Plasma Atrial Natriuretic Peptide and Brain Natriuretic Peptide Levels After Radiofrequency Catheter Ablation of Atrial Fibrillation

Yamada, Takumi; Murakami, Yoshimasa; Okada, Taro; Okamoto, Mitsuhiro; Shimizu, Takeshi; Toyama, Junji; Yoshida, Yukihiko; Tsuboi, Nobuyuki; Ito, Teruo; Muto, Masahiro; Kondo, Takahisa; Inden, Yasuya; Hirai, Makoto; Murohara, Toyoaki

doi:10.1016/j.amjcard.2005.12.071

Cited by 51 publications

(44 citation statements)

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“…Previous studies have demonstrated that the BNP level can be a useful marker for evaluating the efficacy of PVI in AF patients. [2][3][4] This study also demonstrated that the BNP level could be a useful marker for evaluating the efficacy of antiarrhythmic drug therapy in patients with recurrent AF after PVI.…”

Section: Discussionmentioning

confidence: 83%

“…1) It has been demonstrated that successful elimination of AF by pulmonary vein isolation (PVI) normalizes the elevated plasma brain natriuretic peptide (BNP) level. [2][3][4] Though PVI has been established as a reliable therapy for curing AF, the recurrence rate has been relatively high and a repeat ablation procedure is sometimes required. [5][6][7][8] It has been reported that in some cases of unsuccessful ablation, antiarrhythmic drugs that were ineffective before the PVI may become effective (hybrid therapy) after.…”

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confidence: 99%

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Plasma Brain Natriuretic Peptide Level After Hybrid Therapy With Pulmonary Vein Isolation and Antiarrhythmic Drugs for Atrial Fibrillation

et al. 2008

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SUMMARYThe atrial fibrillation (AF) recurrence rate after pulmonary vein isolation (PVI) has been relatively high and in some unsuccessful PVI cases, antiarrhythmic drugs that were ineffective before PVI may become effective (hybrid therapy). The purpose of this study was to investigate the relationship between the brain natriuretic peptide (BNP) level and the effect of the hybrid therapy.In 28 lone AF patients undergoing hybrid therapy, the plasma BNP level was measured before PVI and before and 3 months after administering an antiarrhythmic drug. Fifteen patients were free of AF after the hybrid therapy (effective group), and 13 still had recurrent AF after (noneffective group). At baseline, in all patients the BNP level was elevated, and there were no significant differences in the BNP level between the 2 groups. The BNP level was significantly decreased after PVI in the effective group (56.8 ± 23.1 versus 37.5 ± 16.7 pg/mL, P < 0.05) but not in the noneffective group (74.3 ± 47.8 versus 79.7 ± 54.4 pg/mL, NS). The elevated BNP level normalized in all effective group patients. The criterion consisting of a net value of < 60.0 pg/mL or a reduction in the BNP level of > 10.0 pg/mL after PVI predicted the effective group patients with a high accuracy.A significant reduction in the BNP level after PVI may be a useful predictor of the responders to antiarrhythmic drug therapy in patients with recurrent AF after PVI. The hybrid therapy may be effective in patients whose PVs serve as a dominant AF substrate. (Int Heart J 2008; 49: 143-151)

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Section: Discussionmentioning

confidence: 83%

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confidence: 99%

Plasma Brain Natriuretic Peptide Level After Hybrid Therapy With Pulmonary Vein Isolation and Antiarrhythmic Drugs for Atrial Fibrillation

et al. 2008

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“…Potential mediators of vasoconstriction might be of neurohumoral origin, as suggested by raised plasma levels of atrial natriuretic peptide or brain natriuretic peptide under AF (22), as well as their renormalization after successful catheter ablation of AF (23). Additionally, raised levels of the angiotensin-converting enzyme have been found in chronic AF (24).…”

Section: Pathophysiologic Considerationsmentioning

confidence: 99%

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

Range¹,

Paul²,

Schäfers³

et al. 2009

J Nucl Med

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Recent studies have shown that idiopathic atrial fibrillation (AF) is associated with diminished myocardial perfusion and perfusion reserve, which are also impaired in various forms of cardiomyopathies. In many cases, AF develops during progression of dilated cardiomyopathy (DCM) and may aggravate heart failure. This study compared myocardial perfusion between patients with nonischemic DCM with and without AF. Methods: Twelve men (age 6 SD, 55 6 12 y) who had DCM and persistent AF were compared with a group of 18 men (mean age, 43 6 15 y, P 5 not statistically significant) who had DCM and sinus rhythm and with 22 healthy controls (mean age, 47 6 13 y, P 5 not statistically significant). Myocardial blood flow (MBF) was noninvasively quantified at rest and during adenosine infusion using PET and radioactive-labeled water (H 2 15 O PET). Results: Compared with controls, DCM patients without AF showed impaired hyperemic perfusion (2.52 6 1.29 vs. 3.57 6 0.88 mL/min/mL, P 5 0.014) and perfusion reserve (2.10 6 1.01 vs. 3.37 6 0.97, P 5 0.003). However, compared with DCM patients without AF, DCM patients with AF showed an additional impairment in resting perfusion (0.82 6 0.31 mL/min/mL, P 5 0.010) and hyperemic perfusion (1.32 6 0.93 mL/min/mL, P 5 0.022), and compared with controls, DCM patients with AF showed a further diminishment of perfusion reserve (1.68 6 0.94 vs. 3.37 6 0.97, P , 0.001) accompanied by the highest coronary vascular resistance of all groups. Conclusion: Compared with patients with sinus rhythm, patients with AF have significantly reduced myocardial perfusion reserve and increased coronary resistance in nonischemic DCM. Further studies on the underlying pathomechanisms are warranted.

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“…AF causes variable filling times and irregular atrial contractions, causing local stretch at a cellular level that may cause release of natriuretic peptides such as NT-proBNP. 30 Because it is known that plasma levels of NT-proBNP decrease in patients with paroxysmal or persisting AF after restoration of sinus rhythm, 31,32 and because acute paroxysms increase BNP levels, 33 these effects appear dynamic in nature.…”

Section: Tion Of Long-term Anticoagulation Therapy (Re-ly) and The Apmentioning

confidence: 99%

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

Holl

Bos

Domburg

et al. 2018

Clinical Cardiology

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BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia in the emergency department. The CHA2DS2‐VASc score helps to predict thromboembolic risk; however, the rate of other adverse cardiac events is more difficult to predict.HypothesisThe biomarker N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has prognostic value in patients presenting to the emergency department with AF.MethodsDuring a 1.5‐year period, a prospective study was performed in consecutive patients presenting to the emergency department with AF on the presenting electrocardiogram. At baseline, NT‐proBNP was measured. The primary endpoints were all‐cause death and major adverse cardiac events (MACE: all‐cause mortality, myocardial infarction, or revascularization).ResultsA total of 355 patients were included (mean age, 71 years; 55% male). The median duration of follow‐up was 2 years. After adjustment for baseline variables, the logNT‐proBNP was independently correlated with death (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.18‐1.99) and MACE (HR: 1.27, 95% CI: 1.03‐1.58). After adjustment for baseline variables, a high NT‐proBNP value (>500 pmol/L) was independently correlated with death (HR: 2.26, 95% CI: 1.19‐4.28), and for MACE a trend was seen (HR: 1.67, 95% CI: 0.96‐2.91) compared with a low value (<250 pmol/L).ConclusionsIn patients presenting to the emergency department with AF, higher NT‐proBNP values are independently associated with an increased mortality and MACE. Therefore, this biomarker may be a useful prognostic marker in the management and treatment of these patients.

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Plasma Atrial Natriuretic Peptide and Brain Natriuretic Peptide Levels After Radiofrequency Catheter Ablation of Atrial Fibrillation

Cited by 51 publications

References 14 publications

Plasma Brain Natriuretic Peptide Level After Hybrid Therapy With Pulmonary Vein Isolation and Antiarrhythmic Drugs for Atrial Fibrillation

Plasma Brain Natriuretic Peptide Level After Hybrid Therapy With Pulmonary Vein Isolation and Antiarrhythmic Drugs for Atrial Fibrillation

Myocardial Perfusion in Nonischemic Dilated Cardiomyopathy With and Without Atrial Fibrillation

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

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