Decrease of plasma N-terminal pro β-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure
- Author:
- No author available
- Journal Title:
- CHINESE MEDICAL JOURNAL
- Issue:
- 6
- DOI:
- 10.3760/cma.j.issn.0366-6999.2009.06.005
- Key Word:
- N-terminal pro β type natriuretic peptide;chronic heart failure;cardiac resynchronization therapy
Abstract： Background N-terminal pro β-type natriuretic peptide (NT pro BNP) has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy (CRT).Methods A total of 44 patients with chronic heart failure (34 male and 10 female, mean age of (58±13) years, New York Heart Association (NYHA) class 3.3±0.5, QRS duration (150±14) milliseconds) who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired ttest were performed to analyze the data.Results After a mean of (16.3±5.5) months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP ((1.70±1.28) vs (1.07±0.88) pmol/ml, P <0.001) in responders. Percentage change in NT pro BNP level (△BNP%) was a statistically significant predictor of long term clinical improvement at 3 months of follow-up.Conclusions △BNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.
- [1]张向阳,朱继红.Clinical significance of N-terminal pro-brain natriuretic peptide[J].2004,(11).
- [2]Malek I,Bytesnik J,Karasova L,etc.Decrease in plasma B-type natriuretic peptide early after initiation of cardiac resynchronization therapy predicts clinical improvement at 12 months.[J].2006,8(8).
- [3]Kappenberger L,Cleland JG,Tavazzi L,etc.The effect of cardiac resynchronization on morbidity and mortality in heart failure.[J].2005,352(15).
- [4]Gabe B, Bleeker,Theodorus A M, Kaandorp,Hildo J, Lamb,etc.Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy.[J].2006,113(7).
- [5]Hartter E,Berger R,Pacher R,etc.Prognostic evaluation of neurohumoral plasma levels before and during beta-blocker therapy in advanced left ventricular dysfunction.[J].2001,38(2).
- [6]Bristow MR,Krueger S,DeMets D,etc.Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure.[J].2004,350(21).
- [7]Pitzalis MV,Di Serio F,Romito R,etc.Prognostic value of brain natriuretic peptide in the management of patients receiving cardiac resynchronization therapy.[J].2006,8(5).
- [8]Levin ER,Gardner DG,Samson WK.Natriuretic peptides.[J].1998,339(5).
- [9]D J, Sahn,A, DeMaria,J, Kisslo,etc.Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.[J].1978,58.
- [10]Garcia A,Gardetto N,Kazanagra R,etc.A rapid bedside test for B-type peptide predicts treatment outcomes in patients admitted for decompensated heart failure: a pilot study.[J].2001,37(2).
- [11]Frampton CM,Nicholls MG,Yandle TG,etc.Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations (see comments)[J].2000,355(9210).
- [12]Kunio Miyatake,Shiro Izumi,Mitsunori Okamoto,etc.Semiquantitative grading of severity of mitral regurgitation by real-time two-dimensional Doppler flow imaging technique[J].1986,7(1).