title: N-terminal pro-atrial natriuretic peptide as a biochemical marker of long-term interventional success after radiofrequency catheter ablation of paroxysmal supraventricular tachyarrhythmias.
abstract: Radiofrequency (RF) catheter ablation has been shown to be highly effective in the treatment of supraventricular tachycardias. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (B-type natriuretic peptide; BNP) are secreted by the heart mainly in response to myocardial stretch induced by volume load. The aim of the present study was to determine the time course of the N-terminal prohormone forms of ANP (NT-proANP) and BNP (NT-proBNP) in patients undergoing radiofrequency (RF) catheter ablation for paroxysmal supraventricular tachycardias. Serial blood samples were taken from 13 patients with symptomatic paroxysmal supraventricular tachycardias undergoing RF ablation and from 13 age- and gender-matched healthy controls. Blood was taken before ablation (day 0, baseline), and at day one and day 120 after ablation. Levels of NT-proANP were significantly higher before RF ablation (4862+/-726 pmol/l) as compared to day one (2021+/-220 pmol/l) and day 120 after RF ablation (2470+/-349 pmol/l) (with p<0.01 on day one and p<0.05 on day 120; n=13). The size of the left atrium decreased from 41.0+/-5.5 mm before ablation to 34.9+/-5.9 mm (n=13; p<0.05) on day 120 as measured by M-mode echocardiography. Levels of NT-proBNP showed comparable values before and on day one and day 120 after ablation and were not significantly elevated as compared to healthy controls. NT-proANP levels are increased in patients presenting with paroxysmal supraventricular tachycardias and decrease one day after radiofrequency catheter ablation, possibly reflecting a transient reduction of ANP secretion from injured myocardial cells. Lower NT-proANP levels in the long-term time course may result from reduction of atrial volume load and reconstitution of atrial architecture after successful treatment of supraventricular tachycardias. NT-proANP may serve as a useful laboratory marker to describe the long-term interventional success after RF ablation.
authors.affiliation: First Department of Medicine, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. martina.brueckmann@med.ma.uni-heidelberg.de
authors.forename: Martina
authors.initials: M
authors.lastname: Brueckmann
authors.forename: Thomas
authors.initials: T
authors.lastname: Bertsch
authors.forename: Ursula
authors.initials: U
authors.lastname: Hoffmann
authors.forename: Siegfried
authors.initials: S
authors.lastname: Lang
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Kaden
authors.forename: Christian
authors.initials: C
authors.lastname: Wolpert
authors.forename: Guenter
authors.initials: G
authors.lastname: Huhle
authors.forename: Martin
authors.initials: M
authors.lastname: Borggrefe
authors.forename: Karl K
authors.initials: KK
authors.lastname: Haase
mesh_terms: D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood*; D013614:Tachycardia, Paroxysmal / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000097:blood* / Q000503:physiopathology / Q000601:surgery
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D009320:Atrial Natriuretic Factor