TY - JOUR
T1 - Elevated B-type natriuretic peptide levels in patients with nonischemic cardiomyopathy predict occurrence of arrhythmic events
AU - Simon, Tobias
AU - Becker, Ruediger
AU - Voss, Frederik
AU - Bikou, Olympia
AU - Hauck, Melanie
AU - Licka, Manuela
AU - Katus, Hugo A.
AU - Bauer, Alexander
PY - 2008/5
Y1 - 2008/5
N2 - Background: Patients with nonischemic cardiomyopathy (DCM) are at high risk for sudden cardiac death (SCD). However, the predictive value of prophylactic implantation of implantable cardioverter defibrillators (ICD) in this patient cohort is yet unclear. Methods and Results: Whether NT pro BNP levels and/or reproducible non sustained ventricular tachycardias (NSVTs) are predictive for SCD was prospectively tested in 30 patients with DCM and LVEF ≤ 40%. All patients received Holter-recordings (HR) on three consecutive days and baseline NT-pro BNP levels were determined. Patients were followed for occurrence of ventricular tachyarrhythmias or unexplained syncope. A great degree of variability was found regarding the occurrence of NSVTs (10% had NSVTs in two consecutive HR, 10% in three consecutive HR, 30% in one HR and 50% had no NSVTs). Patients with NSVTs in more than one HR had significantly higher NT-pro BNP levels (first quartile: 715 pg/ml, median 2,176 pg/ml, third quartile 5,755 pg/ml vs. first quartile 273 pg/ml, median 566 pg/ml, third quartile 1,350 pg/ml, P = 0.0388). During a mean follow-up of 21.6 ± 1.2 months patients with an arrhythmic event had significantly higher NT-pro BNP levels than patients without event (first quartile: 1,002 pg/ml, median 4,075 pg/ml, third quartile 7,777 pg/ml vs. first quartile 173 pg/ml, median 267 pg/ml, third quartile 1,220 pg/ml, P = 0.0135). NT-pro BNP levels of 2,259 pg/ml were identified as optimal cut-off value for the prediction of arrhythmic events (P = 0.0313). In contrast reproducible NSVTs were not predictive for arrhythmic events (P = 0.0960). Conclusion: The present study demonstrates that in patients with DCM the value of reproducible NSVTs in predicting arrhythmic events is low. In contrast raised NT-pro BNP levels significantly correlated with occurrence of symptomatic ventricular arrhythmias. Larger prospective trials are required to confirm these results.
AB - Background: Patients with nonischemic cardiomyopathy (DCM) are at high risk for sudden cardiac death (SCD). However, the predictive value of prophylactic implantation of implantable cardioverter defibrillators (ICD) in this patient cohort is yet unclear. Methods and Results: Whether NT pro BNP levels and/or reproducible non sustained ventricular tachycardias (NSVTs) are predictive for SCD was prospectively tested in 30 patients with DCM and LVEF ≤ 40%. All patients received Holter-recordings (HR) on three consecutive days and baseline NT-pro BNP levels were determined. Patients were followed for occurrence of ventricular tachyarrhythmias or unexplained syncope. A great degree of variability was found regarding the occurrence of NSVTs (10% had NSVTs in two consecutive HR, 10% in three consecutive HR, 30% in one HR and 50% had no NSVTs). Patients with NSVTs in more than one HR had significantly higher NT-pro BNP levels (first quartile: 715 pg/ml, median 2,176 pg/ml, third quartile 5,755 pg/ml vs. first quartile 273 pg/ml, median 566 pg/ml, third quartile 1,350 pg/ml, P = 0.0388). During a mean follow-up of 21.6 ± 1.2 months patients with an arrhythmic event had significantly higher NT-pro BNP levels than patients without event (first quartile: 1,002 pg/ml, median 4,075 pg/ml, third quartile 7,777 pg/ml vs. first quartile 173 pg/ml, median 267 pg/ml, third quartile 1,220 pg/ml, P = 0.0135). NT-pro BNP levels of 2,259 pg/ml were identified as optimal cut-off value for the prediction of arrhythmic events (P = 0.0313). In contrast reproducible NSVTs were not predictive for arrhythmic events (P = 0.0960). Conclusion: The present study demonstrates that in patients with DCM the value of reproducible NSVTs in predicting arrhythmic events is low. In contrast raised NT-pro BNP levels significantly correlated with occurrence of symptomatic ventricular arrhythmias. Larger prospective trials are required to confirm these results.
KW - NT-pro BNP
KW - Non sustained ventricular tachycardias
KW - Nonischemic cardiomyopathy
KW - Risk stratification
KW - Sudden cardiac death
UR - http://www.scopus.com/inward/record.url?scp=44249118880&partnerID=8YFLogxK
U2 - 10.1007/s00392-007-0629-2
DO - 10.1007/s00392-007-0629-2
M3 - Article
C2 - 18193374
AN - SCOPUS:44249118880
SN - 1861-0684
VL - 97
SP - 306
EP - 309
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 5
ER -