Impact of Midregional N‐Terminal Pro–Atrial Natriuretic Peptide and Soluble Suppression of Tumorigenicity 2 Levels on Heart Rhythm in Patients Treated With Catheter Ablation for Atrial Fibrillation: The Biorhythm Study

Author:

Badoz Marc12,Serzian Guillaume1,Favoulet Baptiste1,Sellal Jean‐Marc34ORCID,De Chillou Christian3ORCID,Hammache Néfissa34ORCID,Laurent Gabriel5,Mebazaa Alexandre67,Ecarnot Fiona12,Bardonnet Karine8,Seronde Marie‐France12,Schiele François12ORCID,Meneveau Nicolas12ORCID

Affiliation:

1. Department of CardiologyUniversity Hospital Besançon Besançon France

2. EA3920University of Burgundy Franche‐Comté Besançon France

3. Department of Cardiology Centre Hospitalier Régional Universitaire de NancyUniversité de Lorraine Nancy France

4. IADIINSERM U1254Université de Lorraine Nancy France

5. Department of Cardiology University Hospital François Mitterand Dijon France

6. INSERM UMR‐S 942 Paris France

7. Department of Anesthesiology and Critical Care Medicine Assistance Publique ‐ Hôpitaux de ParisSaint Louis Lariboisière University Hospitals Paris France

8. Department of BiochemistryUniversity Hospital Besançon Besançon France

Abstract

Background We assessed the impact of preprocedural plasma levels of MRproANP (midregional N‐terminal pro–atrial natriuretic peptide) and sST2 (soluble suppression of tumorigenicity 2) on recurrence of atrial fibrillation (AF) at 1 year after catheter ablation of AF. Methods and Results This was a prospective, multicenter, observational study including patients undergoing catheter ablation of AF. MRproANP and sST2 were measured in a peripheral venous blood preprocedure, and MRproANP was assessed in the right and left atrial blood during ablation. The primary end point was recurrent AF between 3 and 12 months postablation, defined as a documented (>30 seconds) episode of AF, flutter, or atrial tachycardia. We included 106 patients from December 2017 to March 2019; 105 had complete follow‐up, and the mean age was 63 years with 74.2% males. Overall, 34 patients (32.1%) had recurrent AF. In peripheral venous blood, MRproANP was significantly higher in patients with recurrent AF (median, 192.2; [quartile 1–quartile 3, 155.9–263.9] versus 97.1 [60.9–150.7] pmol/L; P <0.0001), as was sST2 (median, 30.3 [quartile 1–quartile 3, 23.3–39.3] versus 23.4 [95% CI, 17.4–33.0] ng/mL; P =0.0033). In the atria, MRproANP was significantly higher than in peripheral blood and was higher during AF than during sinus rhythm. Receiver operating characteristic curve analysis identified a threshold of MRproANP>107.9 pmol/L to predict AF recurrence at 1 year and a threshold of >26.7 ng/mL for sST2. By multivariate analysis, MRproANP>107.9 pmol/L was the only independent predictor of recurrent AF (OR, 24.27; 95% CI, 4.23–139.18). MRproANP<107.9 pmol/L identified subjects at very low risk of recurrence (negative predictive value >95%). Conclusions Elevated MRproANP level independently predicts recurrent AF, whereas sST2 levels do not appear to have any prognostic value in assessing the risk of recurrence of AF up to 1 year after catheter ablation. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03351816.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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