Low fibrosis biomarker levels predict cardiac resynchronization therapy response

Area of Science:

• Cardiology
• Biomarkers
• Heart Failure

Background:

• Cardiac fibrosis is linked to heart failure and poor outcomes.
• Existing research on fibrosis biomarkers for predicting cardiac resynchronization therapy (CRT) response yields conflicting results.
• Accurate prediction of CRT response is crucial for optimizing patient treatment.

Purpose of the Study:

• To evaluate the predictive value of cardiac fibrosis biomarkers for CRT response.
• To determine if baseline fibrosis biomarker levels can identify patients likely to benefit from CRT.

Main Methods:

• A multicenter study included 60 patients undergoing CRT implantation.
• Patients had clinical evaluation, echocardiography, and blood fibrosis biomarker assessment (PICP, PIIINP) pre-implantation.
• CRT response was defined at 6 months by a composite endpoint including survival, heart failure hospitalization, and left ventricular (LV) reverse remodeling.

Main Results:

• 63% of patients (38/60) were positive responders to CRT at 6 months.
• Responders had significantly lower baseline levels of PICP and PIIINP compared to non-responders.
• A PICP level ≤163 ng/ml independently predicted positive CRT response (OR=7.8, p=0.023).

Conclusions:

• Lower baseline cardiac fibrosis, indicated by reduced PICP and PIIINP levels, is associated with positive CRT response.
• Procollagen type I C-terminal propeptide (PICP) may serve as a valuable biomarker for selecting patients who will benefit from CRT.
• Integrating fibrosis biomarker assessment into pre-CRT evaluation could enhance treatment personalization and improve patient outcomes.