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Updated: Feb 24, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Percutaneous Closure of Left Atrial Appendage affects Mid-Term Release of MR-proANP
Michael Behnes1, Benjamin Sartorius2, Annika Wenke2
1First Department of Medicine, University Medical Center Mannheim (UMM), Faculty of Medicine, Mannheim, University of Heidelberg, Mannheim, Germany. michael.behnes@umm.de.
Insights
Percutaneous left atrial appendage closure in atrial fibrillation patients significantly increases mid-regional pro-atrial natriuretic peptide (MR-proANP) levels. This finding suggests a modulation of neuro-humoral hemostasis following LAA occlusion.
Area of Science:
- Cardiology
- Biomarkers
- Medical Devices
Background:
- The left atrial appendage (LAA) is a key source of thrombus formation in atrial fibrillation (AF).
- LAA also plays a role in neuro-humoral hemostasis.
- Percutaneous LAA closure is an alternative to oral anticoagulation in AF patients with contraindications.
Purpose of the Study:
- To evaluate changes in biomarker expression before and after successful percutaneous LAA closure.
- To assess the impact of LAA occlusion on neuro-humoral hemostasis.
Main Methods:
- Prospective enrollment of 42 AF patients undergoing percutaneous LAA closure.
- Blood samples collected pre-intervention (T1) and at mid-term follow-up (T2, ≥6 months).
- Assessed serum levels of high-sensitivity troponin I/T (hsTnI, hsTnT), NT-proBNP, and MR-proANP.
Main Results:
- No significant changes observed in hsTnT, hsTnI, or NT-proBNP levels between T1 and T2.
- Serum MR-proANP levels significantly increased from median 245.7 pmol/l at T1 to 254 pmol/l at T2 (p=0.037).
- Successful percutaneous LAA closure demonstrated a significant increase in MR-proANP at mid-term follow-up.
Conclusions:
- Percutaneous LAA closure impacts neuro-humoral hemostasis.
- The observed increase in MR-proANP suggests a potential alteration in cardiac neuro-hormonal function post-LAA occlusion.
Abstract:
The left atrial appendage (LAA) represents both a predisposing source of thrombus formation and of neuro-humoral haemostasis. This study aims to evaluate changes of biomarker expression before and after successful percutaneous closure of the LAA. Patients with atrial fibrillation and contraindication for oral anticoagulant therapy were enrolled. Blood samples were taken within 24 hours before (T1) and at least 6 months (mid-term) (T2) after successful implantation of LAA occlusion devices. Blood levels of high sensitivity troponin I and T (hsTnI, hsTnT), aminoterminal pro-brain natriuretic peptide (NT-proBNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) were evaluated at both time points. A total of 42 patients with successful percutaneous LAA closure were included. Median mid-term follow-up was of 183 days. HsTnT, hsTnI and NT-proBNP did not show any significant differences over time. Serum levels of MR-proANP increased significantly between immediate pre-intervention (T1: median = 245.7 pmol/l, IQR 155.8-361.3 pmol/l) and at mid-term follow-up (T2: median = 254 pmol/l, IQR 183.4-396.4 pmol/l) (p = 0.037). These results indicate, that percutaneous LAA closure affects neuro-humoral haemostasis by increasing MR-proANP serum levels at mid-term follow-up.
