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Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation
The relationship between natriuretic peptides and atrial distension is not fully understood. We sought to examine their interrelationship and how they relate to atrial fibrillation (AF) recurrence following catheter ablation. We analyzed patients enrolled in the AMIO-CAT trial (amiodarone vs. placeb...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589158/ https://www.ncbi.nlm.nih.gov/pubmed/37428246 http://dx.doi.org/10.1007/s10554-023-02913-y |
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author | Olsen, Flemming Javier Darkner, Stine Goetze, Jens Peter Chen, Xu Henningsen, Kristoffer Pehrson, Steen Svendsen, Jesper Hastrup Biering-Sørensen, Tor |
author_facet | Olsen, Flemming Javier Darkner, Stine Goetze, Jens Peter Chen, Xu Henningsen, Kristoffer Pehrson, Steen Svendsen, Jesper Hastrup Biering-Sørensen, Tor |
author_sort | Olsen, Flemming Javier |
collection | PubMed |
description | The relationship between natriuretic peptides and atrial distension is not fully understood. We sought to examine their interrelationship and how they relate to atrial fibrillation (AF) recurrence following catheter ablation. We analyzed patients enrolled in the AMIO-CAT trial (amiodarone vs. placebo for reducing AF recurrence). Echocardiography and natriuretic peptides were assessed at baseline. Natriuretic peptides included mid-regional proANP (MR-proANP) and N-terminal proBNP (NT-proBNP). Atrial distension was assessed by left atrial strain measured by echocardiography. The endpoint was AF recurrence within 6 months after a 3-month blanking period. Logistic regression was used to assess the association between log-transformed natriuretic peptides and AF. Multivariable adjustments were made for age, gender, randomization, and left ventricular ejection fraction. Of 99 patients, 44 developed AF recurrence. No differences in natriuretic peptides nor echocardiography were observed between the outcome groups. In unadjusted analyses, neither MR-proANP nor NT-proBNP were significantly associated with AF recurrence [MR-proANP: OR = 1.06 (0.99–1.14), per 10% increase; NT-proBNP: OR = 1.01 (0.98–1.05), per 10% increase]. These findings were consistent after multivariable adjustments. However, atrial strain significantly modified the association between MR-proANP and AF (p for interaction = 0.009) such that MR-proANP was associated with AF in patients with high atrial strain [OR = 1.24 (1.06–1.46), p = 0.008, per 10% increase] but not in patients with low atrial strain. In patients with high atrial strain, an MR-proANP > 116 pmol/L posed a fivefold higher risk of AF recurrence [HR = 5.38 (2.19–13.22)]. Atrial natriuretic peptide predicts AF recurrence in patients with preserved atrial distension. Assessing atrial strain may assist the interpretation of natriuretic peptides. GRAPHICAL ABSTRACT: [Image: see text] |
format | Online Article Text |
id | pubmed-10589158 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-105891582023-10-22 Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation Olsen, Flemming Javier Darkner, Stine Goetze, Jens Peter Chen, Xu Henningsen, Kristoffer Pehrson, Steen Svendsen, Jesper Hastrup Biering-Sørensen, Tor Int J Cardiovasc Imaging Original Paper The relationship between natriuretic peptides and atrial distension is not fully understood. We sought to examine their interrelationship and how they relate to atrial fibrillation (AF) recurrence following catheter ablation. We analyzed patients enrolled in the AMIO-CAT trial (amiodarone vs. placebo for reducing AF recurrence). Echocardiography and natriuretic peptides were assessed at baseline. Natriuretic peptides included mid-regional proANP (MR-proANP) and N-terminal proBNP (NT-proBNP). Atrial distension was assessed by left atrial strain measured by echocardiography. The endpoint was AF recurrence within 6 months after a 3-month blanking period. Logistic regression was used to assess the association between log-transformed natriuretic peptides and AF. Multivariable adjustments were made for age, gender, randomization, and left ventricular ejection fraction. Of 99 patients, 44 developed AF recurrence. No differences in natriuretic peptides nor echocardiography were observed between the outcome groups. In unadjusted analyses, neither MR-proANP nor NT-proBNP were significantly associated with AF recurrence [MR-proANP: OR = 1.06 (0.99–1.14), per 10% increase; NT-proBNP: OR = 1.01 (0.98–1.05), per 10% increase]. These findings were consistent after multivariable adjustments. However, atrial strain significantly modified the association between MR-proANP and AF (p for interaction = 0.009) such that MR-proANP was associated with AF in patients with high atrial strain [OR = 1.24 (1.06–1.46), p = 0.008, per 10% increase] but not in patients with low atrial strain. In patients with high atrial strain, an MR-proANP > 116 pmol/L posed a fivefold higher risk of AF recurrence [HR = 5.38 (2.19–13.22)]. Atrial natriuretic peptide predicts AF recurrence in patients with preserved atrial distension. Assessing atrial strain may assist the interpretation of natriuretic peptides. GRAPHICAL ABSTRACT: [Image: see text] Springer Netherlands 2023-07-10 2023 /pmc/articles/PMC10589158/ /pubmed/37428246 http://dx.doi.org/10.1007/s10554-023-02913-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Paper Olsen, Flemming Javier Darkner, Stine Goetze, Jens Peter Chen, Xu Henningsen, Kristoffer Pehrson, Steen Svendsen, Jesper Hastrup Biering-Sørensen, Tor Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title | Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title_full | Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title_fullStr | Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title_full_unstemmed | Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title_short | Interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
title_sort | interplay between natriuretic peptides and left atrial mechanics and the relation to recurrence of atrial fibrillation following catheter ablation |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10589158/ https://www.ncbi.nlm.nih.gov/pubmed/37428246 http://dx.doi.org/10.1007/s10554-023-02913-y |
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