Effect of left atrial appendage closure on heart failure biomarker NT-proANP

Effect of left atrial appendage closure on heart failure biomarker NT-proANP.

Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, affecting about 1-2% of the general population. The incidence of AF increases with age and AF carries a five-fold increased risk of cardioembolic events, accounting for roughly 20% of all strokes. Strokes related to AF tend to be more severe, often resulting in worse neurological outcomes (1).  

The left atrial appendage (LAA) is a finger-shaped extension originating from the main body of the left atrium. In AF, thrombus formation often occurs within the LAA due to decreased contractile function and blood flow stasis. 90% of thrombi in nonvalvular AF patients and 57% in valvular AF patients are located in the left atrial appendage (LAA). Though oral anticoagulants serve as the primary treatment for preventing strokes in patients with atrial fibrillation, they are not suitable for all patients due to certain contraindications. Targeting the LAA has emerged as an alternative treatment approach to decrease the risk of stroke or systemic embolism in patients with atrial fibrillation (2-5).

In a study published in 2024, researchers investigated the impact of left atrial appendage (LAA) closure on systemic homeostasis in patients with atrial fibrillation. The study aimed to understand how occluding the LAA influences systemic biomarkers related to coagulation, inflammation, and endothelial function. Results suggest that LAA closure not only reduces stroke risk but may also favorably modulate systemic physiological processes, potentially contributing to improved overall cardiovascular health in these patients (5).

Effect of left atrial appendage closure on heart failure biomarker NT-proANP

In the subanalysis of this trial, researchers also examined the effects of left atrial appendage (LAA) closure on heart failure biomarkers, including NT-proBNP, NT-proANP, Galectin-3, and GDF-15 in patients with atrial fibrillation. The results demonstrated that LAA closure did not significantly influence the levels of HF biomarkers 6 months after the procedure. (6).

In a recent study researchers investigated the hemodynamic and echocardiography changes during and after LAA closure (7). Biomarkers for heart failure were measured including, N-terminal pro-B-type natriuretic peptide (NT-proBNP), N-terminal-pro-atrial natriuretic peptide (NT-proANP) and growth-differentiation factor-15 (GDF-15). The results show that LAA Closure was associated with an acute increase in both rest and postexercise LA pressure. The acute changes during LAAC were explained mostly by the saline and contrast dye given during LAAC and not by the worsening of the reservoir function associated with the procedure. In addition, no increase in NT-proANP and other HF biomarkers or changes in echocardiography parameters after 3 or 6 months after the procedure were observed (7).

About NT-proANP

NT-proANP (N-terminal pro-atrial natriuretic peptide) is a biomarker derived from the precursor of atrial natriuretic peptide (ANP), a hormone produced primarily by the atria of the heart. It plays a key role in regulating blood pressure, blood volume, and electrolyte balance by promoting natriuresis (excretion of sodium) and vasodilation.

Elevated levels of NT-proANP are often associated with conditions involving increased atrial pressure and volume overload, such as heart failure, atrial fibrillation, and other cardiac dysfunctions. Because it is relatively stable and easier to measure than active ANP, NT-proANP is frequently used in clinical settings to assess and monitor cardiac function.

About NT-proBNP

NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a biomarker released from the heart in response to increased wall stress, typically due to conditions like heart failure. It is a non-active fragment of the prohormone BNP (B-type natriuretic peptide), which is produced mainly by the ventricles of the heart when they are under strain.

Elevated levels of NT-proBNP are indicative of cardiac stress and are commonly used in clinical practice to diagnose, assess the severity, and monitor the progression of heart failure. It also helps differentiate cardiac from non-cardiac causes of symptoms such as shortness of breath. Because NT-proBNP is stable in blood samples and has a longer half-life than BNP, it is a reliable biomarker for evaluating cardiac function across various clinical settings.

 

NT proANP ELISA (cat. No. BI-20892) Assay Kit

• CONVENIENT – small sample volume – 10 µl / well
• HIGH QUALITY kit – full validation package
• TRUSTED – cited in over 175 publications
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• FLEXIBLE- assay is suitable for human and non-human samples (rodents and others)

 

NT-proBNP (cat. no. SK-1204) ELISA Assay Kit

• TRUSTED – widely cited in over 140 publications 
• HIGH QUALITY kit – fully validated assays following international quality guidelines
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RAT NT-proBNP ELISA (BI-1204R) Assay Kit

• CONVENIENT – 10µl sample/well, kit control included
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 Literature 

1. Left Atrial Appendage Closure and Systemic Homeostasis: The LAA HOMEOSTASIS Study. Lakkireddy D, Turagam M, Afzal MR, Rajasingh J, Atkins D, Dawn B, Di Biase L, Bartus K, Kar S, Natale A, Holmes DJ Jr.J Am Coll Cardiol. 2018 Jan 16;71(2):135-144. doi: 10.1016/j.jacc.2017.10.092. Erratum in: J Am Coll Cardiol. 2018 Feb 6;71(5):590. doi: 10.1016/j.jacc.2018.01.005. PMID: 29325636.
2. The Left Atrial Appendage: Target for Stroke Reduction in Atrial Fibrillation. Ramlawi B, Abu Saleh WK, Edgerton J. Methodist Debakey Cardiovasc J. 2015 Apr-Jun;11(2):100-3. doi: 10.14797/mdcj-11-2-100. PMID: 26306127; PMCID: PMC4547664.
3. The left atrial appendage: anatomy, function, and noninvasive evaluation. Beigel R, Wunderlich NC, Ho SY, Arsanjani R, Siegel RJ. JACC Cardiovasc Imaging. 2014 Dec;7(12):1251-65. doi: 10.1016/j.jcmg.2014.08.009. PMID: 25496544.
4. Left atrial appendage exclusion in atrial fibrillation. Rozen G, Margolis G, Marai I, Roguin A, Rahamim E, Planer D, Heist EK, Amir O, Tahiroglu I, Ruskin J, Mansour M, Elbaz-Greener G. Front Cardiovasc Med. 2022 Sep 13;9:949732. doi: 10.3389/fcvm.2022.949732. PMID: 36176999; PMCID: PMC9513198.
5. Left atrial appendage closure for stroke prevention in atrial fibrillation: current status and perspectives. Landmesser U, Skurk C, Tzikas A, Falk V, Reddy VY, Windecker S. Eur Heart J. 2024 Aug 21;45(32):2914-2932. doi: 10.1093/eurheartj/ehae398. PMID: 39027946; PMCID: PMC11335376.
6. The effect of left atrial appendage closure on heart failure biomarkers: A PRAGUE-17 trial subanalysis. Herman D, Osmancik P, Neuzil P, Hala P, Lekesova V, Benesova K, Hozman M, Jarkovsky J, Novackova M, Widimsky P, Reddy VY; PRAGUE-17 Trial Investigators. J Cardiovasc Electrophysiol. 2021 Oct;32(10):2645-2654. doi: 10.1111/jce.15206. Epub 2021 Aug 26. PMID: 34402135.
7. Acute and Short‐Term Hemodynamic and Echocardiography Changes During and After Left Atrial Appendage Closure. Dalibor Herman, Petr Peichl, Marek Hozman, Bronislav Janek, Tomas Knize, Teodora Vichova, Hana Linkova, Jana Vesela, Jakub Karch, Naďa Valosková, Eva Borisincova, Pavel Osmancik, J Interventional Cardiology, Dec. 2025. https://doi.org/10.1155/joic/5515180Digital Object Identifier (DOI)