Role of sCD40L in the prediction of super-response to cardiac resynchronization therapy
C Pujol1, N Varo Cenarruzabeitia, M Rodríguez Mañero
1Department of Congenital Heart Diseases. German Heart Center of Munich. Germany. claupujol@gmail.com.
Insights
Soluble CD40 ligand (sCD40L) significantly correlates with super response (SR) to Cardiac Resynchronization Therapy (CRT). Wider QRS width, absence of mitral regurgitation, and lead position predict SR in CRT patients.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Management
Background:
- Cardiac Resynchronization Therapy (CRT) is a treatment for heart failure.
- Predicting super response (SR) to CRT is crucial for patient outcomes.
- Biomarkers like Interleukin 6 and Tumoral Necrosis Factor alpha have not been extensively studied for CRT SR prediction.
Purpose of the Study:
- To investigate the predictive role of specific biomarkers, including sCD40L, for SR to CRT.
- To identify clinical and echocardiographic factors associated with SR after CRT implantation.
Main Methods:
- Clinical, electrocardiographic, and echocardiographic data were collected pre-CRT and at one-year follow-up.
- SR was defined as a ≥30% reduction in left ventricular end-systolic volume (LVESV).
- Multivariate logistic regression and ROC curve analyses were performed on pre-implant blood samples and clinical data.
Main Results:
- 46% of patients achieved SR to CRT.
- Higher sCD40L concentrations were observed in SR patients (6.9 vs. 4.4 ng/mL, p=0.02).
- Independent predictors of SR included wider QRS width, absence of mitral regurgitation, and left ventricular lead placement in a lateral-medial position.
Conclusions:
- Soluble CD40 ligand (sCD40L) shows a significant correlation with SR to CRT.
- QRS width, absence of mitral regurgitation, and lead position are independent predictors of SR in this patient cohort.
Background:
The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.
Methods:
Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.
Results:
50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?
Conclusions:
sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.
More Related Videos
10:17Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
Published on: April 11, 2025
11:00Assessment of Sarcoplasmic Reticulum Calcium Reserve and Intracellular Diastolic Calcium Removal in Isolated Ventricular Cardiomyocytes
Published on: September 18, 2017
