Predictive value of B-type natriuretic peptide levels in patients with paroxysmal and persistent atrial fibrillation undergoing pulmonary vein isolation

Degener, Stephan; Pattberg, Sarah V.; Feuersenger, Henrike; Bansmann, P. M.; Shin, Dong‐In; Krummenauer, Frank; Horlitz, Marc

doi:10.1007/s10840-010-9540-2

Cited by 18 publications

(16 citation statements)

References 37 publications

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“…In accordance with previous studies [16,21,22], baseline NT-pro-BNP values decreased significantly in patients after successful restoration of sinus rhythm. Patients with recurrence of AF had no significant reduction in median NT-pro-BNP after ablation.…”

Section: Nt-pro-bnpsupporting

confidence: 92%

N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

Solheim

Off

Hoff

et al. 2011

J Interv Card Electrophysiol

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Section: Nt-pro-bnpsupporting

confidence: 92%

N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

Solheim

Off

Hoff

et al. 2011

J Interv Card Electrophysiol

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“…Finally, 18 studies that met the inclusion criteria were included in our meta-analysis. Among them, 10 studies 8,[12][13][14][15][16][17][18][19][20] evaluated the association between baseline BNP levels and AF recurrence after catheter ablation while the 8 other studies [21][22][23][24][25][26][27][28] investigated the potential role of NT-pro BNP. Study characteristics: The demographic and clinical properties of eligible studies are presented in Table I and Table II, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…As we included a small number of studies for each group, formal assessment of publication bias with funnel plots might not be appropriate. Baseline BNP and post-ablation AF recurrence: Of the 10 studies on BNP included, 4,12,15,18,19) showed patients with AF recurrence after catheter ablation had significantly greater baseline BNP than those without AF recurrence. Overall, these data were synthesized with the other 6 studies 8,13,14,16,17,20) and the pooled SMD was 0.55 (95% CI: 0.26-0.84, P < 0.001, Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…Thus, the follow-up period might be a potential stratification factor for further investigations, although the effect was not observed when the same subgroup analysis was conducted in currently eligible studies on BNP. Moreover, previous studies 8,13,15,22,39) have suggested that non-paroxysmal AF, longer duration of AF, and larger left atrial size might reflect higher AF burden, which is correlated with elevated natriuretic peptides levels. However, in our study, covariates including AF type, AF duration, LAD, mean followup period, and concomitant heart failure did not show significant differences on meta-regression.…”

Section: Discussionmentioning

confidence: 99%

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Association Between Baseline Natriuretic Peptides and Atrial Fibrillation Recurrence After Catheter Ablation

et al. 2016

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SummaryNatriuretic peptides like B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro BNP) are reported to be increased in atrial fibrillation (AF) patients. However, the prognostic roles of BNP and NT-pro BNP in post-ablation AF recurrence remain inconclusive. We performed this meta-analysis to investigate the potential role of baseline natriuretic peptides in predicting AF recurrence after catheter ablation.Electronic databases were searched for studies that evaluated the potential relationship between AF recurrence and baseline BNP or NT-pro BNP levels. The pooled standardized mean difference (SMD) and 95% confidence interval (CI) were calculated to quantify differences in BNP or NT-pro BNP levels between patients with and without AF recurrence.Ten studies on BNP and 8 studies on NT-pro BNP were included, in which 411 of 1300 patients and 256 of 846 patients experienced AF recurrence, respectively. Overall, the pooled SMD of studies on BNP was 0.55 (95% CI: 0.26-0.84, P < 0.001) while the pooled SMD of studies on NT-pro BNP was 0.96 (95% CI: 0.62-1.30, P < 0.0001). Meta-regression was conducted by AF type, AF duration, follow-up period, left atrial dimension (LAD), and concomitant heart failure, after which subgroup analysis demonstrated only follow-up period (3 months or > 3 months) in the NT-pro BNP group might account for the heterogeneity. Sensitivity analyses indicated both the results were stable.Meta-analysis of current eligible studies suggested that both increased baseline BNP and NT-pro BNP levels are associated with greater risk of AF recurrence after catheter ablation, which could be biomarkers for predicting AF recurrence. (Int Heart J 2016; 57: 183-189) Key words: BNP, NT-pro BNP, Predictive A trial fibrillation (AF) is the most common arrhythmia and a rising global burden with progressive increases in prevalence, incidence, and AF-associated mortality during past decades. 1) Catheter ablation for rhythm control was recommended in specific patient populations with paroxysmal, persistent, or long-standing persistent AF by the latest guideline.2) However, relapse is still common since the singleprocedure efficacy of AF ablation was estimated to be 60-80% in paroxysmal AF and 50-70% in persistent AF.3) Since ablation techniques have been developed over time, the relapse rate might be partially due to the complicated pathological mechanisms and our limited knowledge of AF. Thus, stratification of patients who will sustain a better rhythm outcome after catheter ablation may be beneficial to clinical practice. Natriuretic peptides (BNP, NT-pro BNP) are primarily secreted by myocytes in response to a number of stimuli, and have been widely used as important diagnostic and monitoring tools for cardiovascular diseases. 4) Meanwhile, it has been shown that AF patients had higher plasma natriuretic peptide concentrations than controls and the elevated natriuretic peptide levels decreased when sinus rhythm was restored by transcatheter ablation.5-7) Somehow, it is inconsistent whether increase...

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“…BNP is elevated in AF patients with increased atrial pressure, and has been related to AF recurrence post CA . Serum BNP was found to be elevated preablation and declined postablation in patients with persistent AF, and BNP was reported as independent predictor of AF recurrence in the study .…”

Section: Discussionmentioning

confidence: 64%

Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project

Deng

Shantsila

Guo

et al. 2018

Journal of Arrhythmia

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BackgroundBiomarkers have been related to the arrhythmia recurrence following catheter ablation (CA) of atrial fibrillation (AF). We hypothesized that concurrent measurement of several biomarkers would additively improve their predictive value.MethodsOne thousand four hundred and ten consecutive AF patients (68% male; 57.2 ± 11.6 years) undergoing CA were enrolled. Baseline characteristics, serum B type brain natriuretic peptide (BNP) and high sensitivity C reactive protein (hsCRP), estimated glomerular filtration rate (eGFR), ablation parameters, arrhythmia data at discharge, 1, 3, 6, and then every 6 months post CA were collected. Follow‐up ended when arrhythmia recurred or until 31st December 2016.ResultsThree hundred and sixty‐five (25.9%) patients had arrhythmia recurrence post‐CA during a mean follow‐up of 20.7 ± 8.8 months. BNP, hsCRP, and eGFR levels and their cut‐off values of 237.45 pg/mL, 1.6 mg/dL, and 82.5 mL/min/1.73 m2 were good predictors for AF recurrence (all P < 0.01). On multivariate analysis, increasing BNP and hsCRP, decreasing eGFR, gender, and early recurrence (ER) were independent predictors of AF recurrence (all P < 0.01). Compared to BNP alone, BNP plus eGFR or both eGFR and CRP showed incrementally better predictive values (ROC comparisons, all P < 0.01). Similar findings were evident in the subgroups of patients with paroxysmal or nonparoxysmal AF.ConclusionMeasurement of BNP, CRP, and eGFR were incrementally additive to clinical risk factors in a cumulative manner to improve prediction of arrhythmia recurrence post‐CA of AF. The implications of poor arrhythmia outcome in AF patients with multiple abnormal biomarkers pre‐CA procedure may help with patient selection and inform the likelihood of success or the need of more complicated CA procedure(s).

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Predictive value of B-type natriuretic peptide levels in patients with paroxysmal and persistent atrial fibrillation undergoing pulmonary vein isolation

Abstract: Pre-ablation BNP level seems to be an independent marker for successful PVI procedures in patients with paroxysmal and persistent AF; however, the observed level of association is moderate.

Cited by 18 publications

References 37 publications

N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

N-terminal pro-B-type natriuretic peptide level at long-term follow-up after atrial fibrillation ablation: a marker of reverse atrial remodelling and successful ablation

Association Between Baseline Natriuretic Peptides and Atrial Fibrillation Recurrence After Catheter Ablation

Multiple biomarkers and arrhythmia outcome following catheter ablation of atrial fibrillation: The Guangzhou Atrial Fibrillation Project

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