Abstract 17294: Serum B-type Natriuretic Peptide at the Time of Ventricular Tachycardia Ablation Correlates With Myocardial Substrate

• Published in: Circulation (New York, N.Y.) N.Y.), 2016-11, Vol.134 (Suppl_1 Suppl 1), p.A17294-A17294
• Main Authors: Lugo, Ricardo M, Yang, Sushan, Al Aboud, Asad, Blair, Marcia, Tomasek, Kelsey, Su, Yan Ru, Gupta, Deepak, Shoemaker, Benjamin, Wells, Quinn, Kanagasundram, Arvindh
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

IntroductionElevated serum B-type Natriuretic Peptide (BNP) has been shown to independently predict an increased risk of ventricular arrhythmias.HypothesisSerum BNP levels positively correlate with the burden of left ventricular (LV) myocardial scar.MethodsWe studied 36 consecutive patients (mean age 67.8 years, 94% male, 72% ischemic etiology) enrolled in the Vanderbilt Ventricular Tachycardia Ablation Registry who underwent catheter ablation for substrate-mediated monomorphic ventricular tachycardia between 2014-2016. Serum BNP was measured from central venous blood collected at the time of venous access prior to starting the ablation procedure. LV endocardial scar area (cm) was quantified from CARTO3 electroanatomic mapping, with scar defined by bipolar electrogram amplitude < 1.5mV.ResultsLarger scar area was significantly associated with higher BNP levels (Pearson’s rho = 0.53, p = 0.0009, Figure 1). The association between scar area and BNP levels persisted even after accounting for the LV volume (r = 0.356, p = 0.042). In a multi-variable adjusted linear regression analysis including age and LV ejection fraction (LVEF), each 1 cm increase in scar area was associated with a 5.0 pg/mL higher BNP level (95% CI 0.2 - 9.8, p = 0.043). This relationship was similar when using LV volume in place of LVEF (p = 0.047).ConclusionsLarger LV scar burden is one pathophysiologic mechanism by which serum BNP levels may be a biomarker for the prediction of a patient’s individual risk for ventricular arrhythmias.