Department of Human Sciences, Guglielmo Marconi University, Rome, Italy.
Department of Clinical Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University, Rome, Italy -
Minerva Cardiol Angiol. 2023 Dec;71(6):673-680. doi: 10.23736/S2724-5683.23.06324-X. Epub 2023 Jun 20.
Atrial fibrillation is the most common arrhythmia worldwide and is associated with significant morbidity and mortality. Despite the effectiveness of catheter-based ablation, periprocedural complication and recurrences remain a concern. In this context, we aim to appraise the potential impact of brain-derived neurotrophic factor (BDNF) on reducing episodes of paroxysmal atrial fibrillation (PAF).
22 patients with an established diagnosis of PAF and without structural heart disease were considered. Every patient received 20 drops of GUNA-BDNF administered in the morning. During the 24 months of follow-up, the arrhythmic burden was measured by the average monthly duration of PAF episodes.
At the end of the follow-up period (24 months), data from 22 patients, of whom 17 men and five women, were analyzed. The arrhythmic burden, measured in terms of average monthly duration of PAF episodes, was found significantly reduced after the administration of low dose BDNF (9.5 vs. 65.3 minutes per month, P<0.001). A total of 17 out of 22 patients saw their arrhythmic burden eliminated or consistently reduced, furthermore two patients underwent a drastic reduction of the average monthly duration of AF (more than 200 minutes compared to the baseline). Only four patients, despite the administration of BDNF, still experienced an arrhythmic burden of 20 minutes or more. Considering the age groups, the major reduction was observed in people aged 70 or more, who were also the most represented in the sample. These results are coherent with the poor literature currently available.
BDNF low dose therapy has shown to have an impacting role in reducing the arrhythmic burden and recurrences of AF, with a particular effectiveness in patients over 70 and without structural heart disease. We should welcome this work, despite it limitations. Further clinical and molecular studies are needed before-considering BDNF low dose as a tool against PAF.
心房颤动是全球最常见的心律失常，与显著的发病率和死亡率相关。尽管导管消融术有效，但围手术期并发症和复发仍然令人担忧。在此背景下，我们旨在评估脑源性神经营养因子（BDNF）在减少阵发性心房颤动（PAF）发作方面的潜在影响。
共纳入 22 例确诊为 PAF 且无结构性心脏病的患者。每位患者均接受 20 滴 GUNA-BDNF 晨起给药。在 24 个月的随访期间，通过平均每月 PAF 发作持续时间来测量心律失常负担。
在随访期末（24 个月），对 22 例患者（17 例男性和 5 例女性）的数据进行了分析。通过平均每月 PAF 发作持续时间来衡量心律失常负担，发现低剂量 BDNF 给药后明显降低（9.5 分钟/月 vs. 65.3 分钟/月，P<0.001）。22 例患者中有 17 例患者的心律失常负担得到消除或持续降低，此外有 2 例患者的平均每月 AF 发作持续时间明显减少（与基线相比减少 200 多分钟）。尽管给予 BDNF，但仍有 4 例患者的心律失常负担仍为 20 分钟或更长时间。考虑到年龄组，70 岁或以上的患者观察到的主要减少，他们也是样本中最具代表性的人群。这些结果与目前有限的文献一致。
BDNF 低剂量治疗已显示出在降低 AF 的心律失常负担和复发方面具有重要作用，对 70 岁以上且无结构性心脏病的患者尤其有效。尽管存在局限性，我们仍应欢迎这项工作。在考虑将 BDNF 低剂量作为治疗 PAF 的手段之前，还需要进行进一步的临床和分子研究。
