Clinical Significance of B-Type Natriuretic Peptide Levels at 3 Months after Atrial Fibrillation Ablation.

Sen Matsumoto,Mamoru Ohnishi,Masashi Ishimi,Yasuharu Matsunaga-Lee,Yuzuru Takano,Koichi Tachibana,Nobutaka Masunaga

doi:10.3390/diseases9030049

Sen Matsumoto, Mamoru Ohnishi + Show 5 more

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https://doi.org/10.3390/diseases9030049

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Journal: Diseases	Publication Date: Jul 1, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: Hoshigaoka Medical Center, Osaka Rosai Hospital

Abstract

The role of B-type natriuretic peptide (BNP) levels as a predictor of arrhythmia recurrence (AR) after atrial fibrillation (AF) ablation remains unclear. In this study, we investigated the association of BNP levels before and 3 months after ablation with the risk of AR. A total of 234 patients undergoing their first session of AF ablation were included (68% male, mean age of 69 years). The cut-off value for discriminating AR was determined based on the maximum value of the area under the receiver operating characteristic (ROC) curve. The impact of BNP levels on AR was evaluated using Cox regression analysis. ROC curve analysis showed that the area under the curve for BNP at 3 months after the procedure was larger (0.714) compared to BNP levels before ablation (0.593). Elevated levels of BNP 3 months after the procedure (>40.5 pg/mL, n = 96) was associated with a higher risk of AR compared to those without elevated levels (34.4% vs. 10.9%, p < 0.01). Multivariate Cox regression analysis revealed that elevated BNP levels were associated with an increased risk of AR (hazard ratio 2.43; p = 0.014). Elevated BNP levels 3 months after AF ablation were a significant prognostic factor in AR, while baseline BNP levels were not.

Highlights

B-type natriuretic peptide (BNP) is a well-known marker of heart disease; elevated BNP levels have been reported in patients with atrial fibrillation (AF) [2]
Since BNP levels were not normally distributed, the analysis was performed after logarithmic transformation
We found that elevated levels of BNP before and 3 months after ablation were associated with an increased risk of arrhythmia recurrence (AR)

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The introduction of radiofrequency catheter ablation has broadened the treatment options available for patients with atrial fibrillation (AF), whose management presents a complicated challenge to physicians [1]. Catheter ablation has allowed sinus rhythm maintenance in patients with persistent AF; chronicity has been forced. B-type natriuretic peptide (BNP) is a well-known marker of heart disease; elevated BNP levels have been reported in patients with AF [2]. NT-proBNP has been reported to be a predictor of AF onset after adjustment for known risk factors [3]

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