Objective:To explore the influence oflow-dose amiodarone alone or combined with Perindopril treatment on plasma ANP

NT-ProBNP

and hs-CRP in patients with paroxysmal atrial fibrillation(PAF).Methods:112 patients with PAF and 50 health people as controls were enrolled in the study.Patients with PAF were randomly assigned to two treatment subgroups:Group 1(R1)

receiving treatment of low-dose amiodarone alone

Group 2(R2)

receiving treamtment of low-dose amiodarone plus Perindopril.Blood samples of baseline

6-month

12-month after treatment were obtained.The Plasma ANP

NT-ProBNP

and hs-CRP were measured by radioimmunoassay

electrochemiluminescence immunoassay

and immunoturbidimetric assay

respectvily.Left atrial diameter was measured with transthoracic echocardiogram at baseline and 6

12 months after treamtment.The follow-up endpoint was the incidence of AF documented by 12-lead ECG or Holter at 14 days and within 12months after treamtment.Results:(1)At baseline

6 months and 12 months after the use of amiodarone

the levels of ANP and NT-ProBNP were significantly elevated in patients with PAF when compared with control subjects.The plasma concentrations were markedly decreased after treatment.(2)At 6 months and 12 months after the use of amiodarone

the Plasma ANP and NT-ProBNP levels of R1 and AF recurrence groups were respectively higher than that of R2 and maintenance of sinus rhythm(SR)groups greatly(.3)The Kaplan Meier survival analysis demonstrated that the maintenance of sinus rhythm in R2 group(P= 0.02

log-rank test)was significantly higher than that in R1 group.(4)After12 months of follow-up

the left atrial diameter in group R2 was significantly smaller than that in group R1(35.73 mm±5.90 mm vs 37.85 mm± 4.70 mm

P= 0.04).Conclusion:The combination of perindopril and low-dose amiodarone is more effective than low-dose amiodarone alone to decrease the plasma ANP and NT-ProBNP concentrations

inhibit left atrial enlargement

reduce AF recurrence in patients with paroxysmal AF.