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心房颤动消融术后3个月时B型利钠肽水平的临床意义

Clinical Significance of B-Type Natriuretic Peptide Levels at 3 Months after Atrial Fibrillation Ablation.

作者信息

Matsumoto Sen, Matsunaga-Lee Yasuharu, Ishimi Masashi, Ohnishi Mamoru, Masunaga Nobutaka, Tachibana Koichi, Takano Yuzuru

机构信息

JCHO Hoshigaoka Medical Center, Department of Cardiovascular Medicine, Hirakata 573-8511, Japan.

Division of Cardiology, Osaka Rosai Hospital, Osaka 591-8025, Japan.

出版信息

Diseases. 2021 Jul 1;9(3):49. doi: 10.3390/diseases9030049.

Abstract

The role of B-type natriuretic peptide (BNP) levels as a predictor of arrhythmia recurrence (AR) after atrial fibrillation (AF) ablation remains unclear. In this study, we investigated the association of BNP levels before and 3 months after ablation with the risk of AR. A total of 234 patients undergoing their first session of AF ablation were included (68% male, mean age of 69 years). The cut-off value for discriminating AR was determined based on the maximum value of the area under the receiver operating characteristic (ROC) curve. The impact of BNP levels on AR was evaluated using Cox regression analysis. ROC curve analysis showed that the area under the curve for BNP at 3 months after the procedure was larger (0.714) compared to BNP levels before ablation (0.593). Elevated levels of BNP 3 months after the procedure (>40.5 pg/mL, n = 96) was associated with a higher risk of AR compared to those without elevated levels (34.4% vs. 10.9%, < 0.01). Multivariate Cox regression analysis revealed that elevated BNP levels were associated with an increased risk of AR (hazard ratio 2.43; = 0.014). Elevated BNP levels 3 months after AF ablation were a significant prognostic factor in AR, while baseline BNP levels were not.

摘要

B型利钠肽(BNP)水平作为心房颤动(AF)消融术后心律失常复发(AR)预测指标的作用仍不明确。在本研究中,我们调查了消融术前及术后3个月时BNP水平与AR风险之间的关联。共纳入234例首次接受AF消融的患者(男性占68%,平均年龄69岁)。根据受试者工作特征(ROC)曲线下面积的最大值确定鉴别AR的临界值。使用Cox回归分析评估BNP水平对AR的影响。ROC曲线分析显示,与消融术前的BNP水平(0.593)相比,术后3个月时BNP的曲线下面积更大(0.714)。术后3个月时BNP水平升高(>40.5 pg/mL,n = 96)的患者与未升高者相比,AR风险更高(34.4% 对10.9%,<0.01)。多变量Cox回归分析显示,BNP水平升高与AR风险增加相关(风险比2.43;=0.014)。AF消融术后3个月时BNP水平升高是AR的一个重要预后因素,而基线BNP水平则不是。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ffd/8293247/ef3611d94951/diseases-09-00049-g001.jpg

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