High recurrence of atrial fibrillation in patients with high tissue atrial natriuretic peptide and amyloid levels after concomitant maze and mitral valve surgery

Junbeom Park, Seung Hyun Lee, Jihei Sara Lee, Jae Hyung Park, Boyoung Joung, Moon Hyoung Lee, Byung Chul Chang, Hui Nam Pak

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background Hemodynamic burden is thought to play a role in valvular atrial fibrillation (AF), but the detailed pathophysiology is unclear. We hypothesized that atrial natriuretic peptide (ANP) tissue levels and amyloid deposits in the left atrial appendage (LAA) were associated with the pre-operative hemodynamic status and post-operative rhythm outcome in patients undergoing a concomitant mitral valve and maze surgery. Methods We quantified the fibrosis, atrial amyloid deposits, ANP tissue levels, and multiple biomarker proteins (Western blot) in LAA tissues taken from 26 patients (53.8% male, 58.4 ± 9.7 years) who underwent concomitant maze and mitral valve surgery. The histologic and biochemical results were compared with the pre-operative pulmonary artery pressure (PAP) and post-operative rhythm outcome. Results The ANP tissue level was positively correlated with the atrial amyloid deposit areas (R = 0.880, p < 0.001), but not with the degree of fibrosis. The pre-operative systolic PAP negatively correlated with both the ANP tissue expression level (R = −0.467, p = 0.019) and atrial amyloid deposit area (R = −0.589, p = 0.008). The angiotensin II tissue expression level was significantly higher in tissues without ANP expression than in those with expression (p = 0.003). AF recurrence after the maze operation was significantly lower in patients without than in those with ANP expression (log rank p = 0.031, HR 3.779, 95% CI 1.163–12.277, p = 0.027). Conclusions A lower ANP atrial tissue expression and amyloid deposits were correlated with a high pre-operative hemodynamic loading, and those patients had a paradoxically lower AF recurrence after relief of the hemodynamic burden by concomitant maze and mitral valve surgery.

Original languageEnglish
Pages (from-to)345-352
Number of pages8
JournalJournal of Cardiology
Volume69
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Atrial Natriuretic Factor
Mitral Valve
Amyloid
Atrial Fibrillation
Amyloid Plaques
Recurrence
Hemodynamics
Atrial Appendage
Pulmonary Artery
Fibrosis
Pressure
Angiotensin II
Biomarkers
Western Blotting

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Junbeom ; Lee, Seung Hyun ; Lee, Jihei Sara ; Park, Jae Hyung ; Joung, Boyoung ; Lee, Moon Hyoung ; Chang, Byung Chul ; Pak, Hui Nam. / High recurrence of atrial fibrillation in patients with high tissue atrial natriuretic peptide and amyloid levels after concomitant maze and mitral valve surgery. In: Journal of Cardiology. 2017 ; Vol. 69, No. 1. pp. 345-352.
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title = "High recurrence of atrial fibrillation in patients with high tissue atrial natriuretic peptide and amyloid levels after concomitant maze and mitral valve surgery",
abstract = "Background Hemodynamic burden is thought to play a role in valvular atrial fibrillation (AF), but the detailed pathophysiology is unclear. We hypothesized that atrial natriuretic peptide (ANP) tissue levels and amyloid deposits in the left atrial appendage (LAA) were associated with the pre-operative hemodynamic status and post-operative rhythm outcome in patients undergoing a concomitant mitral valve and maze surgery. Methods We quantified the fibrosis, atrial amyloid deposits, ANP tissue levels, and multiple biomarker proteins (Western blot) in LAA tissues taken from 26 patients (53.8{\%} male, 58.4 ± 9.7 years) who underwent concomitant maze and mitral valve surgery. The histologic and biochemical results were compared with the pre-operative pulmonary artery pressure (PAP) and post-operative rhythm outcome. Results The ANP tissue level was positively correlated with the atrial amyloid deposit areas (R = 0.880, p < 0.001), but not with the degree of fibrosis. The pre-operative systolic PAP negatively correlated with both the ANP tissue expression level (R = −0.467, p = 0.019) and atrial amyloid deposit area (R = −0.589, p = 0.008). The angiotensin II tissue expression level was significantly higher in tissues without ANP expression than in those with expression (p = 0.003). AF recurrence after the maze operation was significantly lower in patients without than in those with ANP expression (log rank p = 0.031, HR 3.779, 95{\%} CI 1.163–12.277, p = 0.027). Conclusions A lower ANP atrial tissue expression and amyloid deposits were correlated with a high pre-operative hemodynamic loading, and those patients had a paradoxically lower AF recurrence after relief of the hemodynamic burden by concomitant maze and mitral valve surgery.",
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High recurrence of atrial fibrillation in patients with high tissue atrial natriuretic peptide and amyloid levels after concomitant maze and mitral valve surgery. / Park, Junbeom; Lee, Seung Hyun; Lee, Jihei Sara; Park, Jae Hyung; Joung, Boyoung; Lee, Moon Hyoung; Chang, Byung Chul; Pak, Hui Nam.

In: Journal of Cardiology, Vol. 69, No. 1, 01.01.2017, p. 345-352.

Research output: Contribution to journalArticle

TY - JOUR

T1 - High recurrence of atrial fibrillation in patients with high tissue atrial natriuretic peptide and amyloid levels after concomitant maze and mitral valve surgery

AU - Park, Junbeom

AU - Lee, Seung Hyun

AU - Lee, Jihei Sara

AU - Park, Jae Hyung

AU - Joung, Boyoung

AU - Lee, Moon Hyoung

AU - Chang, Byung Chul

AU - Pak, Hui Nam

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Hemodynamic burden is thought to play a role in valvular atrial fibrillation (AF), but the detailed pathophysiology is unclear. We hypothesized that atrial natriuretic peptide (ANP) tissue levels and amyloid deposits in the left atrial appendage (LAA) were associated with the pre-operative hemodynamic status and post-operative rhythm outcome in patients undergoing a concomitant mitral valve and maze surgery. Methods We quantified the fibrosis, atrial amyloid deposits, ANP tissue levels, and multiple biomarker proteins (Western blot) in LAA tissues taken from 26 patients (53.8% male, 58.4 ± 9.7 years) who underwent concomitant maze and mitral valve surgery. The histologic and biochemical results were compared with the pre-operative pulmonary artery pressure (PAP) and post-operative rhythm outcome. Results The ANP tissue level was positively correlated with the atrial amyloid deposit areas (R = 0.880, p < 0.001), but not with the degree of fibrosis. The pre-operative systolic PAP negatively correlated with both the ANP tissue expression level (R = −0.467, p = 0.019) and atrial amyloid deposit area (R = −0.589, p = 0.008). The angiotensin II tissue expression level was significantly higher in tissues without ANP expression than in those with expression (p = 0.003). AF recurrence after the maze operation was significantly lower in patients without than in those with ANP expression (log rank p = 0.031, HR 3.779, 95% CI 1.163–12.277, p = 0.027). Conclusions A lower ANP atrial tissue expression and amyloid deposits were correlated with a high pre-operative hemodynamic loading, and those patients had a paradoxically lower AF recurrence after relief of the hemodynamic burden by concomitant maze and mitral valve surgery.

AB - Background Hemodynamic burden is thought to play a role in valvular atrial fibrillation (AF), but the detailed pathophysiology is unclear. We hypothesized that atrial natriuretic peptide (ANP) tissue levels and amyloid deposits in the left atrial appendage (LAA) were associated with the pre-operative hemodynamic status and post-operative rhythm outcome in patients undergoing a concomitant mitral valve and maze surgery. Methods We quantified the fibrosis, atrial amyloid deposits, ANP tissue levels, and multiple biomarker proteins (Western blot) in LAA tissues taken from 26 patients (53.8% male, 58.4 ± 9.7 years) who underwent concomitant maze and mitral valve surgery. The histologic and biochemical results were compared with the pre-operative pulmonary artery pressure (PAP) and post-operative rhythm outcome. Results The ANP tissue level was positively correlated with the atrial amyloid deposit areas (R = 0.880, p < 0.001), but not with the degree of fibrosis. The pre-operative systolic PAP negatively correlated with both the ANP tissue expression level (R = −0.467, p = 0.019) and atrial amyloid deposit area (R = −0.589, p = 0.008). The angiotensin II tissue expression level was significantly higher in tissues without ANP expression than in those with expression (p = 0.003). AF recurrence after the maze operation was significantly lower in patients without than in those with ANP expression (log rank p = 0.031, HR 3.779, 95% CI 1.163–12.277, p = 0.027). Conclusions A lower ANP atrial tissue expression and amyloid deposits were correlated with a high pre-operative hemodynamic loading, and those patients had a paradoxically lower AF recurrence after relief of the hemodynamic burden by concomitant maze and mitral valve surgery.

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