ArticleClinical cardiology2020
Are the atrial natriuretic peptides a missing link predicting low-voltage areas in atrial fibrillation? Introducing the novel biomarker-based atrial fibrillation substrate prediction (ANP) score.
Article in Clinical cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 21 citations in OpenAlex.
- Atrial to brain natriuretic peptide ratio as a marker of atrial remodeling severity and post-ablation recurrence risk in atrial fibrillation patients with left atrial enlargement.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- The impact of left atrial voltage abnormality on ablation outcomes in paroxysmal atrial fibrillation and its pre-procedural predictors: an observational retrospective study.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Article
- Multi-modal artificial intelligence algorithm for the prediction of left atrial low-voltage areas in atrial fibrillation patient based on sinus rhythm electrocardiogram and clinical characteristics: a retrospective, multicentre study.European heart journal. Digital health · 2025Article
- Atrial Cardiomyopathy: From Diagnosis to Treatment.Reviews in cardiovascular medicine · 2025Review
- Predictors of Low Voltage Zone and Sex Differences in Low Voltage Zone Distribution in Patients with Atrial Fibrillation.Reviews in cardiovascular medicine · 2023Article
- Atrial Natriuretic Peptides as a Bridge between Atrial Fibrillation, Heart Failure, and Amyloidosis of the Atria.International journal of molecular sciences · 2023Review
- Ischemia with Nonobstructive Coronary Artery Disease and Atrial Cardiomyopathy-Two Sides of the Same Story?Life (Basel, Switzerland) · 2023Review
- Role of Cardiac Natriuretic Peptides in Heart Structure and Function.International journal of molecular sciences · 2022Review
- Risk Factors of Early Atrial Fibrillation Recurrence Following Electrical Cardioversion When Left Ventricular Ejection Fraction Is Preserved.Medicina (Kaunas, Lithuania) · 2022Article
- The predictive value of galectin-3 levels on left atrial low voltage areas assessed by high-density mapping in patients with paroxysmal atrial fibrillation.Journal of arrhythmia · 2022Article
- NT-proANP levels in peripheral and cardiac circulation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- Left Atrial Cardiomyopathy - A Challenging Diagnosis.Frontiers in cardiovascular medicine · 2022Review
- It Is Necessary to Re-understand the Low-Voltage Area in Atrial Fibrillation Patients.Frontiers in cardiovascular medicine · 2022Review
- Response to the Letter: The NT-proANP puzzle - a small piece that makes the big picture.Clinical cardiology · 2021Article
- Low voltage areas, atrial natriuretic peptides and fibrosis: Challenges and controversies.Clinical cardiology · 2021Article
- Are the atrial natriuretic peptides a missing link predicting low-voltage areas in atrial fibrillation? Introducing the novel biomarker-based atrial fibrillation substrate prediction (ANP) score.Clinical cardiology · 2020Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with atrial fibrillation (AF), left atrial (LA) enlargement, and the presence of low-voltage areas (LVAs) indicate an advanced disease stage. NT-proANP is a biomarker, which is significantly higher in both phenotypes. Prediction of LVAs before catheter ablation could impact the prognosis and therapeutical management in AF patients.
objectiveThe aim of this study was to (a) analyze the predictive value of a novel biomarker-based AF substrate prediction score, and (b) compare it with DR-FLASH and APPLE scores.
methodsPatients undergoing first AF catheter ablation were included. LA volume (LAV) was analyzed prior to ablation using cardiovascular magnetic resonance imaging (CMR). Blood plasma samples from the femoral vein were collected before AF ablation. NT-proANP was analyzed using commercially available assays. LVAs were determined using high-density maps during catheter ablation and defined as <0.5 mV. The novel ANP score (one point for Age ≥ 65 years, NT-proANP > 17 ng/mL, and Persistent AF) was calculated at baseline.
resultsThe study population included 156 AF patients (64 ± 10 years, 65% males, 61% persistent AF, 28% LVAs). The cut-off ANP score ≥ 2 demonstrated 77% sensitivity and 70% specificity. On logistic regression (odds ratio [OR] 3.469) and receiver operating characteristic (ROC) analysis (area under the curve [AUC] 0.778, P < .001), the ANP score significantly predicted LVAs presence. There were no differences between novel ANP score - which is a new one - is described in the Abstract; with APPLE (AUC 0.718, P = .378) and DR-FLASH (AUC 0.766, P = .856) scores.
conclusionsThe novel biomarker-based ANP score demonstrates good prediction of LVAs.
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