Kashimura Shin, Ikemura Nobuhiro, Kohsaka Shun, Katsumata Yoshinori, Kimura Takehiro, Shinmura Daisuke, Fukumoto Kotaro, Negishi Koji, Ueda Ikuko, Takatsuki Seiji, Ieda Masaki
Department of Cardiology, Yokohama Municipal Citizen's Hospital, 1-1, Mitsuzawa-nishicho, Kanagawa-ku, Yokohama 221-0855, Japan.
Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
J Clin Med. 2024 Jan 11;13(2):407. doi: 10.3390/jcm13020407.
Catheter ablation (CA) benefits atrial fibrillation (AF) patients with heart failure (HF). Brain natriuretic peptide (BNP), a marker of left-ventricular pressure load, may serve as a potential surrogate for predicting quality of life (QOL) in a broader range of patients.
Within the multicenter KiCS-AF registry, 491 AF patients underwent CA without clinical HF (e.g., documented history of HF, left ventricular ejection fraction ≤ 40%, or BNP levels ≥ 100 pg/mL). Participants, aged 61 ± 10 years, were categorized by baseline BNP quartiles. Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) questionnaire assessments were assessed at baseline and 1 year.
A lower baseline BNP correlated with reduced AFEQT scores. Post CA, all groups showed significant AFEQT score improvements. The lower-BNP group displayed notable enhancements (18.2 ± 1.2, 15.0 ± 1.1, 12.6 ± 1.2, 13.6 ± 1.2, < 0.005), especially in symptom and treatment concern areas. Even those with normal BNP levels (≤18.4 pg/mL) exhibited significant QOL improvements. Comparing paroxysmal AF (PAF) and non-PAF groups, the PAF group, especially with higher BNP levels, showed greater AFEQT score improvements.
This study establishes BNP as a predictive marker for QOL enhancement in non-HF patients undergoing CA for AF. BNP levels represent AF stages, with individuals in earlier stages, especially within normal BNP levels, experiencing greater QOL improvements.
导管消融术（CA）对心力衰竭（HF）的心房颤动（AF）患者有益。脑钠肽（BNP）作为左心室压力负荷的标志物，可能在更广泛的患者群体中作为预测生活质量（QOL）的潜在替代指标。
在多中心KiCS-AF注册研究中，491例无临床HF（如记录的HF病史、左心室射血分数≤40%或BNP水平≥100 pg/mL）的AF患者接受了CA。年龄为61±10岁的参与者按基线BNP四分位数进行分类。在基线和1年时对心房颤动对生活质量的影响（AFEQT）问卷评估进行评估。
较低的基线BNP与降低的AFEQT评分相关。CA术后，所有组的AFEQT评分均有显著改善。低BNP组表现出显著提高（18.2±1.2、15.0±1.1、12.6±1.2、13.6±1.2，P<0.005），尤其是在症状和治疗关注领域。即使是BNP水平正常（≤18.4 pg/mL）的患者也表现出生活质量的显著改善。比较阵发性AF（PAF）和非PAF组，PAF组，尤其是BNP水平较高的患者，AFEQT评分改善更大。
本研究确定BNP为接受CA治疗AF的非HF患者生活质量改善的预测标志物。BNP水平代表AF阶段，处于早期阶段的个体，尤其是BNP水平正常的个体，生活质量改善更大。
