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NT-proANP levels in peripheral and cardiac circulation

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Recent studies have reported an association between N-terminal atrial natriuretic peptide (NT-proANP) and the progression of atrial fibrillation (AF). However, NT-proANP levels in peripheral and cardiac circulation in AF patients and in non-AF individuals need to be defined. The aims of the current study are (1) to analyze NT-proANP levels in peripheral and cardiac circulation in AF patients and (2) to compare NT-proANP levels in individuals with and without AF.

Methods

We recruited AF patients who were undergoing their first AF catheter ablation and non-AF individuals. Blood plasma samples taken from the femoral vein and the left atrium (LA) were collected before AF ablation in the AF patients and from the cubital vein in the non-AF controls. Low voltage areas (LVAs) were determined using high-density maps during catheter ablation and defined as < 0.5 mV.

Results

The study included 189 AF patients (64 ± 10 years, 59% male, 61% persistent AF, 30% LVAs) and 26 non-AF individuals (58 ± 10 years, 50% male). Patients with AF were significantly older and had larger LA (p < 0.05). Compared to non-AF controls, peripheral and cardiac NT-proANP levels were significantly higher in AF patients without and with LVAs (median 5.4, 10.5, 14.8 ng/ml, respectively, p < 0.001). In multivariable analysis, NT-proANP (OR 1.238, 95% CI 1.007–1.521, p = 0.043) remained significantly different between non-AF individuals and AF patients. In AF, NT-proANP levels were significantly higher in the cardiac blood samples than in the peripheral blood (median 13.0 versus 11.4 ng/ml, p = 0.003). The ability to predict LVAs was modest when using cardiac NT-proANP (AUC 0.661) and peripheral NT-proANP (AUC 0.635), without statistical difference (p = 0.937).

Conclusions

NT-proANP levels are higher in individuals with AF than in controls and are more pronounced in progressed AF. Elevated cardiac and peripheral NT-proANP levels similarly predict LVAs.

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Acknowledgements

The authors thank Vanessa A. Hanger for her careful review and editing of the manuscript.

Funding

PB and JK received funding from Helios Kliniken GmbH, Berlin, Germany (Internal Grant, HRC-ID: 045620). During manuscript preparation, JK was supported by the Marie Sklodowska-Curie Actions under the European Union’s Horizon 2020 research and innovation program (grant agreement No 838259).

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Authors and Affiliations

  1. Department of Cardiology, Heart Center Leipzig At University of Leipzig, Leipzig, Germany

    Petra Büttner, Danilo Obradovic & Holger Thiele

  2. Department of Electrophysiology, Heart Center Leipzig At University of Leipzig, Leipzig, Germany

    Timm Seewöster & Gerhard Hindricks

  3. School of Medicine – Cardiovascular Medicine, Boston University, 72 E Concord St, Boston, MA, 02118, USA

    Jelena Kornej

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  1. Petra Büttner
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  2. Timm Seewöster
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Contributions

Conceptualization, formal analysis, funding acquisition, supervision, visualization, writing – original draft preparation, writing – review and editing – PB, TS, JK; data curation – JK; patients’ inclusion – DO, JK; writing – review and editing – HT, GH.

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Correspondence to Jelena Kornej.

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Petra Büttner and Timm Seewöster contributed equally to this work.

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Büttner, P., Seewöster, T., Obradovic, D. et al. NT-proANP levels in peripheral and cardiac circulation. J Interv Card Electrophysiol 63, 409–415 (2022). https://doi.org/10.1007/s10840-021-01020-z

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