Abstract
The left atrial appendage (LAA) represents both a predisposing source of thrombus formation and of neuro-humoral haemostasis. This study aims to evaluate changes of biomarker expression before and after successful percutaneous closure of the LAA. Patients with atrial fibrillation and contraindication for oral anticoagulant therapy were enrolled. Blood samples were taken within 24 hours before (T1) and at least 6 months (mid-term) (T2) after successful implantation of LAA occlusion devices. Blood levels of high sensitivity troponin I and T (hsTnI, hsTnT), aminoterminal pro-brain natriuretic peptide (NT-proBNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) were evaluated at both time points. A total of 42 patients with successful percutaneous LAA closure were included. Median mid-term follow-up was of 183 days. HsTnT, hsTnI and NT-proBNP did not show any significant differences over time. Serum levels of MR-proANP increased significantly between immediate pre-intervention (T1: median = 245.7 pmol/l, IQR 155.8–361.3 pmol/l) and at mid-term follow-up (T2: median = 254 pmol/l, IQR 183.4–396.4 pmol/l) (p = 0.037). These results indicate, that percutaneous LAA closure affects neuro-humoral haemostasis by increasing MR-proANP serum levels at mid-term follow-up.
Highlights
From the perspective of a cardiologist the left atrial appendage (LAA) represents a central part of the heart
All patients revealed successful percutaneous LAA closure being assessed during intervention and at mid-term follow-up with complete lobe coverage and no peri-device leaks of more than 5 mm
Blood samples for biomarker measurements were obtained from all patients at T1 and T2 within a median follow-up of 183 days (interquartile range (IQR), 174–207 days) after successful percutaneous closure of the LAA. 55% patients were re-hospitalized during follow-up
Summary
From the perspective of a cardiologist the left atrial appendage (LAA) represents a central part of the heart. Contraindication for oral anticoagulants such as recurring bleedings bring up a need for an alternative therapy In this case, percutaneous LAA closure is the recommended option[6,7,8,9]. The “Left Atrial Appendage Occlusion and Biomarker Evaluation” (LABEL) study aims to label the neuro-humoral changes after percutaneous LAA closure by evaluating several biomarkers to gain more pathophysiological insights. Evaluates some of the most referenced cardiac biomarkers - NT-proBNP, MR-proANP, hsTnT, hsTnI – before and after successful percutaneous closure of the LAA
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