心房利钠肽可以预测症状性主动脉狭窄术后受损心房重塑及迟发心房纤颤

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:yfan828
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Background: Aortic stenosis(AS) and atrial fibrillation(AF)are commonly encountered in clinical practice. Natriuretic peptides(NP) are endogenous cardiac hormones, which have been shown to increase in patients with heart failure, and valvular or congenital heart disease. We aimed to determine the association between atrial NP(ANP) and late postoperative AF after surgery for AS along with temporal changes in plasma ANP levels and left atrial(LA) volumes. Methods: 22 patients(16 males/6 females, mean age: 61 years) with symptomatic AS and 8 healthy volunteers(5 males/3 females) were enrolled into our study. All the patients studied underwent transthoracic echocardiography, which was repeated during the follow-up. N-terminal ANP(N-ANP) was studied initially and at the 2-month follow-up. Postoperatively, the patients were followed up for 12 months for AF attacks. Results: Patients with AS had significantly higher levels of N-ANP, left ventricular(LV)end-diastolic pressure, E/A ratio, LV mass and LA volumes compared to the controls. Patients with postoperative AF attacks were significantly older, had higher N-ANP levels and LV end-diastolic pressure in addition to higher LA volumes and longer symptom duration compared to patients without AF. Age at the time of operation(p=0.011) and N-ANP at the 2nd month(p=0.047) were found to be independent predictors for late AF attacks during follow-up in regression analysis. Besides, N-ANP(p< 0.001) at the 2-month follow-up independently predicted impaired LA remodeling. Conclusion: ANP might be an important factor to identify AS patients at risk for late postoperative AF attacks. Background: Aortic stenosis (AS) and atrial fibrillation (AF) are commonly encountered in clinical practice. Natriuretic peptides (NP) are endogenous cardiac hormones, which have been shown to increase in patients with heart failure, and valvular or congenital heart disease. Methods to determine the association between atrial NP (ANP) and late postoperative AF after surgery for AS along with temporal changes in plasma ANP levels and left atrial (LA) volumes. Methods: 22 patients (16 males / 6 females, mean age: 61 years) with symptomatic AS and 8 healthy volunteers (5 males / 3 females) were enrolled into our study. All the patient studied underwent transthoracic echocardiography, which was repeated during the follow-up. N-terminal ANP (N-ANP) was studied initially and at the 2-month follow-up. Postoperatively, the patients were followed up for 12 months for AF attacks. Results: Patients with AS had significantly higher levels of N-ANP, left ventricular (LV) end- diastolic pressure, E / A ratio, LV ma ss and LA volumes compared to the controls. Patients with postoperative AF attacks were significantly older, had higher N-ANP levels and LV end-diastolic pressure in addition to higher LA volumes and longer symptom duration compared to patients without AF. Age at the time of operation (p = 0.011) and N-ANP at the 2nd month (p = 0.047) were found to be independent predictors for late AF attacks during follow-up in regression analysis. 2-month follow-up independently predicted impaired LA remodeling. Conclusion: ANP might be an important factor to identify AS patients at risk for late postoperative AF attacks.
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