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A. Basics
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01. History of Cardiology
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07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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29. Rehabilitation and Sports Cardiology
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32. Cardiovascular Nursing
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Pericardial Fluid and Serum NT-pro-BNP and GDF-15 in Patients with Atrial Fibrillation Submitted to Aortic Valve Replacement Surgery
Session:
Posters - C. Arrhythmias and Device Therapy
Speaker:
Mariana Fragão-Marques
Congress:
CPC 2021
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.8 Atrial Fibrillation - Clinical
Session Type:
Posters
FP Number:
---
Authors:
Mariana Fragão-Marques; Isaac Barroso; Rui Farinha; Isabel Miranda; Diana Martins; Jennifer Mancio; João Rocha-Neves; João Tiago-Guimarães; Inês Falcão-Pires; Adelino Leite-Moreira
Abstract
<p style="text-align:justify"><strong>Background:</strong> Growth Differentiation Factor-15 (GDF-15) has been reported as a potential predictor of atrial fibrillation (AF). Moreover, NT-proB-type natriuretic peptide (NT-pro-BNP) has been consistently associated with AF, including in hypertrophic cardiomyopathy. This study aimed to evaluate the association of GDF-15 and NT-pro-BNP in two different biological matrices with persistent AF in severe aortic stenosis patients submitted to aortic valve replacement surgery (AVR), its association with atrial matrix remodeling, as well as with 30-day postoperative outcomes.</p> <p style="text-align:justify"><strong>Methods:</strong> A posthoc analysis of a prospective study on a cohort of aortic stenosis patients was performed. 126 patients with severe aortic stenosis submitted to AVR surgery in a tertiary hospital were assessed, between 2009 and 2019.</p> <p style="text-align:justify"><strong>Results:</strong> GDF-15 and NT-pro-BNP were increased in AF patients with aortic stenosis when measured in the pericardial fluid (p=0.030). NT-pro-BNP was increased in AF patients in in pericardial fluid (p&lt;0.001) and in serum (p=0.002). Moreover, when measuring AUROC (area under the ROC curve) pericardial fluid NT-pro-BNP, pericardial fluid NT-pro-BNP had the highest area (0.85 [0.75-0.96]). Pericardial fluid and serum GDF-15 were significantly increased in acute kidney injury (AKI) (p=0.027 and p=0.015, respectively). COL1A1 and COL3A1 gene expression increased when pericardial fluid NT-pro-BNP values were higher (p=0.005 and p=0.033, respectively). In addition, TIMP4 was positively correlated with pericardial fluid GDF-15 (p=0.025).</p> <p style="text-align:justify"><strong>Conclusions:</strong> Persistent AF in severe aortic stenosis was associated with increased levels of pericardial fluid GDF-15 and serum and pericardial fluid NT-pro-BNP. NT-pro-BNP in the pericardium had a higher diagnostic accuracy than its serum counterpart. AKI after AVR surgery was associated with higher quantifications of both serum and pericardial fluid GDF-15. Collagen type I, collagen type III as well as MMP2 and TIMP4 atrial gene expression were positively correlated with pericardial fluid NT-pro-BNP and pericardial fluid GDF-15, respectively.</p>
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