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Decrease in plasma B-type natriuretic peptide early after initiation of cardiac resynchronization therapy predicts
Milos Kubánek1, Ivan Málek, Jan Bytesník
1Department of Cardiology, Institute for Clinical and Experimental Medicine, Vídesnská 1958/9, Prague 140 21, Czech Republic. mikb@medicon.cz
European Journal of Heart Failure
|March 21, 2006
Summary
Changes in B-type natriuretic peptide (BNP) levels after cardiac resynchronization therapy (CRT) predict long-term heart failure improvement. Early BNP reduction indicates a better response to CRT treatment.
Area of Science:
- Cardiology
- Heart Failure Management
- Biomarker Research
Background:
- Neurohormonal activation is linked to outcomes in chronic heart failure (CHF) pharmacotherapy.
- Cardiac resynchronization therapy (CRT) is a treatment for CHF.
- The predictive value of neurohormonal changes post-CRT is not fully understood.
Purpose of the Study:
- To test if neurohormonal changes after CRT initiation predict long-term clinical outcomes.
- To evaluate the relationship between B-type natriuretic peptide (BNP) and big endothelin-1 (big ET-1) levels and CRT response.
Main Methods:
- 43 CHF patients received CRT; pharmacotherapy remained stable.
- Plasma BNP and big ET-1 levels were measured pre- and 3-months post-CRT.
- Clinical, echocardiographic, and exercise parameters were monitored long-term.
Main Results:
- CRT significantly reduced BNP and big ET-1 levels, particularly in responders.
- A decrease in BNP levels was observed (345.4+/-346 to 267.7+/-320.8 pg/ml, p<0.01).
- Percentage change in BNP at 3 months was a stronger predictor of long-term improvement than other parameters.
Conclusions:
- The percentage change in plasma BNP levels from baseline to 3 months is the strongest predictor of long-term CRT response.
- BNP level changes show potential for predicting patient outcomes in CRT.
- This finding aids in optimizing CHF management strategies.