NT-ProBNP Predicts Rhythm Stability After Cardioversion of Lone Atrial Fibrillation

Möllmann, Helge; Weber, Michael; Elsässer, Albrecht; Nef, Holger; Dill, Thorsten; Rixe, Johannes; Schmitt, J; Sperzel, Johannes; Hamm, Christian W.

doi:10.1253/circj.72.921

Cited by 38 publications

(29 citation statements)

References 32 publications

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“…16 Furthermore, lower BNP levels in these patients were found to predict rhythm stability after successful cardioversion to sinus rhythm. 12 Very few studies in the literature evaluated the natriuretic peptide axis in lone AF patients undergoing radiofrequency ablation of their arrhythmia. 14 -16 The main finding from these studies is that BNP levels are elevated at baseline and significantly decrease in patients who maintain sinus rhythm but not in those with recurrent arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

“…For patients in AF, lower BNP levels predicted rhythm stability after cardioversion to sinus rhythm. 12 The most important observations were in a study by Ellinor et al, 9 who reported discordant levels of natriuretic peptides in lone AF patients. In contrast to patients with heart disease or cardiovascular risk factors, in whom the hemodynamic burden of AF results in elevation of both BNP and atrial natriuretic peptide, 13 lone AF patients were found to have BNP elevation without significant atrial natriuretic peptide elevation.…”

Section: Clinical Perspective On P 2082mentioning

confidence: 96%

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Plasma B-Type Natriuretic Peptide Levels and Recurrent Arrhythmia After Successful Ablation of Lone Atrial Fibrillation

et al. 2011

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Background-Plasma B-type natriuretic peptide (BNP) is abnormally elevated in patients with lone atrial fibrillation (AF).The exact significance and prognostic implications of this elevation have yet to be determined. Little is known about BNP in lone AF patients undergoing arrhythmia ablation. We sought to determine the relationship between BNP levels and the risk of recurrent arrhythmia after ablation of lone AF. Methods and Results-We followed up 726 patients with lone AF undergoing first-time arrhythmia ablation. All had BNP levels measured on the day of ablation with of the point-of-care Triage Meter assay (Biosite Diagnostics, San Diego, CA). At baseline, factors associated with elevated BNP levels in multivariable linear regression analysis (with log BNP being the dependent variable) were older age (␤ regression coefficient for ϩ1-year change, 0.025; PϽ0.0001), longer duration of AF (␤ for ϩ1-year change, 0.031; Pϭ0.01), nonparoxysmal AF (versus paroxysmal; ␤, 0.52; PϽ0.0001), and larger left atrial size (␤ for ϩ1-cm 2 change, 0.040; PϽ0.0001). The BNP levels were strongly associated with arrhythmia recurrence in univariate-(hazard ratio for ϩ1-log-BNP change, 2.32; 95% confidence interval, 2.11 to 2.74; PϽ0.001) and covariate-(hazard ratio for ϩ1-log-BNP change, 2.13; 95% confidence interval, 2.06 to 2.38; PϽ0.001) adjusted Cox proportional hazards analysis. The covariate-adjusted hazard ratios for recurrent arrhythmia were 1.6, 2.7, 4.3, and 5.7 for the second, third, fourth, and fifth quintiles, respectively, compared with patients in the lowest quintile (P for trend across quintiles Ͻ0.001). Conclusions-B-type natriuretic peptide levels correlate with AF burden (chronicity, altered hemodynamics, and anatomic remodeling) in patients with lone AF and are strong predictors of recurrent arrhythmia after ablation. Elevated BNP levels may reflect increased cardiac chamber wall stress and/or intrinsic atrial disease, thus increasing the risk of arrhythmia recurrence.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical Perspective On P 2082mentioning

confidence: 96%

Plasma B-Type Natriuretic Peptide Levels and Recurrent Arrhythmia After Successful Ablation of Lone Atrial Fibrillation

et al. 2011

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“…We speculate that a high % increase in BNP (≥15%) reflects episodes of increased BNP secretion following short-term increases in transmural cardiac pressure probably due to arrhythmia. 35, 36 Actually, previous studies reported that changes in BNP occur rapidly after cardioversion of atrial fibrillation in patients with CHF. 37, 38 Therefore, changes in BNP might be useful independent of the recent value of BNP, and might be helpful in the management of stable outpatients with NICHF.…”

Section: Discussionmentioning

confidence: 99%

Biological Variation of Brain Natriuretic Peptide and Cardiac Events in Stable Outpatients With Nonischemic Chronic Heart Failure

Nishiyama

Tsutamoto

Yamaji

et al. 2011

Circ J

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Background: To evaluate the biological variation and prognostic value of brain natriuretic peptide (BNP) for stable outpatients with nonischemic chronic heart failure (NICHF). Methods and Results:Biological variation in BNP was evaluated using an automated assay system in 140 outpatients with NICHF. The stable clinical condition during the 2-month study period was defined as unchanged NYHA and unchanged left ventricular ejection fraction; therefore, 7 patients were excluded during the 2 months. Thereafter, 133 patients were prospectively followed and the relationship between cardiac events and the plasma BNP concentrations (at baseline and after 2 months) were evaluated as well as the changes in BNP. The biological variation in BNP (2-month interval) was calculated as 22.3%. During a mean follow-up period of 42 months, 26 patients had cardiac events. According to stepwise multivariate analyses, plasma BNP after 2 months (P= 0.0002) and % change in BNP (P=0.0067) were significant independent predictors of cardiac events. Conclusions:These findings indicated that a combination of the absolute value of BNP after 2 months and % increase in BNP (2-month interval) is useful for predicting cardiac events in stable outpatients with NICHF. (Circ J 2011; 75: 341 - 347)

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“…The association between NT-pro-BNP level and atrial fibrillation has been less studied and understood. Some studies have proved that NT-pro-BNP is increased in atrial fibrillation [16][17][18][19]. The proposed mechanisms are high frequency of atrial myocyte contraction and local atrial inflammation [18].…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have proved that NT-pro-BNP is increased in atrial fibrillation [16][17][18][19]. The proposed mechanisms are high frequency of atrial myocyte contraction and local atrial inflammation [18]. It has been also recommended that BNP increases within 4 hours from the onset of atrial inflammation; whether this applies to NT-pro-BNP is also not clear [20].…”

Section: Discussionmentioning

confidence: 99%

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

Safi

Bayat

Ahmadi

et al. 2017

Romanian Journal of Internal Medicine

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Background. The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters. Methods. Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram. Results. It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia. Conclusion. PTMC procedure leads to reduce the level of NT-pro-BNP. The change in NT-pro-BNP is an indicator for change in MS severity indicated by decreasing MPG parameter. Lower change in PAP as well as higher change in NT-pro-BNP is predicted following PTMC in the group with AF compared to those with normal sinus rhythm.

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NT-ProBNP Predicts Rhythm Stability After Cardioversion of Lone Atrial Fibrillation

Cited by 38 publications

References 32 publications

Plasma B-Type Natriuretic Peptide Levels and Recurrent Arrhythmia After Successful Ablation of Lone Atrial Fibrillation

Plasma B-Type Natriuretic Peptide Levels and Recurrent Arrhythmia After Successful Ablation of Lone Atrial Fibrillation

Biological Variation of Brain Natriuretic Peptide and Cardiac Events in Stable Outpatients With Nonischemic Chronic Heart Failure

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

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