1
|
Kashimura S, Ikemura N, Kohsaka S, Katsumata Y, Kimura T, Shinmura D, Fukumoto K, Negishi K, Ueda I, Takatsuki S, Ieda M. Clinical Utility of Baseline Brain Natriuretic Peptide Levels on Health Status Outcomes after Catheter Ablation for Atrial Fibrillation in Individuals without Heart Failure. J Clin Med 2024; 13:407. [PMID: 38256541 PMCID: PMC10816027 DOI: 10.3390/jcm13020407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Catheter ablation (CA) benefits atrial fibrillation (AF) patients with heart failure (HF). Brain natriuretic peptide (BNP), a marker of left-ventricular pressure load, may serve as a potential surrogate for predicting quality of life (QOL) in a broader range of patients. METHODS Within the multicenter KiCS-AF registry, 491 AF patients underwent CA without clinical HF (e.g., documented history of HF, left ventricular ejection fraction ≤ 40%, or BNP levels ≥ 100 pg/mL). Participants, aged 61 ± 10 years, were categorized by baseline BNP quartiles. Atrial Fibrillation Effect on QualiTy-of-Life (AFEQT) questionnaire assessments were assessed at baseline and 1 year. RESULTS A lower baseline BNP correlated with reduced AFEQT scores. Post CA, all groups showed significant AFEQT score improvements. The lower-BNP group displayed notable enhancements (18.2 ± 1.2, 15.0 ± 1.1, 12.6 ± 1.2, 13.6 ± 1.2, p < 0.005), especially in symptom and treatment concern areas. Even those with normal BNP levels (≤18.4 pg/mL) exhibited significant QOL improvements. Comparing paroxysmal AF (PAF) and non-PAF groups, the PAF group, especially with higher BNP levels, showed greater AFEQT score improvements. CONCLUSIONS This study establishes BNP as a predictive marker for QOL enhancement in non-HF patients undergoing CA for AF. BNP levels represent AF stages, with individuals in earlier stages, especially within normal BNP levels, experiencing greater QOL improvements.
Collapse
Affiliation(s)
- Shin Kashimura
- Department of Cardiology, Yokohama Municipal Citizen’s Hospital, 1-1, Mitsuzawa-nishicho, Kanagawa-ku, Yokohama 221-0855, Japan (K.N.)
| | - Nobuhiro Ikemura
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Yoshinori Katsumata
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Takehiro Kimura
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Daisuke Shinmura
- Department of Cardiology, Yokohama Municipal Citizen’s Hospital, 1-1, Mitsuzawa-nishicho, Kanagawa-ku, Yokohama 221-0855, Japan (K.N.)
| | - Kotaro Fukumoto
- Department of Cardiology, Yokohama Municipal Citizen’s Hospital, 1-1, Mitsuzawa-nishicho, Kanagawa-ku, Yokohama 221-0855, Japan (K.N.)
| | - Koji Negishi
- Department of Cardiology, Yokohama Municipal Citizen’s Hospital, 1-1, Mitsuzawa-nishicho, Kanagawa-ku, Yokohama 221-0855, Japan (K.N.)
| | - Ikuko Ueda
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Seiji Takatsuki
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| | - Masaki Ieda
- Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan (Y.K.); (T.K.); (I.U.); (M.I.)
| |
Collapse
|