N-terminal pro-atrial natriuretic peptide as a biochemical marker of long-term interventional success after radiofrequency catheter ablation of paroxysmal supraventricular tachyarrhythmias

Clin Chem Lab Med. 2004;42(8):896-902. doi: 10.1515/CCLM.2004.145.

Abstract

Radiofrequency (RF) catheter ablation has been shown to be highly effective in the treatment of supraventricular tachycardias. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (B-type natriuretic peptide; BNP) are secreted by the heart mainly in response to myocardial stretch induced by volume load. The aim of the present study was to determine the time course of the N-terminal prohormone forms of ANP (NT-proANP) and BNP (NT-proBNP) in patients undergoing radiofrequency (RF) catheter ablation for paroxysmal supraventricular tachycardias. Serial blood samples were taken from 13 patients with symptomatic paroxysmal supraventricular tachycardias undergoing RF ablation and from 13 age- and gender-matched healthy controls. Blood was taken before ablation (day 0, baseline), and at day one and day 120 after ablation. Levels of NT-proANP were significantly higher before RF ablation (4862+/-726 pmol/l) as compared to day one (2021+/-220 pmol/l) and day 120 after RF ablation (2470+/-349 pmol/l) (with p<0.01 on day one and p<0.05 on day 120; n=13). The size of the left atrium decreased from 41.0+/-5.5 mm before ablation to 34.9+/-5.9 mm (n=13; p<0.05) on day 120 as measured by M-mode echocardiography. Levels of NT-proBNP showed comparable values before and on day one and day 120 after ablation and were not significantly elevated as compared to healthy controls. NT-proANP levels are increased in patients presenting with paroxysmal supraventricular tachycardias and decrease one day after radiofrequency catheter ablation, possibly reflecting a transient reduction of ANP secretion from injured myocardial cells. Lower NT-proANP levels in the long-term time course may result from reduction of atrial volume load and reconstitution of atrial architecture after successful treatment of supraventricular tachycardias. NT-proANP may serve as a useful laboratory marker to describe the long-term interventional success after RF ablation.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Atrial Natriuretic Factor / blood*
  • Biomarkers / blood
  • Catheter Ablation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Protein Precursors / blood*
  • Tachycardia, Paroxysmal / blood*
  • Tachycardia, Paroxysmal / physiopathology
  • Tachycardia, Paroxysmal / surgery
  • Tachycardia, Supraventricular / blood*
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / surgery

Substances

  • Biomarkers
  • N-terminal proatrial natriuretic peptide
  • Protein Precursors
  • Atrial Natriuretic Factor