Department of Cardiology, Heart Center Leipzig At University of Leipzig, Leipzig, Germany.
Department of Electrophysiology, Heart Center Leipzig At University of Leipzig, Leipzig, Germany.
J Interv Card Electrophysiol. 2022 Mar;63(2):409-415. doi: 10.1007/s10840-021-01020-z. Epub 2021 Jun 25.
Recent studies have reported an association between N-terminal atrial natriuretic peptide (NT-proANP) and the progression of atrial fibrillation (AF). However, NT-proANP levels in peripheral and cardiac circulation in AF patients and in non-AF individuals need to be defined. The aims of the current study are (1) to analyze NT-proANP levels in peripheral and cardiac circulation in AF patients and (2) to compare NT-proANP levels in individuals with and without AF.
We recruited AF patients who were undergoing their first AF catheter ablation and non-AF individuals. Blood plasma samples taken from the femoral vein and the left atrium (LA) were collected before AF ablation in the AF patients and from the cubital vein in the non-AF controls. Low voltage areas (LVAs) were determined using high-density maps during catheter ablation and defined as < 0.5 mV.
The study included 189 AF patients (64 ± 10 years, 59% male, 61% persistent AF, 30% LVAs) and 26 non-AF individuals (58 ± 10 years, 50% male). Patients with AF were significantly older and had larger LA (p < 0.05). Compared to non-AF controls, peripheral and cardiac NT-proANP levels were significantly higher in AF patients without and with LVAs (median 5.4, 10.5, 14.8 ng/ml, respectively, p < 0.001). In multivariable analysis, NT-proANP (OR 1.238, 95% CI 1.007-1.521, p = 0.043) remained significantly different between non-AF individuals and AF patients. In AF, NT-proANP levels were significantly higher in the cardiac blood samples than in the peripheral blood (median 13.0 versus 11.4 ng/ml, p = 0.003). The ability to predict LVAs was modest when using cardiac NT-proANP (AUC 0.661) and peripheral NT-proANP (AUC 0.635), without statistical difference (p = 0.937).
NT-proANP levels are higher in individuals with AF than in controls and are more pronounced in progressed AF. Elevated cardiac and peripheral NT-proANP levels similarly predict LVAs.
最近的研究报告称，N 端脑利钠肽前体（NT-proANP）与心房颤动（AF）的进展有关。然而，AF 患者外周和心脏循环中的 NT-proANP 水平以及非 AF 个体中的 NT-proANP 水平仍需确定。本研究的目的是：（1）分析 AF 患者外周和心脏循环中的 NT-proANP 水平；（2）比较 AF 患者和非 AF 个体的 NT-proANP 水平。
我们招募了正在接受首次 AF 导管消融术的 AF 患者和非 AF 个体。在 AF 患者进行 AF 消融术之前，从股静脉和左心房（LA）采集血浆样本，在非 AF 对照组中从肘静脉采集。在导管消融过程中使用高密度图确定低电压区（LVA），并定义为 <0.5 mV。
该研究共纳入 189 例 AF 患者（64 ± 10 岁，59%为男性，61%为持续性 AF，30%为 LVA）和 26 例非 AF 个体（58 ± 10 岁，50%为男性）。与非 AF 对照组相比，无 LVA和有 LVA 的 AF 患者的外周和心脏 NT-proANP 水平均显著升高（中位数分别为 5.4、10.5、14.8 ng/ml，均 p < 0.001）。多变量分析显示，NT-proANP（OR 1.238，95%CI 1.007-1.521，p = 0.043）在非 AF 个体和 AF 患者之间仍有显著差异。在 AF 中，心脏血样中的 NT-proANP 水平明显高于外周血样（中位数分别为 13.0 与 11.4 ng/ml，p = 0.003）。当使用心脏 NT-proANP（AUC 0.661）和外周 NT-proANP（AUC 0.635）预测 LVA 时，其能力均适中，且无统计学差异（p = 0.937）。
AF 患者的 NT-proANP 水平高于对照组，且在进展性 AF 中更为明显。升高的心脏和外周 NT-proANP 水平同样可预测 LVA。
