Legallois Damien, Sorbets Emmanuel, Chenevier-Gobeaux Camille, Hallouche Maya, Boubaya Marouane, Charnaux Nathalie, Lebon Alain, Levy Vincent, Beygui Farzin, Meune Christophe
Cardiology Department, Caen University Hospital, Caen, France.
Cardiology Department, FACT (French Alliance for Cardiovascular Trials), Avicenne and Bichat Hospital, Bobigny, France.
J Appl Lab Med. 2017 Mar 1;1(5):522-531. doi: 10.1373/jalm.2016.021477.
An accurate estimate of the duration of atrial fibrillation (AF) is critical for its safe and successful management. We examined the ability of midregional pro-atrial natriuretic peptide (MR-proANP) to identify patients presenting with AF of ≤48 vs >48 h in duration.
We prospectively studied 106 patients presenting with AF of known duration. We examined the predictive values of MR-proANP and N-terminal pro-brain natriuretic peptide (NT-proBNP) in the detection of recent-onset AF, in addition to other factors identified by multiple variable analyses.
In patients presenting with AF of ≤48 vs >48 h in duration, the median MR-proANP plasma concentration was 147.7 [95.3-197.4] pmol/L vs 220.4 [154.0-303.1] pmol/L (P <0.001). MR-proANP and NT-proBNP were correlated (r = 0.5, P <10-7), but MR-proANP tended to better discriminate AF of ≤48 h in duration than NT-proBNP (P = 0.09). A score including heart rate, dyspnea, and MR-proANP concentration accurately detected AF of ≤48 h in duration (area under the curve = 0.890; 95% CI, 0.828-0.952). A score of 98 points was an optimal cutoff that excluded AF of ≤48 h in duration with a sensitivity of 95%, while a score of 132.5 points was an optimal cutoff that confirmed AF of ≤48 h in duration with a sensitivity of 95%. Overall, a score ≤98 or ≥132.5 identified AF of ≤48 h in duration in 56% of patients.
A score based on a model including heart rate, dyspnea, and plasma MR-proANP concentration was helpful in identifying AF of ≤48 h in duration.
准确估计房颤（AF）的持续时间对其安全、成功管理至关重要。我们研究了中段心房利钠肽前体（MR-proANP）识别房颤持续时间≤48小时与>48小时患者的能力。
我们前瞻性研究了106例已知房颤持续时间的患者。除多变量分析确定的其他因素外，我们还研究了MR-proANP和N末端脑利钠肽前体（NT-proBNP）在检测近期发作房颤中的预测价值。
房颤持续时间≤48小时与>48小时的患者相比，MR-proANP血浆浓度中位数分别为147.7[95.3 - 197.4]pmol/L和220.4[154.0 - 303.1]pmol/L（P<0.001）。MR-proANP与NT-proBNP相关（r = 0.5，P<10-7），但MR-proANP在区分持续时间≤48小时的房颤方面往往比NT-proBNP更好（P = 0.09）。一个包含心率、呼吸困难和MR-proANP浓度的评分能准确检测出持续时间≤48小时的房颤（曲线下面积 = 0.890；95%CI，0.828 - 0.952）。98分是排除持续时间≤48小时房颤的最佳截断值，敏感性为95%，而132.5分是确诊持续时间≤48小时房颤的最佳截断值，敏感性为95%。总体而言，评分≤98或≥132.5可在56%的患者中识别出持续时间≤48小时的房颤。
基于心率、呼吸困难和血浆MR-proANP浓度的模型评分有助于识别持续时间≤48小时的房颤。
