title: Gene expression of the natriuretic peptide system in atrial tissue of patients with paroxysmal and persistent atrial fibrillation.
abstract: BACKGROUND
  Circulating cardiac natriuretic peptides play an important role in maintaining volume homeostasis, especially during conditions affecting hemodynamics. During atrial fibrillation (AF), levels of plasma atrial natriuretic peptide (ANP) becomes elevated. The aim of this study was to gather information about gene expression of the natriuretic peptide system on the atrial level in patients with AF.
  
  
  RESULTS
  Right atrial appendages of 36 patients with either paroxysmal or persistent AF were compared with 36 case matched controls in sinus rhythm for mRNA expression of pro- atrial natriuretic peptide (pro-ANP), pro-brain natriuretic peptide (pro-BNP), and their natriuretic peptide receptor type-A (NPR-A). We investigated patients without (n = 36) and with (n = 36) valvular disease. Persistent AF was associated with higher mRNA expression of pro-BNP (+66%, P = 0.04, in patients without valvular disease, and +69%, P < 0.01, in patients with valvular disease) and lower mRNA expression of NPR-A (-58%, P = 0.02, in patients without valvular disease, and -62 %, P < 0.01, in patients with valvular disease). The mRNA content of pro-ANP was only increased in patients with valvular disease (+12%, P = 0.03). No changes were observed in patients with paroxysmal AF.
  
  
  CONCLUSIONS
  This study demonstrates that persistent, but not paroxysmal, AF induces alterations in gene expression of pro-BNP and NPR-A on the atrial level. Although AF generally is associated with an increase of plasma ANP level, a change in mRNA content of pro-ANP is only observed in the presence of concomitant valvular disease and is of minor magnitude.
authors.affiliation: Department of Cardiology, Thoraxcenter, University Hospital Groningen, The Netherlands.
authors.forename: A E
authors.initials: AE
authors.lastname: Tuinenburg
authors.forename: B J
authors.initials: BJ
authors.lastname: Brundel
authors.forename: I C
authors.initials: IC
authors.lastname: Van Gelder
authors.forename: R H
authors.initials: RH
authors.lastname: Henning
authors.forename: M P
authors.initials: MP
authors.lastname: Van Den Berg
authors.forename: C
authors.initials: C
authors.lastname: Driessen
authors.forename: J G
authors.initials: JG
authors.lastname: Grandjean
authors.forename: W H
authors.initials: WH
authors.lastname: Van Gilst
authors.forename: H J
authors.initials: HJ
authors.lastname: Crijns
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000378:metabolism*; D009320:Atrial Natriuretic Factor / Q000235:genetics*; D005260:Female; D006325:Heart Atria / Q000378:metabolism*; D006349:Heart Valve Diseases / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000235:genetics*; D011498:Protein Precursors / Q000235:genetics; D012333:RNA, Messenger / Q000032:analysis*; D017461:Receptors, Atrial Natriuretic Factor / Q000235:genetics*
chemical_list: D011498:Protein Precursors; D012333:RNA, Messenger; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D017461:Receptors, Atrial Natriuretic Factor