Positive Response to Cardiac Resynchronization Therapy: The Role of NT-proBNP

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@article{e5e015e187624481be02fc3e44288010,
title = "Positive Response to Cardiac Resynchronization Therapy: The Role of NT-proBNP",
abstract = "Abstract Background: Cardiac resynchronization therapy (CRT) is effective, but only 60-70{\%} of patients benefit from the therapy. Despite numerous implantations, identification of predictive factors for response is still a challenge. We sought to assess the correlation of echocardiographic and clinical response to baseline demographics in relation to change in NT-proBNP levels at 6 months. Methods: 211 patients on optimal medical therapy were included retrospectively (72 ± 10 yrs., 66{\%} LBBB, 48{\%} DCMP, 80{\%} male) and investigated at baseline and 6 months later. Improvement of ≥ 1 NYHA class was used as a marker for clinical response, and >15{\%} reduction of left ventricular end-systolic volume was used to de ne reverse remodeling. NT-proBNP levels were measured at baseline and at 6 months and were compared to echocardiographic and clinical response status.Results: Four groups were identi ed: 1) non-responder, 2) echo responder, 3) clinical responder, and 4) double responder (echo and clinical). Responders were younger (70 vs. 74 years, p=0.04), had better NYHA class (2.1 vs. 2.5, p=0.01) and had lower NT- proBNP compared to non-responders at baseline. NT-proBNP slightly increased or remained unchanged in non-responders, whereas reduction in NT-proBNP was of similar magnitude for clinical or echo responders, and was most pronounced for double responders. A reduction of NT-proBNP ≥25{\%} separated non- responders from responders (p=0.01). No signi cant differences in NT-proBNP levels and no signi cant changes in NT-proBNP were found across the responder subgroups.Conclusion: Six-month reduction in NT-proBNP is most pronounced for “double responders, ” but was comparable in patients with either clinical or echo response. Lack of NT-proBNP reduction can help identify the non-responders for further intervention.Keywords Cardiac resynchronization therapy; Electrocardiography; Echocardiography",
keywords = "Cardiac resynchronization therapy; Electrocardiography; Echocardiography",
author = "ZOLTAN BAKOS and CHRISTIAN REITAN and UZMA CHAUDHRY and {WERTHER EVALDSSON}, ANNA and Anders Roijer and Lingwei Wang and Pyotr Platonov and Rasmus Borgquist",
year = "2016",
month = "3",
day = "25",
doi = "10.4172/2324-8602.1000259",
language = "English",
volume = "5",
journal = "International journal of cardiovascular research",
issn = "2324-8602",
number = "2",

}