Department of Medical Translational Sciences, University of Campania "Luigi Vanvitelli"-Monaldi Hospital, Naples, Italy.
Clinical Biochemistry Unit, Monaldi Hospital, Naples, Italy.
J Cardiovasc Electrophysiol. 2019 Dec;30(12):2914-2919. doi: 10.1111/jce.14211. Epub 2019 Oct 9.
The aim of the present study was to evaluate the role of high-sensitivity cardiac troponin I, N terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase-MB mass concentration (CK-MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients.
The study enrolled 60 consecutive DM1 patients (age 50.3 ± 7.3 years, 34 male) who underwent pacemaker (PM) implantation for cardiac rhythm abnormalities and 60 PM recipients whose age and sex matched served as control group. All DM1 patients underwent a 12-lead electrocardiogram, 2D color Doppler echocardiogram, biomarkers measurements and device interrogation at implantation, 1 month after and every 6 months thereafter for a minimum of 2-year follow-up.
The study population was divided into two groups according to the presence of AF (AF group vs non-AF group). The AF group was older (47.3 ± 8 vs 38.6 ± 7 years, P = .03) and showed higher serum levels of NT-proBNP (151 ± 38.4 vs 107.3 ± 24.2 pg/mL, P < .001) and CP (18.9 ± 4.5 vs 7 ± 2.3 P < .001) than non-AF Group. NT-proBNP (P < .001) and CP (P < .001) were found to be an independent predictor of AF. Based on the receiver-operating characteristics curve analysis, the cut-off value for NT-proBNP that best predicted AF event in DM1 patients was 123 pg/ml (sensitivity of 83.3% and specificity of 86.5%); the cut-off value for CP that best predicted AF event in DM1 patients was 9 pmol/L (sensitivity of 89% and specificity of 87%).
NT-proBNP and CP represent two independent predictors of AF onset in DM1 population with conduction disturbances underwent PM implantation.
本研究旨在评估高敏心肌肌钙蛋白 I、N 末端脑利钠肽前体（NT-proBNP）、肌酸激酶同工酶质量浓度（CK-MB mass）和 copeptin（CP）在预测 1 型肌强直性营养不良（DM1）患者发生心房颤动（AF）中的作用。
该研究纳入了 60 例连续的 DM1 患者（年龄 50.3±7.3 岁，34 名男性），他们因心律失常而行起搏器（PM）植入，60 例 PM 接受者年龄和性别相匹配作为对照组。所有 DM1 患者在植入时、植入后 1 个月以及此后每 6 个月进行 12 导联心电图、二维彩色多普勒超声心动图、生物标志物测量和设备检查，随访至少 2 年。
根据 AF 的存在，研究人群被分为两组（AF 组与非-AF 组）。AF 组年龄更大（47.3±8 岁 vs 38.6±7 岁，P=0.03），血清 NT-proBNP（151±38.4 与 107.3±24.2 pg/ml，P<0.001）和 CP（18.9±4.5 与 7±2.3，P<0.001）水平更高。NT-proBNP（P<0.001）和 CP（P<0.001）是 AF 的独立预测因子。基于受试者工作特征曲线分析，NT-proBNP 预测 DM1 患者发生 AF 事件的最佳截断值为 123 pg/ml（敏感性为 83.3%，特异性为 86.5%）；CP 预测 DM1 患者发生 AF 事件的最佳截断值为 9 pmol/L（敏感性为 89%，特异性为 87%）。
在因传导障碍而行 PM 植入的 DM1 人群中，NT-proBNP 和 CP 是 AF 发生的两个独立预测因子。
