High Plasma Human Atrial Natriuretic Peptide and Reduced Transthoracic Left Atrial Appendage Wall‐Motion Velocity Are Noninvasive Surrogate Markers for Assessing Thrombogenesis in Patients with Paroxysmal Atrial Fibrillation

Yoshida, Naoyasu; Okamoto, Masahiro; Hirao, Hidekazu; Suenari, Kazuyoshi; Nanba, Kiyomi; Uchida, Mio; Yamazato, Ryo; Watari, Yuichiro; Fukuda, Yukihiro; Ueda, Hironori

doi:10.1111/echo.12501

Cited by 8 publications

(5 citation statements)

References 27 publications

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“…Moreover, the values are affected by the age, and other factors, as well Despite the fact that LA appendage could be analyzed by modern transthoracic echocardiographic methodologies including TDI, 3DSTE etc., LA appendage and pulmonary veins were excluded from evaluations. There are several aspects of HCM including genetic background, history of embolism, development of arrhythmias, etc., their relationship with the LA dysfunction was not examined in this study. The effects of dynamic obstructions on LA functional parameters were not examined in this study. LA function deteriorated in patients with sick sinus syndrome and in those with paroxysmal atrial fibrillation . However, all of our patients and controls were in sinus rhythm. This was a single‐center experience and limited by a relatively small number of HCM patients.…”

Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy–Insights from the MAGYAR‐Path Study

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Three‐Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy–Insights from the MAGYAR‐Path Study

et al. 2014

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“…Robust studies have demonstrated a relationship between ANP and the development of AF (12)(13)(14)(15). A frameshift mutation in the ANP gene was identified in patients with familial AF, and its frameshift product was shown to exhibit modified proteolytic degradation and a markedly longer half-life than ANP (14,15,31), indicating that abnormalities in ANP are involved in the pathogenesis of AF.…”

Section: Discussionmentioning

confidence: 99%

“…This study also found that overexpression of musclin can suppress the worsening of chronic heart failure (CHF) after myocardial infarction (MI) by inhibiting clearance of NP family members. A series of studies have reported the relationship of ANP or BNP with AF (12)(13)(14)(15), and NP has been recommended as a tool for the routine evaluation of patients with AF (16). Accordingly, physical exercise can up-regulate circulating musclin (17) and reduce the risk of atrial arrhythmias (18).…”

Section: Introductionmentioning

confidence: 99%

Decreased plasma musclin levels are associated with potential atrial fibrillation in non-diabetic patients

Zhong¹,

Zhang²,

Tang³

et al. 2021

Ann Transl Med

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Background: Musclin is involved in the regulation of natriuretic peptide (NP) clearance and may affect the concentration of atrial natriuretic peptide (ANP). It has also been found to play an important role in several diseases, such as diabetes mellitus and hypertension. Both abnormalities in ANP and associated medical history are involved in the pathogenesis of atrial fibrillation (AF). However, plasma concentration of musclin as a biomarker for risk stratification in patients with AF has not been fully investigated.Methods: Plasma musclin levels were measured in 290 patients with AF (including 199 paroxysmal AF patients and 91 persistent AF patients) and 120 control subjects. The association between plasma musclin levels and AF onset, as well as its predictive effects on clinical outcomes after cryoballoon ablation were analyzed.Results: AF patients were found to have a lower concentration of plasma musclin than healthy controls.Moreover, in the non-diabetic group and normal N-terminal pro-brain natriuretic peptide (NT-proBNP) level group, the association between lower plasma concentration of musclin and AF remained significant.According to receiver operating characteristic (ROC) curve analysis, the optimal cut-off point of musclin for predicting AF onset was 54.94 ng/mL, which had a sensitivity of 81.67% and a specificity of 31.47%[area under the ROC curve (AUC) =60.71%]. In follow-up studies, both diabetes and left atrial size were independent predictors of AF recurrence after ablation, while musclin showed only a modest relationship with the outcome of cryoballoon ablation.Conclusions: Our data indicated that decreased musclin was associated with the onset of AF. Moreover, lower plasma levels of musclin were an independent risk factor of AF in non-diabetic patients. Our studies suggest that musclin could be a predictive factor for the onset of AF.

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“…Since the LAA is a common site of thrombus formation, the association of the NLR with the LAA function and size has the potential to be an exciting finding. The LAA function ranges from normal to low in PAF patients ( 27 ). In the present study, the NLR also ranged from normal to high and was associated with the LAA wall motion velocity in the non-valvular PAF patients with SEC.…”

Section: Discussionmentioning

confidence: 99%

In Paroxysmal Atrial Fibrillation Patients, the Neutrophil-to-lymphocyte Ratio Is Related to Thrombogenesis and More Closely Associated with Left Atrial Appendage Contraction than with the Left Atrial Body Function

et al. 2018

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Objective The neutrophil-to-lymphocyte ratio (NLR) is an inflammation marker that can be used to detect atrial inflammatory changes, which may contribute to a reduced left atrial (LA) function and thrombosis. Our study aimed to determine whether or not the association of NLR with the LA appendage (LAA) function in relation to thrombogenesis differs from the association with the LA body function in paroxysmal atrial fibrillation (PAF) patients. Methods A total of 183 PAF patients were studied. The LA volume index, mitral flow velocity (A), and mitral annular motion velocity (A′) were examined using transthoracic echocardiography. The LAA area, LAA wall motion velocity, and presence of spontaneous echo contrast (SEC) were examined using transesophageal echocardiography. Results The NLR of patients with cerebral embolism was significantly greater than in patients without the disorder. A cut-off point of 2.5 for the NLR had a sensitivity of 71% and a specificity of 74% in predicting cerebral embolism. The patients with an NLR ≥2.5 had a higher CHADS2 score and greater LA volume index or LAA area than those with an NLR <2.5. The NLR was an independent risk factor for SEC and was significantly correlated with the LAA wall motion velocity (r=-0.409) in 153 patients without SEC and with the LAA wall motion velocity and LAA area (r=-0.583, r=0.654, respectively) in 30 patients with SEC, but not with the LA volume index, A, or A′ in either group. Conclusion In PAF patients, a high NLR indicates thrombogenesis with a high degree of certainty and is associated with reduced LAA contraction rather than with the LA body function.

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High Plasma Human Atrial Natriuretic Peptide and Reduced Transthoracic Left Atrial Appendage Wall‐Motion Velocity Are Noninvasive Surrogate Markers for Assessing Thrombogenesis in Patients with Paroxysmal Atrial Fibrillation

Abstract: Higher plasma HANP and lower LAA wall-motion velocity may be noninvasive surrogate markers for assessing left atrial thrombogenesis during sinus rhythm in paroxysmal AF patients.

Cited by 8 publications

References 27 publications

Three‐Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy–Insights from the MAGYAR‐Path Study

Three‐Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy–Insights from the MAGYAR‐Path Study

Decreased plasma musclin levels are associated with potential atrial fibrillation in non-diabetic patients

In Paroxysmal Atrial Fibrillation Patients, the Neutrophil-to-lymphocyte Ratio Is Related to Thrombogenesis and More Closely Associated with Left Atrial Appendage Contraction than with the Left Atrial Body Function

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