title: B-Type Natriuretic Peptide Levels Predict Ventricular Arrhythmia Post Left Ventricular Assist Device Implantation.
abstract: B-type natriuretic peptide (BNP) levels have been shown to predict ventricular arrhythmia (VA) and sudden death in patients with heart failure. We sought to determine whether BNP levels before left ventricular assist device (LVAD) implantation can predict VA post LVAD implantation in advanced heart failure patients. We conducted a retrospective study consisting of patients who underwent LVAD implantation in our institution during the period of May 2009-March 2013. The study was limited to patients receiving a HeartMate II or HeartWare LVAD. Acute myocardial infarction patients were excluded. We compared between the patients who developed VA within 15 days post LVAD implantation to the patients without VA. A total of 85 patients underwent LVAD implantation during the study period. Eleven patients were excluded (five acute MI, four without BNP measurements, and two discharged earlier than 13 days post LVAD implantation). The incidence of VA was 31%, with 91% ventricular tachycardia (VT) and 9% ventricular fibrillation. BNP remained the single most powerful predictor of VA even after adjustment for other borderline significant factors in a multivariate logistic regression model (P < 0.05). BNP levels are a strong predictor of VA post LVAD implantation, surpassing previously described risk factors such as age and VT in the past.
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Yaron
authors: Y
authors: Hellman
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Adnan S
authors: AS
authors: Malik
authors: Department of Biostatistics, IU School of Medicine, Indianapolis, IN, USA.
authors: Hongbo
authors: H
authors: Lin
authors: Department of Biostatistics, IU School of Medicine, Indianapolis, IN, USA.
authors: Changyu
authors: C
authors: Shen
authors: IU Health Cardiovascular Surgeons, Indianapolis, IN, USA.
authors: I-Wen
authors: IW
authors: Wang
authors: IU Health Cardiovascular Surgeons, Indianapolis, IN, USA.
authors: Thomas C
authors: TC
authors: Wozniak
authors: IU Health Cardiovascular Surgeons, Indianapolis, IN, USA.
authors: Zubair A
authors: ZA
authors: Hashmi
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Jeanette
authors: J
authors: Pickrell
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Milena
authors: M
authors: Jani
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Marco A
authors: MA
authors: Caccamo
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Irmina
authors: I
authors: Gradus-Pizlo
authors: Krannert Institute of Cardiology, IU School of Medicine, Indianapolis, IN, USA.
authors: Azam
authors: A
authors: Hadi
mesh_terms: D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D007196:Indiana; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: B-type natriuretic peptide; Left ventricular assist device; Ventricular arrhythmia; Ventricular fibrillation; Ventricular tachycardia