Abstract
Mr-Proanp Rises during Exercise Even after Surgical Closure of the Left Atrial Appendage: A Sub-Study of the Laacs Randomized Study
Highlights
In this paper we present measurements of MR-proANP levels during exercise tests on two groups of patients who underwent open heart surgery, and who had been randomized to either having the Left Atrial Appendage (LAA) surgically closed as additional procedure or having it left open
We hypothesized that patients with surgical closure of the Left Atrial Appendage (LAA) – would have lower increase of Mid Region-pro-hormone atrial natriuretic peptide (ANP) (MR-proANP) during exercise compared to patients with open LAA
MR-proANP concentration rose significantly: Max ANP: 197.4pM vs. 164.3pM, p=0.4061 MR-proANP increase was not different between the groups
Summary
In this paper we present measurements of MR-proANP levels during exercise tests on two groups of patients who underwent open heart surgery, and who had been randomized to either having the Left Atrial Appendage (LAA) surgically closed as additional procedure or having it left open. ANP is a 28-aminoacid peptide synthesized in the atrial myocytes in response to atrial distension [1,2]. When synthesized ANP is stored in specific intracellular myocyte granules as a pro-hormone (pro-ANP) that undergoes final processing during release into the circulation, to yield the biologically active C-terminal and the inactive N-terminal fragment ANP [2]. N-terminal fragment of pro-hormone-ANP (NT-pro-ANP) derives from the proteolysis of pro-ANP, where pro-ANP is released both as an active hormone and an inactive N-terminal fragment [1]. An assay for NT-proANP has been developed, utilizing antibodies against the mid-region of the molecule, termed mid-regional pro-atrial natriuretic peptide (MR-proANP) [4]
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