Sinus Rhythm Restoration after Atrial Fibrillation: The Clinical Value of N‐Terminal Pro‐BNP Measurements

Danicek, Vladimir; Theodorovich, Nick; Bar-Chaim, Shmuel; Miller, Asaf; Vered, F.A.C.C. Zvi; Koren‐Morag, Nira; Uriel, Nir; Czuriga, István; Shopen, Andrey; Brantriss, Nurit; Kaluski, Edo

doi:10.1111/j.1540-8159.2008.01121.x

Cited by 16 publications

(16 citation statements)

References 31 publications

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“…It was also reported that both NT-proBNP and BNP values decrease after conversion to sinus rhythm in patients with persistent AF [16,17]. Moreover, natriuretic peptides are predictive of recurrent AF after electrical cardioversion.…”

Section: Paroxysmalmentioning

confidence: 99%

The intracardiac concentrations of the N-terminal-pro B-type natriuretic peptide (NT-proBNP) and the determinants of its secretion in patients with atrial fibrillation

Streb¹,

Mitręga²,

Szymała³

et al. 2018

Kardiol Pol

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A b s t r a c tBackground: N-terminal-pro B-type natriuretic peptide (NT-proBNP) is elevated not only in heart failure (HF) but also in atrial fibrillation (AF). The role and secretion pattern of NT-proBNP in AF is still undetermined. Aim:The study aimed to assess NT-proBNP concentrations in patients with and without preserved left ventricular ejection fraction (LVEF) depending on the type of AF. It was also intended to define the main source of NT-proBNP production within the heart. In addition, it aimed to study the relation of NT-proBNP with some echocardiographic parameters reflecting the stretch of heart chambers as well as with the chosen parameters of physical capacity.Methods: Blood samples were collected from the right atrium (RA), left atrium (LA), and femoral artery (FA) in 53 patients referred for occlusion of the LA appendage. Thirty patients were assigned into Group I (LVEF ≥ 50%, no HF symptoms) and the remaining 23 patients to Group II (LVEF < 50%, HF symptoms). NT-proBNP concentrations were determined using the ELISA test. Results:In Group I, the lowest NT-proBNP level was found in RA (460.47 ± 723.15 pg/mL and 1097.72 ± 851.42 pg/mL for paroxysmal and permanent AF, respectively), higher in LA (481.5 ± 724.56 pg/mL and 1188.06 ± 851.42 pg/mL for paroxysmal and permanent AF), and the highest values in FA (537.77 ± 808.49 pg/mL and 1188.04 ± 798.28 pg/mL for paroxysmal and permanent AF). In Group II the NT-proBNP values were significantly higher compared to Group I (p < 0.01), but similarly values in RA were the lowest (183.47 ± 1826.08 pg/mL and 2141.68 ± 1801.69 pg/mL for paroxysmal and permanent AF), intermediate values were observed in LA (1857.57 ± 2221.39 pg/mL and 2386.81 ± 2067.2 pg/mL for paroxysmal and permanent AF), and the highest were seen in FA (1936FA ( .27 ± 2149FA ( .85 and 2437FA ( .33 ± 1999.37 pg/mL for paroxysmal and permanent AF, respectively). In Group I, NT-proBNP from LA best correlated with LA area (r = 0.56) and RA area (r = 0.56). In Group II, the strongest correlations were found between NT-proBNP from LA and left ventricular end-systolic dimension (r = 0.57) and volume (r = 0.6). Conclusions:NT-proBNP is markedly elevated in the majority of patients with AF even in the absence of HF. LA secretion of NT-proBNP is an important contributor to the overall increase of NT-proBNP also in HF patients. In AF patients, the concentration of NT-proBNP correlates with the remodelling of heart chambers, but not with physical capacity.

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Section: Paroxysmalmentioning

confidence: 99%

The intracardiac concentrations of the N-terminal-pro B-type natriuretic peptide (NT-proBNP) and the determinants of its secretion in patients with atrial fibrillation

Streb¹,

Mitręga²,

Szymała³

et al. 2018

Kardiol Pol

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“…It has been also recommended that BNP increases within 4 hours from the onset of atrial inflammation; whether this applies to NT-pro-BNP is also not clear [20]. In demonstrating association between NT-pro-BNP and atrial fibrillation, it has been shown that NT-pro-BNP levels may drop after successful cardioversion of atrial inflammation [17]. Actually, the treatment of atrial inflammation can be reflected by reducing the level of NT-pro-BNP.…”

Section: Discussionmentioning

confidence: 99%

“…The association between NT-pro-BNP level and atrial fibrillation has been less studied and understood. Some studies have proved that NT-pro-BNP is increased in atrial fibrillation [16][17][18][19]. The proposed mechanisms are high frequency of atrial myocyte contraction and local atrial inflammation [18].…”

Section: Discussionmentioning

confidence: 99%

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

Safi

Bayat

Ahmadi

et al. 2017

Romanian Journal of Internal Medicine

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Background. The change in the level of NT-pro-BNP (N-terminal-pro-Brain Natriuretic Peptide) is now considered as a reflection of the hemodynamic alterations and its circulatory reductions reported early after successful PTMC (percutaneous transvenous mitral commissurotomy). The present study aims to assess the change in the level of NT-pro BNP following PTMC in patients with mitral stenosis and also to determine the association between circulatory NT-pro-BNP reduction and post-PTMC echocardiography parameters. Methods. Twenty five symptomatic consecutive patients with severe MS undergoing elective PTMC were prospectively enrolled. All patients underwent echocardiography before and also 24 to 48 hours after PTMC. Peripheral blood samples were taken for measurement of NT-pro-BNP before as well as 24 to 48 hours after PTMC. The patients were also classified in group with normal sinus rhythm or having atrial fibrillation (AF) based on their 12-lead electrocardiogram. Results. It was shown a significant decrease in the parameters of PPG (Peak Pressure Gradient), MPG (Mean Pressure Gradient), PHT (Pressure Half Time), PAP (Pulmonary Arterial Pressure), LAV (Left Atrial Volume), and also a significant increase in MVA (Mitral Valve Area) RVS (Right Ventricular S velocity), and strains of lateral, septal, inferior and anterior walls of LA following PTMC. The mean LVEF remained unchanged after PTMC. The mean NT-pro-BNP before PTMC was 309.20 ± 17.97 pg/lit that significantly diminished after PTMC to 235.72 ± 22.46 pg/lit (p = 0.009). Among all echocardiography parameters, only MPG was positively associated with the change in NT-pro-BNP after PTMC. Comparing the change in echocardiography indices between the patients with normal rhythm and those with AF, lower change in PAP was shown in the group with AF. However, more change in the level of NT-pro-BNP after PTMC was shown in the patients with AF compared to those without this arrhythmia. Conclusion. PTMC procedure leads to reduce the level of NT-pro-BNP. The change in NT-pro-BNP is an indicator for change in MS severity indicated by decreasing MPG parameter. Lower change in PAP as well as higher change in NT-pro-BNP is predicted following PTMC in the group with AF compared to those with normal sinus rhythm.

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“…Some recurrent AF patients yet had a major reduction in AF burden after ablation, which might contribute to a reduction in NT-pro-BNP. We included patients with paroxysmal AF and relatively low AF burden (mean 13.7/20; range [8][9][10][11][12][13][14][15][16][17][18][19][20]. Several of these patients had a baseline NT-pro-BNP well within the normal range, yet there was a statistically significant decrease of NTpro-BNP in patients after successful ablation which correlated with the reduction in LA volume.…”

Section: Nt-pro-bnpmentioning

confidence: 98%

“…Plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) correlates with left atrial (LA) size [12] and epidemiological studies have identified it as a predictor of the development of AF [13]. Successful ablation of AF may initiate a reverse remodelling process in the atria, and LA size and NT-pro-BNP may decrease after restoration of sinus rhythm [14][15][16][17]. In this study, we aimed to investigate the relation between arrhythmia burden, left atrial size and NT-pro-BNP before AF ablation and after long-term follow-up in patients with normal left ventricular systolic function.…”

Section: Introductionmentioning

confidence: 98%

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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Sinus Rhythm Restoration after Atrial Fibrillation: The Clinical Value of N‐Terminal Pro‐BNP Measurements

Abstract: With SR restoration, NTP-BNP decline is observed up to 1 month. NTP-BNP drop is partially or completely abolished by PaAF and RAF, respectively. NTP-BNP does not predict successful SR restoration.

Cited by 16 publications

References 31 publications

The intracardiac concentrations of the N-terminal-pro B-type natriuretic peptide (NT-proBNP) and the determinants of its secretion in patients with atrial fibrillation

The intracardiac concentrations of the N-terminal-pro B-type natriuretic peptide (NT-proBNP) and the determinants of its secretion in patients with atrial fibrillation

The change in NT-pro-BNP and post-PTMC echocardiography parameters in patients with mitral stenosis. A pilot study

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

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