Accessory pathway location affects brain natriuretic peptide level in patients with Wolff–Parkinson–White syndrome

  • Yosuke NakataniEmail author
  • Koji Kumagai
  • Shigeto Naito
  • Kohki Nakamura
  • Kentaro Minami
  • Masahiro Nakano
  • Takehito Sasaki
  • Koichiro Kinugawa
  • Shigeru Oshima



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.


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.


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.


Anterograde conduction with a right or septal accessory pathway increased the BNP level in WPW syndrome patients with normal cardiac function.


Wolff–Parkinson–White syndrome Brain natriuretic peptide Accessory pathway Cardiac dyssynchrony 



This research received no grant from any funding agency in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


This study was not funded.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Second Department of Internal MedicineUniversity of ToyamaToyamaJapan
  2. 2.Division of CardiologyGunma Prefectural Cardiovascular CenterGunmaJapan

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