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Natriuretische Peptide und paroxysmales Vorhofflimmern bei Patienten mit ischämischem Schlaganfall

Vorhersagekraft und diagnostische Wertigkeit

dc.contributor.advisorWachter, Rolf Prof. Dr.
dc.contributor.authorLahno, Rosine Clara
dc.format.extentIII, 49de
dc.titleNatriuretische Peptide und paroxysmales Vorhofflimmern bei Patienten mit ischämischem Schlaganfallde
dc.title.alternativeVorhersagekraft und diagnostische Wertigkeitde
dc.title.translatedNatriuretic peptides and paroxysmal atrial fibrillation in patients with ischämisch strokede
dc.contributor.refereeWachter, Rolf Prof. Dr.
dc.description.abstractengThe detection of paroxysmal atrial fibrillation (pAF) is of central clinical interest in the treatment of stroke patients, as the initiation of sufficient secondary prophylaxis can significantly reduce the risk of recurrent stroke. Prolonged long-term ECG recordings significantly increase the diagnosis rate, but the examination is demanding and, therefore, not applicable to all patients. Several previous studies show that the natriuretic peptides BNP, NT-proBNP, and NT-proANP are significantly elevated in both patients pAF and, thus, may help to identify a group of patients at high risk for pAF. The present investigation is based on a monocentric, prospective longitudinal observational study with 220 patients with ischemic stroke but no known previous AF and no AF present at admission. All patients were evaluated over seven days with a long-term ECG regarding a pAF. In addition, natriuretic peptides BNP, NT-proBNP and NT-proANP were determined at admission, after 6 hours and after 24 hours. A total of 28 patients (=12.7%) were diagnosed with pAF. Plasma levels of all natriuretic peptides studied were significantly higher in the group of patients with pAF than in the group of patients without AF at all three time points and comparable to those in a control group of 47 stroke patients with AF on admission ECG. The diagnostic value of natriuretic peptides appeared as rather moderate in the analysis of ROC curves, the best values being obtained in the analysis of samples after 6 hours (AUC of 0.791 for BNP, 0.635 for NT-pro BNP, and 0.636 for NT-pro ANP). We hypothesized that if conversion of pAF to sinus rhythm occurred shortly before stroke, a decrease in natriuretic peptides might be associated with an increased incidence of pAF. This was not confirmed. In fact, there was an increase in natriuretic peptides. This is presumably, on the one hand, due to an endogenous release in the context of the stroke itself and, on the other hand, to an increased cardiac stress due to the stroke. Further studies will be necessary to determine the optimal time of testing for natriuretic peptides after
dc.contributor.coRefereeMaier, Ilko PD Dr.
dc.affiliation.instituteMedizinische Fakultätde
dc.subject.gokfullInnere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747)de
dc.notes.confirmationsentConfirmation sent 2023-09-25T07:45:01de

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