Accessory pathway location affects brain natriuretic peptide level in patients with Wolff-Parkinson-White syndrome.
OBJECTIVE
The purpose of this study was to investigate the relationship between the accessory pathway location and brain natriuretic peptide (BNP) level in patients with Wolff-Parkinson-White (WPW) syndrome.


METHODS
We divided 102 WPW syndrome patients with normal left ventricular systolic function into four groups: those with manifest right (MR, n = 14), manifest septal (MS, n = 11), manifest left (ML, n = 30), and concealed (C, n = 47) accessory pathways. BNP level and electrophysiological properties, including difference in timing of the ventricular electrogram between the His bundle area and the distal coronary sinus area (His-CS delay), which indicate intraventricular dyssynchrony, were compared.


RESULTS
BNP levels (pg/dl) were higher in the MR and MS groups than in the ML and C groups (MR, 64 ± 58; MS, 55 ± 45; ML, 17 ± 15; C, 25 ± 21; P < 0.001). AV intervals (ms) were shorter in the MR and MS groups than in the ML and C groups (MR, 76 ± 16; MS, 83 ± 6; ML, 101 ± 19; C, 136 ± 20; P < 0.001). His-CS delay (ms) was longer in the MR group than in the other groups (MR, 50 ± 15; MS, 21 ± 7; ML, 23 ± 10; C, 19 ± 8; P < 0.001). The AV interval (P < 0.01) and the His-CS delay (P < 0.001) were negatively and positively correlated, respectively, with the BNP level.


CONCLUSIONS
Anterograde conduction with a right or septal accessory pathway increased the BNP level in WPW syndrome patients with normal cardiac function.
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan. yosuke3gbst@yahoo.co.jp.
Yosuke
http://orcid.org/0000-0002-5427-5048
Y
Nakatani
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Koji
K
Kumagai
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Shigeto
S
Naito
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Kohki
K
Nakamura
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Kentaro
K
Minami
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Masahiro
M
Nakano
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Takehito
T
Sasaki
Second Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
Koichiro
K
Kinugawa
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Gunma, Japan.
Shigeru
S
Oshima
D058606:Accessory Atrioventricular Bundle / Q000097:blood* / Q000175:diagnosis / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018754:Ventricular Dysfunction / Q000097:blood* / Q000175:diagnosis; D014927:Wolff-Parkinson-White Syndrome / Q000097:blood* / Q000175:diagnosis
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
Accessory pathway; Brain natriuretic peptide; Cardiac dyssynchrony; Wolff–Parkinson–White syndrome