title: Incremental predictive value of pre-procedural N-terminal pro-B-type natriuretic peptide for short-term recurrence in atrial fibrillation ablation.
abstract: The objective of this work was to assess the predictive value of pre-procedural N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in patients undergoing atrial fibrillation (AF) ablation. Seventy-three consecutive patients with AF (paroxysmal n = 49, persistent n = 24) and preserved left ventricular (LV) systolic function (LV ejection fraction > 45%) were prospectively enrolled in this study. All of the enrolled patients underwent catheter ablation after a measurement of their plasma NT-proBNP levels, and an echocardiographic examination with assessment of their LV diastolic function and left atrial(LA) volume. Patients with AF recurrence at 3 months had more persistent AF (P = 0.001), a higher LA volume index (P = 0.002), lesser decelerating times (DT) of mitral inflow (P = 0.014), and higher NT-proBNP levels (P < 0.001), when compared with patients with sinus rhythm restoration. The baseline log NT-proBNP correlated significantly with age (r = 0.26, P = 0.025), LA volume index (r = 0.41, P = 0.001), E/E' (r = 0.34, P = 0.007), DT (r = -0.34, P = 0.007), and E (r = 0.25, P = 0.04). The log NT-proBNP (HR 7.76, 95% CI 2.95-20.39, P < 0.001) was an independent predictor of AF recurrence. The measurement of NT-proBNP added incremental predictive value to standard indexes of LA size or diastolic function, including LA volume index and DT (P = 0.02). This study suggests the clinical utility of the level of NT-proBNP as an integrating marker of various risk factors, and as an incremental predictive marker for AF catheter ablation.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Hwang
authors.forename: Jung Woo
authors.initials: JW
authors.lastname: Son
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Nam
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.forename: Byungho
authors.initials: B
authors.lastname: Lee
authors.forename: Jin-Bae
authors.initials: JB
authors.lastname: Kim
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Won-Heum
authors.initials: WH
authors.lastname: Shim
authors.forename: Seung-Yun
authors.initials: SY
authors.lastname: Cho
authors.forename: Sung Soon
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain