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Elevated B-type natriuretic peptide levels in patients with nonischemic cardiomyopathy predict occurrence of

Tobias Simon1, Ruediger Becker, Frederik Voss

  • 1Dept. of Cardiology, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|January 15, 2008
PubMed

Insights

In patients with dilated cardiomyopathy (DCM), elevated NT-proBNP levels predict arrhythmic events, while non-sustained ventricular tachycardias (NSVTs) do not. Further research is needed to confirm these findings for sudden cardiac death (SCD) risk stratification.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Biomarkers

Background:

  • Patients with nonischemic dilated cardiomyopathy (DCM) face a high risk of sudden cardiac death (SCD).
  • The efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention in DCM remains uncertain.

Purpose of the Study:

  • To prospectively evaluate NT-proBNP levels and non-sustained ventricular tachycardias (NSVTs) as predictors of SCD in DCM patients.
  • To determine the clinical utility of these markers in risk stratification for sudden cardiac death.

Main Methods:

  • Prospective study of 30 DCM patients with LVEF ≤ 40%.
  • Three-day Holter monitoring (HR) and baseline NT-proBNP measurements.
  • Follow-up for ventricular tachyarrhythmias or syncope.

Main Results:

  • Reproducible NSVTs showed high variability and were not predictive of arrhythmic events (P = 0.0960).
  • Elevated NT-proBNP levels significantly correlated with arrhythmic events (P = 0.0135).
  • An NT-proBNP cutoff of 2,259 pg/ml predicted arrhythmic events (P = 0.0313).

Conclusions:

  • Reproducible NSVTs have limited value in predicting arrhythmic events in DCM.
  • Elevated NT-proBNP levels are significantly associated with symptomatic ventricular arrhythmias.
  • Larger prospective trials are necessary to validate these findings for SCD prediction.
Abstract

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