title: Atrial and Brain Natriuretic Peptide Secretion After Percutaneous Closure of the Left Atrial Appendage With the Watchman Device.
abstract: OBJECTIVE
  To evaluate the effect of transcatheter closure of the left atrial appendage (LAA) with the Watchman device on the secretion of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP).
  
  
  BACKGROUND
  The LAA plays an important role in the regulation of intravascular volume via release of ANP and BNP. To date, there are no data suggesting substantial effects of hormonal interaction after percutaneous LAA closure for prevention of thromboembolic events in patients with non-valvular atrial fibrillation.
  
  
  METHODS
  From October 2009 until May 2010, transcatheter LAA closure using the Watchman device was performed in 31 patients with non-valvular atrial fibrillation. Venous blood samples were obtained before, immediately after device implantation, and prior to discharge for ANP and BNP measurements.
  
  
  RESULTS
  LAA closure resulted in a significant increase in ANP and BNP levels immediately after the procedure compared with baseline measurements (ANP: from 241 ± 34 pg/mL to 329 ± 30 pg/mL, P<.05; BNP: from 579 ± 196 pg/mL to 698 ± 211 pg/mL, P<.05), and a significant decrease prior to discharge compared with baseline values (ANP: from 241 ± 34 pg/mL to 149 ± 30 pg/mL, P<.001; BNP: from 579 ± 196 pg/mL to 429 ± 147 pg/mL, P<.001).
  
  
  CONCLUSIONS
  These results suggest that percutaneous closure of the LAA results in an intermittent distribution of the vasoactive hormones ANP and BNP followed by a significant attenuation of ANP and BNP secretion in the early postprocedural period. The clinical impacts of these findings need to be evaluated in further studies.
authors.affiliation: University of Leipzig, Heart Center, Department of Internal Medicine/Cardiology, Strümpellstrasse 39, 04389 Leipzig, Germany. Nicolas.majunke@medizin.uni-leipzig.de.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Majunke
authors.forename: Marcus
authors.initials: M
authors.lastname: Sandri
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.forename: Ingo
authors.initials: I
authors.lastname: Daehnert
authors.forename: Norman
authors.initials: N
authors.lastname: Mangner
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Sven
authors.initials: S
authors.lastname: Moebius-Winkler
mesh_terms: D000368:Aged; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000601:surgery*; D001281:Atrial Fibrillation / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000378:metabolism; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor