血清BNP浓度与肺静脉消融术后房颤复发关系的研究

The Relationship between the Plasma Brain Natriuretic Peptide and the Atrial Fibrillation Recurrence by Successful Pulmonary Vein Isolation in Patients with Atrial Fibrillation

目的:研究房颤患者经肺静脉消融后房颤复发与血清脑利钠肽(BNP)之间的关系。方法:采用化学免疫荧光检测法检测68例左室射血分数正常的房颤患者(阵发性房颤48例,持续性房颤20例)消融前血清BNP浓度,两组患者均于术后3个月接受72hHolter监测以观察房颤复发。结果:消融前阵发性房颤组血清BNP浓度低持续性房颤组(81.40±15.20pg/mlvs142.5±32.60pg/ml,P<0.05),阵发性房颤消融术后复发房颤10例(20.9%),其血清BNP浓度较未复发者增高(144.30±20.41pg/mlvs68.5±25.30pg/ml,P<0.05).持续性房颤消融术后9例(45.00%)复发房颤,其血清BNP浓度(193.35±30.25pg/ml)显著高于未复发者及阵发性房颤复发者。结论:房颤患者消融术前血清BNP浓度同肺静脉消融术后房颤复发有关;血清BNP浓度可能对提高房颤消融成功有积极意义。

Objective:To investigate the predictive value of plasma brain natriuretic peptide(BNP)in patients undergoing pulmonary vein isolation concerning stable sinus rhythm after ablation.Method:BNP level was determined by using a chemi-luminescent immunoassay for 68 consecutive patients with atrial fibrillation(AF)(including 48 with paroxysmal AF and 20 with persistent AF)and normal left ventricular ejection fraction、BNP was measured at baseline before pulmonary vein isolation(PVI).All patients received a 72 hours holter monitoring 3 months after radiofrequency(RF)ablation in order to detect recurrent AF episodes.Results:Baseline BNP was significantly lower in patients with paroxysmal AF compared to patients with persistent AF(81.40±15.20pg/ml vs 142.5±32.60 pg/ml,P<0.05).3 months after PVI with paroxysmal AF 10 patients had AF recurrence.Patients with AF recurrence showed significantly higher BNP plasma levels at baseline compared to patients with no recurrence before PVI(144.30±20.41 pg/ml vs 68.5±25.30 pg/ml,P<0.05).3 months after PVI patients with persistent AF had 9 patients(45%)AF recurred.BNP plasma levels(193.35±30.25 pg/ml)at baseline were higher in patients with AF recurred compared to the group of no recurrent and paroxysmal AF recurrence before PVI.Conclusion:Patients with AF and low BNP plasma levels showed a better outcome after PVI.Thus BNP may be helpful in patient selection for a successful treatment of AF by PVI.