Role of NT-proANP and NT-proBNP in patients with atrial fibrillation: Association with atrial fibrillation progression phenotypes

Büttner, Petra; Schumacher, Katja; Dinov, Borislav; Zeynalova, Samira; Sommer, Philipp; Bollmann, Andreas; Husser, Daniela; Hindricks, Gerhard; Kornej, Jelena

doi:10.1016/j.hrthm.2018.03.021

Cited by 40 publications

(32 citation statements)

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“…Different factors including female gender, older age, traditional cardiac risk factors, left ventricular dysfunction, increased epicardial adipose tissue, myocardial fibrosis, and atrial enlargement have been proposed as possible predictors of post‐ablation AF recurrence 330–332 . Moreover, diverse AF recurrence risk‐prediction scores, including APPLE, ALARMEc, ATLAS, BASE‐AF2, CAAP‐AF, DR‐FLASH, and MB‐LATER have been introduced; however, their integration into the daily clinical practice needs further support by healthcare systems 333–342 …”

Section: How To Assess Risk For Adverse Outcomes In Patients With Atrmentioning

confidence: 99%

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population

Nielsen

Lin

Figueiredo

et al. 2020

Journal of Arrhythmia

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Section: How To Assess Risk For Adverse Outcomes In Patients With Atrmentioning

confidence: 99%

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population

Nielsen

Lin

Figueiredo

et al. 2020

Journal of Arrhythmia

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“…This result suggests that NPs might be useful in estimating onset time and determining treatment strategies accordingly in patients without documented AF. In another study investigating progression from paroxysmal AF to persistent AF, predictive ability of NT-proBNP was not observed while NT-proANP levels could predict progression (276). In order to enable NP-guided treatment, extensive studies are necessary to compare different treatment methods in the context of NP levels in patients who are expected to maintain sinus rhythm and have a high likelihood of progression.…”

Section: Identifying the Occurrence Duration And Progression Of Afmentioning

confidence: 99%

Natriuretic Peptides in Clinical Practice

Çavuşoğlu

Alper²,

Altay³

et al. 2019

Anatol J Cardiol

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Natriuretic peptides (NP) are commonly used diagnostic biomarkers in heart failure (HF). While the American HF guideline strongly recommends NPs as class I indication with the level of evidence A in the diagnosis of both acute and chronic HF (1), the European HF guideline recommends them as class I indicationwith the level of evidence A for acute HF and as class IIa indication with the level of evidence C for chronic HF (2). Similarly, NPs have been proven to be strong biomarkers for prognosis and risk assessment in HF. The American HF guideline recommends NPs as class I indication with the level of evidence A in the assessment of prognosis of both acute and chronic HF (1). Moreover, the American HF guideline recommends NP monitorization as class IIa indication with the level of evidence B for achieving optimal treatment target in chronic HF (1). However, it Natriuretic peptides have long been introduced into clinical practice. These biomarkers have certainly been shown to provide useful information in the diagnosis, prognosis and risk stratification in heart failure and also may have a role in the guidance of heart failure therapy. Although, there are some limitations in using of these markers such as lack of specificity, aging, renal dysfunction or obesity, among the huge number of candidates for heart failure biomarkers, only natriuretic peptides are currently widely used in daily clinical practice in heart failure. Recent heart failure guidelines recognize natriuretic peptides as an essential tool in the new diagnostic and therapeutic algorithms. Furthermore, natriuretic peptides are not only used in the diagnosis or prognosis of heart failure, but also these biomarkers are referred to have some potential role in primary prevention, cardio-oncology, advanced heart failure, assessment of response to cardiac resynchronization therapy, pulmonary arterial hypertension, acute coronary syndromes, atrial fibrillation and valvular heart disease. In this article, natriuretic peptides have been reviewed for their updated information and new recommendations in heart failure and also potential role of these biomarkers in the management of various clinical conditions have been addressed in the form of expert opinion based on the available data in the literature.

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“…Одним из дискуссионных вопросов при такой полиморбидности остается корректность диагностики ХСН. Ряд авторов отмечают, что не N-терминальный фрагмент предшественника мозгового натрийуретического пептида (NТ-proBNP), а N-терминальный фрагмент предшественника предсердного натрийуретического пептида (NТ-proANP) значительно повышается у больных ФП за счет значительного миокардиального стресса в предсердиях [2]. Более того, исследователи продемонстрировали, что концентрация NТ-proANP повышается не у всех больных с ФП, а нарастает от одного фенотипа к другому: минимальная -у больных с пароксизмальной формой ФП без увеличения диаметра левого предсердия (ЛП), далеепри персистирующей форме ФП без увеличения размера ЛП, затем -при пароксизмальной и персистирующей формах ФП с увеличением размера ЛП.…”

Section: Introductionunclassified

“…Более того, исследователи продемонстрировали, что концентрация NТ-proANP повышается не у всех больных с ФП, а нарастает от одного фенотипа к другому: минимальная -у больных с пароксизмальной формой ФП без увеличения диаметра левого предсердия (ЛП), далеепри персистирующей форме ФП без увеличения размера ЛП, затем -при пароксизмальной и персистирующей формах ФП с увеличением размера ЛП. Следовательно, натрийуретические пептиды показывают различную чувствительность в зависимости от фенотипа ФП [2].…”

Section: Introductionunclassified

Peculiarities of chronic heart failure formation in patients with persistent atrial fi brillation depending on the renal dysfunction phenotype

Полянская

Козиолова

2020

SMJ

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Aim. To study the features of chronic heart failure (CHF) formation in patients with persistent atrial fibrillation (AF) depending on the phenotype of renal dysfunction.Material and Methods. The study included 60 patients with persistent AF and CHF. To diagnose CHF, echocardiography study was performed and the concentrations of NT-pRoBNP and sST2 in the blood serum were determined. Renal filtration function was assessed by glomerular filtration rate (GFR) calculated based on creatinine and cystatin C. Plasma NGAL concentration was determined to assess tubular dysfunction. Three phenotypes of renal damage were identified. Group 1 included 14 individuals (23.3%) with isolated tubular dysfunction assessed by NGAL; group 2 included 14 patients (23.3%) with isolated glomerular dysfunction assessed by GFR (CKD-EPIcys); group 3 comprised 32 patients (53.3%) with a combination of tubular and glomerular dysfunction.Results. The GFR value (CKD-EPIcre) below 60 mL/min/1.73 m2 was found in 36.7% of patients from groups 2 and 3. The concentration of cystatin C significantly diff ered between groups and was the highest in group 3. The value of GFR (CKDEPIcys) below 60 mL/min/1.73 m2 was detected in 76.7% of patients from all groups. The value of GFR (CKD-EPIcys) significantly diff ered between groups and was the lowest in group 3. When comparing serum creatinine and cystatin C in group 1, eight patients (57.1%) showed latent glomerular dysfunction, which manifested only in the concentration of cystatin C. A relationship was found between the level of DBP and NGAL (r = 0.44; p < 0.05). The correlations were identified between the parameters of left ventricular (LV) diastolic function and indicators of filtration function and tubular apparatus of the kidneys, namely: between E/e’ and NGAL concentration (r = 0.31; p < 0.05); between E/e’ and cystatin C concentration (r = 0,30; p < 0.05); between E/A and NGAL concentration (r = –0.36; p < 0.05); and between septal e’ and cystatin C concentration (r = –0.30; p < 0.05). Relationships were found between the concentrations of NGAL and sST2 (r = 0.44; p < 0.05) and between the concentrations of cystatin C and TIMP-1 (r = 0.39; p < 0.05).Conclusion. The use of blood cystatin C to assess kidney filtration function allowed to detect latent glomerular dysfunction in 57.1% of patients with heart failure and persistent AF, which could not be determined by GFR (CKD-EPIcre). Patients with persistent AF developed CHF with preserved LV EF regardless of the phenotype of renal dysfunction. The severities of glomerular filtration and kidney tubular apparatus abnormalities correlated with the severity of diastolic dysfunction. Unlike clinical indicators and blood concentration of NT-proBNP, sST2 levels allowed to detect the diff erences in heart failure severity in patients with persistent AF depending on the phenotype of renal dysfunction: the lowest severity was observed in the presence of glomerular dysfunction; the highest severity was found in the presence of combined dysfunction. Glomerular dysfunction in patients with CHF and persistent AF was associated with the impaired collagen formation and TIMP-1 activation.

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Role of NT-proANP and NT-proBNP in patients with atrial fibrillation: Association with atrial fibrillation progression phenotypes

Cited by 40 publications

References 27 publications

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population

European Heart Rhythm Association (EHRA)/Heart Rhythm Society (HRS)/Asia Pacific Heart Rhythm Society (APHRS)/Latin American Heart Rhythm Society (LAHRS) expert consensus on risk assessment in cardiac arrhythmias: use the right tool for the right outcome, in the right population

Natriuretic Peptides in Clinical Practice

Peculiarities of chronic heart failure formation in patients with persistent atrial fi brillation depending on the renal dysfunction phenotype

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