Positive Response to Cardiac Resynchronization Therapy : The Role of NT-proBNP
BAKOS, ZOLTAN LU ; REITAN, CHRISTIAN LU ; CHAUDHRY, UZMA LU ; WERTHER EVALDSSON, ANNA LU ; Roijer, Anders LU ; Wang, Lingwei LU
; Platonov, Pyotr
LU
and Borgquist, Rasmus
LU
(2016)
In International journal of cardiovascular research
5(2).
- 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... (More)
- 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 (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/e5e015e1-8762-4481-be02-fc3e44288010
- author
- BAKOS, ZOLTAN
LU
; REITAN, CHRISTIAN
LU
; CHAUDHRY, UZMA
LU
; WERTHER EVALDSSON, ANNA
LU
; Roijer, Anders
LU
; Wang, Lingwei
LU
; Platonov, Pyotr
LU
and Borgquist, Rasmus
LU
- organization
- publishing date
- 2016-03-25
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac resynchronization therapy; Electrocardiography; Echocardiography
- in
- International journal of cardiovascular research
- volume
- 5
- issue
- 2
- publisher
- SciTechnol
- ISSN
- 2324-8602
- DOI
- 10.4172/2324-8602.1000259
- language
- English
- LU publication?
- yes
- id
- e5e015e1-8762-4481-be02-fc3e44288010
- date added to LUP
- 2016-10-21 15:35:52
- date last changed
- 2020-09-12 02:22:14
@article{e5e015e1-8762-4481-be02-fc3e44288010,
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}},
author = {{BAKOS, ZOLTAN and REITAN, CHRISTIAN and CHAUDHRY, UZMA and WERTHER EVALDSSON, ANNA and Roijer, Anders and Wang, Lingwei and Platonov, Pyotr and Borgquist, Rasmus}},
issn = {{2324-8602}},
keywords = {{Cardiac resynchronization therapy; Electrocardiography; Echocardiography}},
language = {{eng}},
month = {{03}},
number = {{2}},
publisher = {{SciTechnol}},
series = {{International journal of cardiovascular research}},
title = {{Positive Response to Cardiac Resynchronization Therapy : The Role of NT-proBNP}},
url = {{http://dx.doi.org/10.4172/2324-8602.1000259}},
doi = {{10.4172/2324-8602.1000259}},
volume = {{5}},
year = {{2016}},
}