Atrial Natriuretic Peptide Predicts Impaired Atrial Remodeling and Occurrence of Late Postoperative Atrial Fibrillation after Surgery for Symptomatic Aortic Stenosis

Abstract

Background: Aortic stenosis (AS) and atrial fibrillation (AF) are commonly encountered in clinical practice. Natriuretic peptides (NP) are endogenous cardiac hormones, which have been shown to increase in patients with heart failure, and valvular or congenital heart disease. We aimed to determine the association between atrial NP (ANP) and late postoperative AF after surgery for AS along with temporal changes in plasma ANP levels and left atrial (LA) volumes. Methods: 22 patients (16 males/6 females, mean age: 61 years) with symptomatic AS and 8 healthy volunteers (5 males/3 females) were enrolled into our study. All the patients studied underwent transthoracic echocardiography, which was repeated during the follow-up. N-terminal ANP (N-ANP) was studied initially and at the 2-month follow-up. Postoperatively, the patients were followed up for 12 months for AF attacks. Results: Patients with AS had significantly higher levels of N-ANP, left ventricular (LV) end-diastolic pressure, E/A ratio, LV mass and LA volumes compared to the controls. Patients with postoperative AF attacks were significantly older, had higher N-ANP levels and LV end-diastolic pressure in addition to higher LA volumes and longer symptom duration compared to patients without AF. Age at the time of operation (p = 0.011) and N-ANP at the 2nd month (p = 0.047) were found to be independent predictors for late AF attacks during follow-up in regression analysis. Besides, N-ANP (p < 0.001) at the 2-month follow-up independently predicted impaired LA remodeling. Conclusion: ANP might be an important factor to identify AS patients at risk for late postoperative AF attacks.

Journal

Journal ID (publisher-id): CRD

Journal ID (nlm-ta): Cardiology

Journal ID (doi): 10.1159/issn.0008-6312

Title: Cardiology

Publisher: S. Karger AG

ISSN (Print): 0008-6312

ISSN (Electronic): 1421-9751

Publication date Subscription-year: 2006

Publication date (Print): May 2006

Publication date (Electronic): 11 May 2006

Volume: 105

Issue: 4

Pages: 207-212

Affiliations

^aDepartment of Cardiology, Faculty of Medicine, Cumhuriyet University, Sivas, and ^bYuksek Ihtisas Education and Research Hospital, Cardiology Clinic, Ankara, Turkey

Article

Publisher ID: 91641 Other ID: Cardiology 2006;105:207–212

DOI: 10.1159/000091641

PubMed ID: 16498244

Copyright statement: © 2006 S. Karger AG, Basel

License:

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Page count

Figures: 1, Tables: 3, References: 18, Pages: 6

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Categories

Subject: Original Research