Impact of Midregional N‐Terminal Pro–Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study

Abstract

Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P <0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P =0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03351816.

Predictive value of soluble suppression of tumorigenicity 2 in atrial fibrillation: a systematic review and meta-analysis

“…A total of 8 studies were analyzed with 1,021 AF patients (including 255 AF recurrence and 766 not recurrence). The pooled analysis of 7 studies ( 14 , 19 , 20 , 22 , 26 , 31 , 33 ) as a continuous variable indicated that sST2 was associated with the risk of AF recurrence (HR:1.09, 95% CI: 1.02–1.16, P < 0.01; I 2 = 89.5% Figure 4 ). Sensitivity analyses showed that the outcomes were stable ( Supplementary Figure S4A ).…”

“…Table 1 displayed the baseline characteristics of 24 included studies from 2015 to 2022, comprising 14 prospective studies ( 14 , 17 – 23 , 26 , 29 – 31 , 33 , 37 ), 4 retrospective studies ( 24 , 25 , 27 , 32 ), 4 cross-sectional studies ( 12 , 13 , 34 , 35 ), and 2 case-control studies ( 28 , 36 ). Eleven studies were conducted in Asia (China, Thailand, Singapore), 10 studies in Europe (Germany, Poland, Finland, France, Norway, Spain, Sweden, Turkey), and 3 study in America (The united states).…”

“…The included studies used various sources of sST2 reagents and adopted diverse detection strategies (e.g., 15 studies used ELISA to detect sST2, 2 used aspect plus assay, 1 used plasma samples assay, and 1 used duoset immunoassay assay). Concerning the purpose of these studies, 12 studies ( 12 , 13 , 21 , 24 , 25 , 27 , 28 , 32 , 34 – 37 ) evaluated the predictive value of sST2 in occurrence of AF, while 8 studies ( 14 , 19 , 20 , 22 , 26 , 29 , 31 , 33 ) evaluated AF recurrence, 5 studies ( 17 , 18 , 23 , 30 , 37 ) evaluated MACEs following AF.…”

Association of Preablation Plasma Corin Levels With Atrial Fibrillation Recurrence After Catheter Ablation: A Prospective Observational Study

“…Third, some clinical studies have found that elevated ANP, or midregional N‐terminal pro‐ANP, type B natriuretic peptide, and N‐terminal pro‐BNP levels were significantly associated with the risk factor of AF recurrence after ablation. 54 , 55 , 56 , 57 , 58 We did not discuss the association between those factors and recurrent AF after ablation. Fourth, plasma corin levels are correlated with immediate heart rhythm, as confirmed by higher concentrations in AF than in sinus rhythm.…”

Diabesity in Elderly Cardiovascular Disease Patients: Mechanisms and Regulators

“…As abdominal visceral adiposity increases, there is a higher risk of noncalcified plaques [ 53 ]. A PARADIGM sub-study has demonstrated that plaque progression is also dependent on ageing [ 54 ].…”