MPS 10-01 Concern of the serum NT-proBNP changes and blood pressure on the improvement of renal function by radiofrequency catheter ablation of atrial fibrillation

Abstract

Objective: Persistence of atrial fibrillation (AF) may have a deep concern with worsening of renal function. Thus, there is a possibility that curative therapy of AF by radiofrequency catheter ablation (RFCA) improves renal function. On the other hand, RFCA for AF can improve the heart function which is partly represented by serum natriuretic peptides. This improvement may also concern with the adequate blood pressure (BP) maintenance after RFCA. In this study, we aimed to clarify the relationship between the renal function and heart function, blood pressure profile in patients with AF, especially focusing on the AF improvement by RFCA. Design and Method: For 221 consecutive patients (149:Male, 72:Female, aging 61 ± 8) with AF treated by RFCA, estimated glomerular filtration rate (eGFR), N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and BP were monitored before, early after (3 to 6 month) and late after (around 1 year) RFCA. Each value was compared before and after RFCA, and relationship between the changes after RFCA of each value was investigated. Results: The eGFR (71.4 ± 16.3 to 82.3 ± 18.9 mL/min/1.73 m2, p < 0.01) and NT-proBNP (368.2 ± 91.3 to 136.9 ± 69.1pg/ml, p < 0.01) were significantly improved early after RFCA. Included group of 41 patients with chronic kidney disease (eGFR < 60 mL/min/1.73 m2) also showed a significant eGFR increase (51.7 ± 9.9 to 62.3 ± 20.9 mL/min/1.73 m2, p < 0.01) early after RFCA. Both values of late after RFCA did not change from early after RFCA. There was a significant negative correlation between eGFR and NT-proBNP before RFCA (r = −0.423, p < 0.05). Moreover, there was a significant correlation between the increase ratio of eGFR (16.5 ± 9.1%) and decrease ratio of NT-proBNP (−63.0 ± 12.6%) after RFCA (r = −0.342, p < 0.05). BP showed no significant changes during total observation. Conclusions: Heart function improvement after RFCA concerns with the maintenance of desirable renal function in patients with AF.