Significance and utility of plasma brain natriuretic peptide concentrations in patients with idiopathic ventricular arrhythmias.
BACKGROUND
Secretion of B-type natriuretic peptide (BNP) appears to be regulated mainly by wall tension, and an increase in the plasma BNP concentration is considered to reflect ventricular structural and functional abnormalities. The aim of this study was to clarify the significance and utility of the measurement of the plasma BNP in the setting of idiopathic ventricular arrhythmias (I-VT/PVCs).


METHODS
This study included 135 patients with symptomatic, monomorphic I-VT/PVCs (73 women; 53 +/- 17 years; 50 ventricular tachycardias [VTs], 85 premature ventricular contractions) who underwent radiofrequency catheter ablation. None had structural heart disease or renal dysfunction.


RESULTS
The plasma BNP concentration exceeded the normal range (>18.4 pg/mL; high BNP concentration) in 79 patients (56%). The high BNP concentration was found more often in I-VT/PVCs originating from the left ventricle (LV; 74%) than the right ventricle (RV; 49%; P < 0.01). The plasma BNP concentration correlated with the age (P = 0.0001) and frequency of premature ventricular contractions (P < 0.0001), and left-sided I-VT/PVCs and the presence of controlled hypertension were independent predictors of a high BNP concentration (both P < 0.05). In patients with a successful ablation and high BNP concentration before the ablation, the BNP concentration decreased to the normal range in 61% of patients after ablation. In patients with a failed ablation, the BNP concentration did not decrease to the normal range after ablation in any of the patients (P < 0.0005).


CONCLUSIONS
The plasma BNP concentration was elevated in about 60% of the patients with symptomatic I-VT/PVCs. Normalization of the high BNP concentration after ablation may indicate a successful ablation.
Tada
Hiroshi
H
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Gunma, Japan. tada.h@cvc.pref.gunma.jp
Ito
Sachiko
S
Shinbo
Goro
G
Tadokoro
Kazuyoshi
K
Ito
Itaru
I
Hashimoto
Tohru
T
Miyaji
Kohei
K
Kaseno
Kenichi
K
Naito
Shigeto
S
Nogami
Akihiko
A
Oshima
Shigeru
S
Taniguchi
Koichi
K
D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D017115:Catheter Ablation; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D017180:Tachycardia, Ventricular / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain