT-proBNP for patients with maintained SR for 1 month are related to lower LA function. The longer duration of persistent AF is associated with higher NT-proANP concentration.

摘要

心房颤动(AF)尽管没有心力衰竭,与利钠肽(NPs)水平升高有关。NP 在窦性节律(SR)恢复后和 AF 持续时间与左心房(LA)功能的关系尚未得到广泛研究。本研究旨在确定 NP 水平的变化,并确定它们与电复律(ECV)后 LA 时相功能的关系。。该研究纳入了 48 例经 ECV 恢复 SR 的持续性 AF 患者。所有患者在 ECV 前均测量 NT-proANP 和 NT-proBNP。ECV 后 24 小时内通过超声心动图容积分析评估 LA 时相功能(、和相)。如果 SR 维持,患者在 1 个月后重复测试。。1 个月后,26 例(54%)患者维持 SR。对于这些患者,NT-proBNP 显著降低(p=0.0001),而 NT-proANP 有降低趋势(p=0.13)。在 SR 恢复后 1 个月,LA 指数容积减小(p=0.0001),LA 功能所有时相均改善(p<0.01)。AF 持续时间<3 个月的患者 NT-proANP 低于持续时间为 6-12 个月的患者(p=0.005)。ECV 前 NT-proANP 浓度较高与 SR 恢复后第一天 LA 功能较低相关(R=-0.456,p=0.005),而 SR 中 1 个月后的 NT-proBNP 浓度与 LA 功能较低显著相关(R=-0.429,p=0.047)。。在 SR 恢复后 1 个月,LA 指数容积、LA 功能所有时相和 NT-proBNP 水平均显著改善。初步结果表明,SR 恢复 1 个月后,较高的基础 NT-proANP 水平和维持 SR 的患者的 NT-proBNP 水平较高与较低的 LA 功能相关。持续性 AF 持续时间较长与较高的 NT-proANP 浓度相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/838f/6441525/d0f559536a84/BMRI2019-7636195.001.jpg

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