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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

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Association of baseline big endothelin-1 level with long-term prognosis among cardiac resynchronization therapy

Shengwen Yang1, Zhimin Liu2, Shangyu Liu1

  • 1State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Clinical Biochemistry
|June 19, 2018
PubMed

Insights

High levels of big endothelin-1 (ET-1) predict worse outcomes in cardiac resynchronization therapy (CRT) patients. Elevated ET-1 is an independent risk factor for mortality and heart failure hospitalization in CRT recipients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Management

Background:

  • Serum big endothelin-1 (ET-1) concentration is a known prognostic indicator in heart failure.
  • The prognostic significance of ET-1 in patients receiving cardiac resynchronization therapy (CRT) is not well-established.

Purpose of the Study:

  • To investigate the prognostic value of baseline big endothelin-1 (ET-1) levels in patients undergoing cardiac resynchronization therapy (CRT).
  • To determine if ET-1 can serve as a predictive biomarker for adverse outcomes in CRT recipients.

Main Methods:

  • A cohort of 367 CRT recipients was analyzed.
  • Patients were stratified into three groups based on baseline big ET-1 tertiles (<0.34, 0.34-0.56, >0.56 pmol/L).
  • Primary endpoints included all-cause mortality and heart transplantation, with heart failure hospitalization (HFH) also assessed.

Main Results:

  • Higher baseline big ET-1 levels (>0.56 pmol/L) were significantly associated with worse event-free survival (Log-rank test, P < .001).
  • Elevated big ET-1 (>0.56 pmol/L) independently predicted the primary endpoint (HR: 2.005, P = .040) and HFH (HR: 2.126, P = .012) after multivariate adjustment.
  • The median follow-up was 21 months, with 13.08% mortality and 27.25% experiencing HFH.

Conclusions:

  • Baseline big endothelin-1 levels greater than 0.56 pmol/L are an independent predictor of mortality and heart failure hospitalization in CRT recipients.
  • Big ET-1 can be incorporated into risk stratification panels to identify high-risk CRT patients.
  • This finding supports enhanced monitoring and potential priority treatment for CRT patients with elevated big ET-1.
Abstract

Keywords:
Big endothelin-1Cardiac resynchronization therapyRisk factor

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