Cor Vasa 2008, 50(5):195-199 | DOI: 10.33678/cor.2008.066

Increase in B-type natriuretic peptide following reprogramming from chronic biventricular pacing to isolated right ventricular pacing.

Radka Hazuková¹, Miloslav Pleskot¹, Aleš Havlíček²

¹ I. interní klinika, Fakultní nemocnice Hradec Králové, Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové, Hradec Králové

² Kardiologické oddělení, Interní klinika, Krajská nemocnice a Ústav zdravotnických studií, Univerzita Pardubice, Pardubice, Česká republika

Background:
In an animal study, hemodynamic overload of 8 mmHg increased the amount of released B-type natriuretic peptide (BNP) within 4 hours.

Aim:
To determine whether the worsening of hemodynamic parameters by 2.0 to 4.8 mmHg (pulmonary artery wedged pressure) due to a change from chronic biventricular pacing (BiVP) to isolated right ventricular pacing (RVP) would increase the plasma levels of BNP in the human body.

Method:
A total of 18 patients with chronically optimized heart failure treatment including BiVP (16.7 ± 13.8 months) were randomized at a 1 : 1 ratio to a 4-hour period of the type of cardiac resynchronization therapy being tested (RVP, or reactivated BiVP). Activation of the remaining type of resynchronization (reactivated BiVP, or RVP) was undertaken on the next day in a cross-over manner. The pacemaker was reset to its default format in the meantime. The plasma levels of BNP and its dynamics were assessed (2 and 6 samples prior to and after activation, respectively).

Results:
Compared with the balanced horizontal trend in BNP noted on BiVP re-activation, a sustained rise in BNP was detected during RVP (p < 0.007). Compared with baseline, there was a significant increase at 3 hours during RVP (+5.71%; p < 0.008), more pronounced at 4 hours (+12.8%; p < 0.0003), while BNP levels were comparable with baseline ones during reactivated BiVP.

Conclusion:
In real-world patients, pacemaker reprogramming from chronic BiVP to RVP will increase plasma BNP levels within 4 hours.

Keywords: B-type natriuretic peptide; Dysfunction; Heart failure; Pacemaker reprogramming

Published: May 1, 2008  Show citation