Predictive value of exercise-induced atrial natriuretic peptide secretion for the presence of left atrial low-voltage areas in patients with persistent atrial fibrillation. Issue 4 (4th July 2017)

• Record Type: Journal Article
• Authors: Yin, Ran; Yang, Zhongming; Peng, Jingtian; Li, Bingong; Fu, Yongnan; Zheng, Zheqi
• Is Part Of: Acta cardiologica. Volume 72:Issue 4(2017)
• Page Start: 433
• Page End: 439
• Publication Date: 2017-07-04
• Subjects: Atrial fibrillation -- atrial natriuretic peptide -- substrate mapping -- catheter ablation; Cardiology -- Periodicals; Cardiology; Cardiologie -- Périodiques; Cardiology; Cardiologie; Periodicals; Periodicals; 616.12005
• DOI: 10.1080/00015385.2017.1335112
• Languages: English
• ISSNs: 0001-5385

Abstract

Abstract : Objectives Left atrial (LA) low-voltage areas (LVAs) are a strong predictor of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI). However, a non-invasive method for evaluating LA-LAVs has not been established yet. The objective of our study was to assess the predictive value of the plasma atrial natriuretic peptide (ANP) level for the presence of LA-LVAs in patients with persistent AF (PeAF). Methods Seventy-two PeAF patients underwent an exercise stress test preprocedurally. LA voltage maps were created after PVI. Demographic, clinical and echocardiographic data were recorded. Plasma levels of ANP at baseline (ANP0) and increase induced by exercise ( Δ ANP) were also measured. Results Compared with patients without LA-LVAs, patients with LA-LVAs had a longer history of AF, higher CHADS2 score and higher ANP0 and lower Δ ANP. LA-LVAs extent correlated with duration of AF history, CHADS2 score and Δ ANP (R = -0.76, P < 0.01). Only Δ ANP independently predicted the presence of LA-LVAs (OR =1.63, P = 0.02). Derived from the ROC curve, Δ ANP <55 pg/mL predicted the presence of LA-LVAs with high accuracy (AUC =0.78; 95% CI =0.57-0.87, P < 0.01). Conclusions Exercise-induced secretion of ANP may be used to predict the presence of LA-LVAs in patients with PeAF before catheter ablation.