Usefulness of NT-pro BNP monitoring to identify echocardiographic responders following cardiac resynchronization therapy
Tóm tắt
Cardiac resynchronization therapy (CRT) improves left ventricular (LV) volumes, mitral regurgitation (MR) severity and symptoms of patients with heart failure (HF). However, ≥ 30% of patients have no significant clinical or echocardiographic improvement following CRT. Reverse remodeling after CRT correlates with improved clinical outcomes. We hypothesized that in NT-pro BNP monitoring is accurate to identify responders following CRT. 42 consecutive patients (mean age 66 ± 12 years, male 68%) with HF undergoing CRT were prospectively enrolled. Responders at follow-up were defined by echocardiography (decrease in LV end systolic volume ≥ 15%). Echocardiography and NT-pro BNP measurement were performed at baseline and repeated 3 to 6 month after CRT. There was no significant difference between responders (n = 29, 69%) and non-responders (n = 13, 31%) regarding baseline NT-pro BNP level. Responders had significantly higher decrease in NT-pro BNP levels during follow-up than non-responders (absolute: -1428 ± 1333 pg.ml-1 vs. -61 ± 959 pg.ml-1, p = 0.002; relative: -45 ± 28% vs. 2 ± 28%, p < 0.0001). A decrease of ≥ 15% in NT-pro BNP 3–6 months after CRT identifies echocardiographic responders with a sensitivity of 90% and a specificity of 77%. NT-pro BNP monitoring can accurately identify echocardiographic responders after CRT.
Tài liệu tham khảo
citation_journal_title=N Engl J Med; citation_title=The effect of cardiac resynchronization on morbidity and mortality in heart failure; citation_author=JG Cleland, JC Daubert, E Erdmann, N Freemantle, D Gras, L Kappenberger; citation_volume=352; citation_publication_date=2005; citation_pages=1539-1549; citation_doi=10.1056/NEJMoa050496; citation_id=CR1
citation_journal_title=N Engl J Med; citation_title=Cardiac resynchronization in chronic heart failure; citation_author=WT Abraham, WG Fisher, AL Smith, DB Delurgio, AR Leon, E Loh; citation_volume=346; citation_publication_date=2002; citation_pages=1845-1853; citation_doi=10.1056/NEJMoa013168; citation_id=CR2
citation_journal_title=J Am Coll Cardiol; citation_title=Long-term benefits of biventricular pacing in congestive heart failure: results from the MUltisite STimulation in cardiomyopathy (MUSTIC) study; citation_author=C Linde, C Leclercq, S Rex, S Garrigue, T Lavergne, S Cazeau; citation_volume=40; citation_publication_date=2002; citation_pages=111-118; citation_doi=10.1016/S0735-1097(02)01932-0; citation_id=CR3
citation_journal_title=N Engl J Med; citation_title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure; citation_author=MR Bristow, LA Saxon, J Boehmer, S Krueger, DA Kass, T De Marco; citation_volume=350; citation_publication_date=2004; citation_pages=2140-2150; citation_doi=10.1056/NEJMoa032423; citation_id=CR4
citation_journal_title=Am J Cardiol; citation_title=Effect of cardiac resynchronization therapy on functional mitral regurgitation in heart failure; citation_author=P Lancellotti, P Melon, N Sakalihasan, A Waleffe, C Dubois, M Bertholet; citation_volume=94; citation_publication_date=2004; citation_pages=1462-1465; citation_doi=10.1016/j.amjcard.2004.07.154; citation_id=CR5
citation_title=Early and late effects of cardiac resynchronization therapy on exercise-induced mitral regurgitation: relationship with left ventricular dyssynchrony, remodelling and cardiopulmonary performance; citation_inbook_title=Eur Heart J; citation_publication_date=2007; citation_id=CR6; citation_author=J Madaric; citation_author=M Vanderheyden; citation_author=C Van Laethem; citation_author=K Verhamme; citation_author=A Feys; citation_author=M Goethals
citation_journal_title=J Am Coll Cardiol; citation_title=A mechanism for immediate reduction in mitral regurgitation after cardiac resynchronization therapy: insights from mechanical activation strain mapping; citation_author=H Kanzaki, R Bazaz, D Schwartzman, K Dohi, LE Sade, J Gorcsan; citation_volume=44; citation_publication_date=2004; citation_pages=1619-1625; citation_doi=10.1016/j.jacc.2004.07.036; citation_id=CR7
citation_journal_title=Pacing Clin Electrophysiol; citation_title=Time course of effects of cardiac resynchronization therapy in chronic heart failure: benefits in patients with preserved exercise capacity; citation_author=MF Piepoli, GQ Villani, U Corra, D Aschieri, G Rusticali; citation_volume=31; citation_publication_date=2008; citation_pages=701-708; citation_doi=10.1111/j.1540-8159.2008.01073.x; citation_id=CR8
citation_journal_title=Lancet; citation_title=Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations; citation_author=RW Troughton, CM Frampton, TG Yandle, EA Espiner, MG Nicholls, AM Richards; citation_volume=355; citation_publication_date=2000; citation_pages=1126-1130; citation_doi=10.1016/S0140-6736(00)02060-2; citation_id=CR9
citation_journal_title=Am Heart J; citation_title=Titration of vasodilator therapy in chronic heart failure according to plasma brain natriuretic peptide concentration: randomized comparison of the hemodynamic and neuroendocrine effects of tailored versus empirical therapy; citation_author=DR Murdoch, TA McDonagh, J Byrne, L Blue, R Farmer, JJ Morton; citation_volume=138; citation_publication_date=1999; citation_pages=1126-1132; citation_doi=10.1016/S0002-8703(99)70079-7; citation_id=CR10
citation_journal_title=Eur Heart J; citation_title=Early and sustained effects of cardiac resynchronization therapy on N-terminal pro-B-type natriuretic peptide in patients with moderate to severe heart failure and cardiac dyssynchrony; citation_author=FM Fruhwald, A Fahrleitner-Pammer, R Berger, F Leyva, N Freemantle, E Erdmann; citation_volume=28; citation_publication_date=2007; citation_pages=1592-1597; citation_doi=10.1093/eurheartj/ehl505; citation_id=CR11
citation_journal_title=J Am Coll Cardiol; citation_title=B-type natriuretic peptide and peak exercise oxygen consumption provide independent information for risk stratification in patients with stable congestive heart failure; citation_author=P de Groote, J Dagorn, B Soudan, N Lamblin, E McFadden, C Bauters; citation_volume=43; citation_publication_date=2004; citation_pages=1584-1589; citation_doi=10.1016/j.jacc.2003.11.059; citation_id=CR12
citation_journal_title=J Am Soc Echocardiogr; citation_title=Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography; citation_author=WA Zoghbi, M Enriquez-Sarano, E Foster, PA Grayburn, CD Kraft, RA Levine; citation_volume=16; citation_publication_date=2003; citation_pages=777-802; citation_doi=10.1016/S0894-7317(03)00335-3; citation_id=CR13
citation_journal_title=J Am Coll Cardiol; citation_title=Intra-left ventricular electromechanical asynchrony. A new independent predictor of severe cardiac events in heart failure patients; citation_author=H Bader, S Garrigue, S Lafitte, S Reuter, P Jais, M Haissaguerre; citation_volume=43; citation_publication_date=2004; citation_pages=248-256; citation_doi=10.1016/j.jacc.2003.08.038; citation_id=CR14
citation_journal_title=Cardiovasc Ultrasound; citation_title=Impact of contractile reserve on acute response to cardiac resynchronization therapy; citation_author=M Moonen, M Senechal, B Cosyns, P Melon, E Nellessen, L Pierard; citation_volume=6; citation_publication_date=2008; citation_pages=65; citation_doi=10.1186/1476-7120-6-65; citation_id=CR15
citation_journal_title=Eur J Echocardiogr; citation_title=Myocardial contractile reserve during exercise predicts left ventricular reverse remodelling after cardiac resynchronization therapy; citation_author=P Lancellotti, M Senechal, M Moonen, E Donal, J Magne, E Nellessen; citation_volume=10; citation_publication_date=2009; citation_pages=663-8; citation_doi=10.1093/ejechocard/jep033; citation_id=CR16
citation_journal_title=Eur J Heart Fail; citation_title=Identification of responders to cardiac resynchronization therapy by contractile reserve during stress echocardiography; citation_author=Q Ciampi, L Pratali, R Citro, M Piacenti, B Villari, E Picano; citation_volume=11; citation_publication_date=2009; citation_pages=489-496; citation_doi=10.1093/eurjhf/hfp039; citation_id=CR17
citation_journal_title=Eur J Heart Fail; citation_title=Decrease in plasma B-type natriuretic peptide early after initiation of cardiac resynchronization therapy predicts clinical improvement at 12 months; citation_author=M Kubanek, I Malek, J Bytesnik, P Fridl, L Riedlbauchova, L Karasova; citation_volume=8; citation_publication_date=2006; citation_pages=832-840; citation_doi=10.1016/j.ejheart.2006.02.006; citation_id=CR18
citation_journal_title=J Card Fail; citation_title=Predictors of remodeling in the CRT era: influence of mitral regurgitation, BNP, and gender; citation_author=TP Cappola, MR Harsch, M Jessup, WT Abraham, JB Young, S Petersen-Stejskal; citation_volume=12; citation_publication_date=2006; citation_pages=182-188; citation_doi=10.1016/j.cardfail.2005.11.003; citation_id=CR19
citation_journal_title=Int J Cardiol; citation_title=Suboptimal medical therapy in patients with systolic heart failure is associated with less improvement by cardiac resynchronization therapy; citation_author=JW Fung, JY Chan, LC Kum, HC Chan, GW Yip, Q Zhang; citation_volume=115; citation_publication_date=2007; citation_pages=214-219; citation_doi=10.1016/j.ijcard.2006.04.034; citation_id=CR20
citation_journal_title=Eur J Heart Fail; citation_title=Prognostic value of brain natriuretic peptide in the management of patients receiving cardiac resynchronization therapy; citation_author=MV Pitzalis, M Iacoviello, F Di Serio, R Romito, P Guida, E De Tommasi; citation_volume=8; citation_publication_date=2006; citation_pages=509-514; citation_doi=10.1016/j.ejheart.2005.10.013; citation_id=CR21
citation_journal_title=Am J Cardiol; citation_title=Usefulness of preimplantation B-type natriuretic peptide level for predicting response to cardiac resynchronization therapy; citation_author=N Lellouche, C De Diego, DA Cesario, M Vaseghi, BN Horowitz, A Mahajan; citation_volume=99; citation_publication_date=2007; citation_pages=242-246; citation_doi=10.1016/j.amjcard.2006.08.018; citation_id=CR22
citation_journal_title=Eur J Heart Fail; citation_title=Electromechanical effects of cardiac resynchronization therapy during rest and stress in patients with heart failure; citation_author=C Valzania, F Gadler, MJ Eriksson, A Olsson, G Boriani, F Braunschweig; citation_volume=9; citation_publication_date=2007; citation_pages=644-650; citation_doi=10.1016/j.ejheart.2007.01.009; citation_id=CR23
citation_journal_title=Europace; citation_title=Coronary and peripheral blood flow changes following biventricular pacing and their relation to heart failure improvement; citation_author=P Flevari, G Theodorakis, I Paraskevaidis, F Kolokathis, A Kostopoulou, D Leftheriotis; citation_volume=8; citation_publication_date=2006; citation_pages=44-50; citation_doi=10.1093/europace/euj015; citation_id=CR24
citation_journal_title=J Am Coll Cardiol; citation_title=Tissue Doppler imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy; citation_author=P Sogaard, H Egeblad, WY Kim, HK Jensen, AK Pedersen, BO Kristensen; citation_volume=40; citation_publication_date=2002; citation_pages=723-730; citation_doi=10.1016/S0735-1097(02)02010-7; citation_id=CR25
citation_journal_title=J Am Coll Cardiol; citation_title=Delayed enhancement magnetic resonance imaging predicts response to cardiac resynchronization therapy in patients with intraventricular dyssynchrony; citation_author=JA White, R Yee, X Yuan, A Krahn, A Skanes, M Parker; citation_volume=48; citation_publication_date=2006; citation_pages=1953-1960; citation_doi=10.1016/j.jacc.2006.07.046; citation_id=CR26
citation_journal_title=J Nucl Med; citation_title=Nuclear imaging in cardiac resynchronization therapy; citation_author=MM Henneman, EE van der Wall, C Ypenburg, GB Bleeker, NR Van de Veire, NA Marsan; citation_volume=48; citation_publication_date=2007; citation_pages=2001-2010; citation_doi=10.2967/jnumed.107.040360; citation_id=CR27
citation_journal_title=Europace; citation_title=Late gadolinium enhancement-cardiovascular magnetic resonance as a predictor of response to cardiac resynchronization therapy in patients with ischaemic cardiomyopathy; citation_author=S Chalil, PW Foley, SA Muyhaldeen, KC Patel, ZR Yousef, RE Smith; citation_volume=9; citation_publication_date=2007; citation_pages=1031-1037; citation_doi=10.1093/europace/eum133; citation_id=CR28
citation_journal_title=Am Heart J; citation_title=Myocardial contractile reserve predicts improvement in left ventricular function after cardiac resynchronization therapy; citation_author=C Ypenburg, A Sieders, GB Bleeker, ER Holman, EE van der Wall, MJ Schalij; citation_volume=154; citation_publication_date=2007; citation_pages=1160-1165; citation_doi=10.1016/j.ahj.2007.07.035; citation_id=CR29
citation_journal_title=Europace; citation_title=Importance of contractile reserve for CRT; citation_author=P Lim, C Bars, L Mitchell-Heggs, C Roiron, N Elbaz, B Hamdaoui; citation_volume=9; citation_publication_date=2007; citation_pages=739-743; citation_doi=10.1093/europace/eum117; citation_id=CR30
citation_journal_title=Heart Rhythm; citation_title=Prospective validation of stress echocardiography as an identifier of cardiac resynchronization therapy responders; citation_author=A Da Costa, J Thevenin, F Roche, E Faure, C Romeyer-Bouchard, M Messier; citation_volume=3; citation_publication_date=2006; citation_pages=406-413; citation_doi=10.1016/j.hrthm.2005.12.017; citation_id=CR31
citation_journal_title=J Nucl Med; citation_title=Extent of viability to predict response to cardiac resynchronization therapy in ischemic heart failure patients; citation_author=C Ypenburg, MJ Schalij, GB Bleeker, P Steendijk, E Boersma, P Dibbets-Schneider; citation_volume=47; citation_publication_date=2006; citation_pages=1565-1570; citation_id=CR32
citation_journal_title=J Interv Card Electrophysiol; citation_title=Presence of left ventricular contractile reserve, evaluated by means of dobutamine stress-echo test, is able to predict response to cardiac resynchronization therapy; citation_author=B Tuccillo, C Muto, R Iengo, M Accadia, S Rumolo, M Canciello; citation_volume=23; citation_publication_date=2008; citation_pages=121-126; citation_doi=10.1007/s10840-008-9255-9; citation_id=CR33
citation_journal_title=Clin Chem; citation_title=Only large reductions in concentrations of natriuretic peptides (BNP and NT-proBNP) are associated with improved outcome in ambulatory patients with chronic heart failure; citation_author=WL Miller, KA Hartman, DE Grill, JC Burnett, AS Jaffe; citation_volume=55; citation_publication_date=2009; citation_pages=78-84; citation_doi=10.1373/clinchem.2008.108928; citation_id=CR34
citation_journal_title=Circulation; citation_title=Left ventricular reverse remodeling but not clinical improvement predicts long-term survival after cardiac resynchronization therapy; citation_author=CM Yu, GB Bleeker, JW Fung, MJ Schalij, Q Zhang, EE van der Wall; citation_volume=112; citation_publication_date=2005; citation_pages=1580-1586; citation_doi=10.1161/CIRCULATIONAHA.105.538272; citation_id=CR35