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

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Positive Response to Cardiac Resynchronization Therapy : The Role of NT-proBNP. / BAKOS, ZOLTAN; REITAN, CHRISTIAN; CHAUDHRY, UZMA; WERTHER EVALDSSON, ANNA; Roijer, Anders; Wang, Lingwei; Platonov, Pyotr; Borgquist, Rasmus.

In: International journal of cardiovascular research, Vol. 5, No. 2, 25.03.2016.

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T1 - Positive Response to Cardiac Resynchronization Therapy

T2 - The Role of NT-proBNP

AU - BAKOS, ZOLTAN

AU - REITAN, CHRISTIAN

AU - CHAUDHRY, UZMA

AU - WERTHER EVALDSSON, ANNA

AU - Roijer, Anders

AU - Wang, Lingwei

AU - Platonov, Pyotr

AU - Borgquist, Rasmus

PY - 2016/3/25

Y1 - 2016/3/25

N2 - 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

AB - 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

KW - Cardiac resynchronization therapy; Electrocardiography; Echocardiography

U2 - 10.4172/2324-8602.1000259

DO - 10.4172/2324-8602.1000259

M3 - Article

VL - 5

JO - International journal of cardiovascular research

JF - International journal of cardiovascular research

SN - 2324-8602

IS - 2

ER -