Author + information
- Received October 8, 2015
- Revision received December 7, 2015
- Accepted December 27, 2015
- Published online April 1, 2016.
- Koki Nakanishi, MDa,∗ (, )
- Shota Fukuda, MDb,
- Hajime Yamashita, MDa,
- Michihiko Kosaka, MDa,
- Naoya Shirai, MDa,
- Atsushi Tanaka, MDc,
- Junichi Yoshikawa, MDd and
- Kenei Shimada, MDe
- aDepartment of Cardiovascular Medicine, Baba Memorial Hospital, Sakai, Japan
- bSecond Department of Internal Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
- cDepartment of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
- dNishinomiya Watanabe Cardiovascular Center, Nishinomiya, Japan
- eDepartment of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka, Japan
- ↵∗Reprint requests and correspondence to:
Dr. Koki Nakanishi, Department of Cardiovascular Medicine, Baba Memorial Hospital, 592-8555 Sakai, Japan.
Objectives This study aimed to investigate the role of atrial natriuretic peptide (ANP) levels to predict left atrial (LA) reverse remodeling in atrial fibrillation (AF) patients.
Background Although LA reverse remodeling after radiofrequency catheter ablation (RFCA) for AF was reported to be associated with favorable outcomes and improvement of LA and left ventricular function, the predictor has not been extensively evaluated.
Methods This study included 104 consecutive patients who underwent RFCA for AF. All patients underwent multidetector computed tomography examination and laboratory tests, including measurement of ANP, plasma B-type natriuretic peptide (BNP), and high-sensitivity C-reactive protein (hs-CRP) levels before and 6 months after RFCA. The study population was divided according to the extent of the decrease in the LA volume index at follow-up; responders were defined as patients who exhibited a ≥15% decrease in the LA volume index.
Results At follow-up, 49 patients (47%) were classified as responders. Pre-procedural serum ANP and BNP levels were significantly higher in the responders than in the nonresponders (both p < 0.01). In the responders, a significant decrease was observed in the log ANP, log BNP, and log hs-CRP levels from baseline to follow-up (all p < 0.01). Multivariate linear regression analysis revealed that log ANP levels before RFCA and maintenance of sinus rhythm during follow-up were independent predictors of LA reverse remodeling (both p < 0.01).
Conclusions In this study, 47% of the patients exhibited LA reverse remodeling after RFCA for AF, with a concomitant improvement in serum ANP, BNP, and hs-CRP levels. The pre-procedural ANP level and maintenance of sinus rhythm were independently associated with LA reverse remodeling.
- atrial fibrillation
- atrial natriuretic peptide
- multidetector computed tomography
- radiofrequency catheter ablation
- reverse remodeling
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received October 8, 2015.
- Revision received December 7, 2015.
- Accepted December 27, 2015.
- 2016 American College of Cardiology Foundation