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High Plasma Human Atrial Natriuretic Peptide and Reduced Transthoracic Left Atrial Appendage Wall‐Motion Velocity Are Noninvasive Surrogate Markers for Assessing Thrombogenesis in Patients with Paroxysmal Atrial Fibrillation
Author(s) -
Yoshida Naoyasu,
Okamoto Mitsunori,
Hirao Hidekazu,
Suenari Kazuyoshi,
Nanba Kiyomi,
Uchida Mio,
Yamazato Ryo,
Watari Yuichiro,
Fukuda Yukihiro,
Ueda Hironori
Publication year - 2014
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12501
Subject(s) - sinus rhythm , medicine , cardiology , atrial fibrillation , atrial natriuretic peptide
Background The clinical relevance of examining human atrial natriuretic peptide ( HANP ) or left atrial appendage ( LAA ) wall‐motion velocity during sinus rhythm in paroxysmal atrial fibrillation ( AF ) patients has not been clearly elucidated. Methods The subjects were 38 patients with paroxysmal AF who underwent transesophageal and transthoracic echocardiography during sinus rhythm. The presence of spontaneous echocontrast ( SEC ) was examined with transesophageal echocardiography and LAA wall‐motion velocity ( LAAWV ) was measured with transthoracic tissue Doppler echocardiography. Plasma HANP was measured within 3 hours after echocardiography. Results Human atrial natriuretic peptide ranged from 12 to 106 pg/mL with an average of 43 ± 24 pg/mL and had a significant correlation with LAAWV (r = −0.57) or LAA flow velocity (r = −0.41). HANP was significantly higher in patients with SEC than in patients without SEC (64 ± 29 vs. 34 ± 15 pg/mL, P = 0.008) and LAAWV was significantly lower in patients with SEC than in patients without SEC (13 ± 5 vs. 20 ± 5 cm/sec, P = 0.002). HANP >44 pg/mL had a sensitivity of 73% and specificity of 89% for diagnosing SEC. SEC was more frequently observed (73%) in patients with HANP >44 pg/mL and/or LAAWV <10 cm/sec as compared with patients (11%) with normal HANP and LAA wall‐motion velocity (P < 0.0001). Conclusion Higher plasma HANP and lower LAA wall‐motion velocity may be noninvasive surrogate markers for assessing left atrial thrombogenesis during sinus rhythm in paroxysmal AF patients.