Natriuretische Peptide und paroxysmales Vorhofflimmern bei Patienten mit ischämischem Schlaganfall

Lahno, Rosine Clara

Vorhersagekraft und diagnostische Wertigkeit

dc.contributor.advisor	Wachter, Rolf Prof. Dr.
dc.contributor.author	Lahno, Rosine Clara
dc.date.accessioned	2023-09-25T07:36:33Z
dc.date.available	2023-11-14T00:50:11Z
dc.date.issued	2023-09-25
dc.identifier.uri	http://resolver.sub.uni-goettingen.de/purl?ediss-11858/14887
dc.identifier.uri	http://dx.doi.org/10.53846/goediss-10110
dc.format.extent	III, 49	de
dc.language.iso	deu	de
dc.rights.uri	http://creativecommons.org/licenses/by/4.0/
dc.subject.ddc	610	de
dc.title	Natriuretische Peptide und paroxysmales Vorhofflimmern bei Patienten mit ischämischem Schlaganfall	de
dc.title.alternative	Vorhersagekraft und diagnostische Wertigkeit	de
dc.type	doctoralThesis	de
dc.title.translated	Natriuretic peptides and paroxysmal atrial fibrillation in patients with ischämisch stroke	de
dc.contributor.referee	Wachter, Rolf Prof. Dr.
dc.date.examination	2023-11-07	de
dc.description.abstracteng	The 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 stroke.	de
dc.contributor.coReferee	Maier, Ilko PD Dr.
dc.subject.eng	stroke	de
dc.subject.eng	af	de
dc.subject.eng	bnp	de
dc.subject.eng	NT-pro-BNP	de
dc.identifier.urn	urn:nbn:de:gbv:7-ediss-14887-2
dc.affiliation.institute	Medizinische Fakultät	de
dc.subject.gokfull	Innere Medizin - Allgemein- und Gesamtdarstellungen (PPN619875747)	de
dc.description.embargoed	2023-11-14	de
dc.identifier.ppn	1867412748
dc.notes.confirmationsent	Confirmation sent 2023-09-25T07:45:01	de

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