Correlation analysis of atrial natriuretic peptide concentration, echocardiographic left atrial and left ventricular dimensions, and renal function parameters in patients after permanent pacemaker implantation

Abstract

Background: Atrial endocrine function was established in the second half of the 20th century, confirming the role of artial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the physiology of the cardiovascular system. The present study was undertaken to evaluate changes in ANP and echocardiographic parameters within the first month after VVI and DDD pacemaker implantation and to evaluate correlations between the parameters.
Methods: The study population consisted of group I - 20 VVI patients aged 71-90 years (mean age 77.5 ± 5.9) and group II - 20 DDD/VDD patients aged 49-81 years (mean age 68.9 ± 11). Fifteen healthy volunteers aged 58–80 years (mean age 72.7 ± 2.8) served as controls. Correlations between ANP levels and cardiac cavity dimensions and between ANP and parameters of renal function were studied.
Results: Blood levels of ANP decreased after pacemaker implantation: in the VVI group from 168.61 ± 81.95 pg/1000 μL to 118.04 ± 61.06 pg/1000 μL at 7 days and to 121.4 ± 71.90 pg/1000 μL at 30 days; and in the DDD/VDD group from 134.89 ± 83.11 pg/1000 μL to 104.96 ± ± 57.09 pg/1000 μL at 7 days and to 110.82 ± 53.32 pg/1000 μL at 30 days. There was a significant correlation between ANP levels and left atrial size in the DDD/VDD group - 0.598 (p = 0.005) and 0.593 (p = 0.005) and left ventricular dimensions - 0.499 (p = 0.024) and 0.485 (p = 0.030).
Conclusions: ANP decreases significantly after pacing implementation in patients selected for implantation of VVI and DDD/VDD pacemakers. ANP correlates significantly with echocardiographic measurements in patients selected for DDD/VDD pacemakers, but no significant correlation is observed in VVI patients qualifying for permanent pacemaker due to atrioventricular block.