{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T11:48:38Z","timestamp":1778932118861,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Science Centre Poland","award":["No. UMO-2019\/33\/B\/NZ5\/02395"],"award-info":[{"award-number":["No. UMO-2019\/33\/B\/NZ5\/02395"]}]},{"name":"National Science Centre Poland","award":["No.UMO-2015\/17\/B\/NZ5\/00125"],"award-info":[{"award-number":["No.UMO-2015\/17\/B\/NZ5\/00125"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Recent data suggest that epicardial left atrial appendage closure (LAAC) is associated with several short-term neurohormonal effects. However, the long-term effects are currently unknown. Objective: To investigate the effects of percutaneous epicardial left atial appendage (LAA) exclusion using LARIAT on neurohormonal profiles at long-term follow-up. Methods: In a prospective single centre study, 60 patients with long-standing, persistent atrial fibrillation (AF) LARIAT were treated. The major hormones of the adrenergic system, renin-angiotensin-aldosterone system (RAAS), and natriuretic peptides were assessed before the intervention and at regular intervals during the following two years. Results: In patients with epicardial LAAC, atrial natriuretic peptide (ANP) levels were significantly increased from baseline at 24 h and decreased at 7 days, 1 month, and 3 months, while remaining unchanged at 12 and 24 months. Noradrenaline levels were significantly lower at 24 h, 7 days, 1 month, 6 months, 12 months, and 24 months, while epinephrine levels decreased significantly at 1 month, 6 months, 12 months, and 24 months. Plasma renin activity significantly decreased at 7 days, 1 month, 6 months, 12 months, and 24 months, while aldosterone levels significantly decreased at 6 months, 12 months, and 24 months. Endothelin-1 and vasopressin showed a significant increase and decrease, respectively, at 24 h, 7 days, 1 month, 6 months, 12 months, and 24 months. There was also a significant decrease in systolic and diastolic blood pressure at 3 months, 6 months, 1 year, and 2 years after the intervention. Conclusions: Epicardial LAAC in AF patients is associated with persistent neurohormonal changes favouring blood pressure reduction.<\/jats:p>","DOI":"10.3390\/jcm11061495","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T11:30:38Z","timestamp":1646825438000},"page":"1495","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Long Term Impact of Epicardial Left Atrial Appendage Ligation on Systemic Hemostasis: LAA HOMEOSTASIS-2"],"prefix":"10.3390","volume":"11","author":[{"given":"Krzysztof","family":"Bartus","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul Hospital, ul. Pradnicka 80, 31-202 Krakow, Poland"},{"name":"Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sri Harsha","family":"Kanuri","sequence":"additional","affiliation":[{"name":"The Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS 66211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3736-8987","authenticated-orcid":false,"given":"Radoslaw","family":"Litwinowicz","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul Hospital, ul. Pradnicka 80, 31-202 Krakow, Poland"},{"name":"Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Ali Elbey","sequence":"additional","affiliation":[{"name":"The Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS 66211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanna","family":"Natorska","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Zabczyk","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Bartus","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Jagiellonian University Medical College, 31-531 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boguslaw","family":"Kapelak","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John Paul Hospital, ul. Pradnicka 80, 31-202 Krakow, Poland"},{"name":"Institute of Cardiology, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rakesh","family":"Gopinnathannair","sequence":"additional","affiliation":[{"name":"The Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS 66211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jalaj","family":"Garg","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwakee, WI 53226, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohit K.","family":"Turagam","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maciej T.","family":"Malecki","sequence":"additional","affiliation":[{"name":"Department of Metabolic Diseases, Jagiellonian University Medical College, 30-688 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall J.","family":"Lee","sequence":"additional","affiliation":[{"name":"Electrophysiology Section, Department of Cardiology, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhanunjaya","family":"Lakkireddy","sequence":"additional","affiliation":[{"name":"The Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS 66211, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.jacep.2015.08.005","article-title":"Left Atrial Appendage Ligation in Nonvalvular Atrial Fibrillation Patients at High Risk for Embolic Events with Ineligibility for Oral Anticoagulation: Initial Report of Clinical Outcomes","volume":"1","author":"Sievert","year":"2015","journal-title":"JACC Clin. 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