Effect of cardiac resynchronization therapy on broad neurohormone biomarkers in heart failure View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2011-02-19

AUTHORS

Ying-xue Dong, John C. Burnett, Horng H. Chen, Sharon Sandberg, Yan-zhong Yang, Yanhua Zhang, Peng-Sheng Chen, Yong-Mei Cha

ABSTRACT

BackgroundNeurohormonal dysregulation contributes to heart failure (HF) progression. We sought to determine the effect of cardiac resynchronization therapy (CRT) on nerve growth factor (NGF), a biomarker that promotes the maturation and survival of sympathetic nerve endings, and amino-terminal propeptide of type III procollagen (PIIINP), a marker of type III collagen synthesis.MethodsThis prospective study consisted of 45 consecutive patients who received cardiac resynchronization therapy defibrillator for advanced HF and 20 healthy age-matched controls. New York Heart Association class, distance of 6-min walk, echocardiography and plasma concentrations of NGF, PIIINP, b-type natriuretic peptide (BNP), norepinephrine, and epinephrine were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume index at 6-month follow-up.ResultsThe baseline BNP (2.61 ± 0.51 vs. 1.53 ± 0.44 ug/L, P < 0.01) and PIIINP (0.88 ± 0.21 vs. 0.71 ± 0.14 μg/L, P = 0.01), but not other biomarkers, were elevated in HF compared to controls. Twenty-two of 45 patients (49%) responded to CRT. The responder group demonstrated significant decrease only in BNP level from 2.61 ± 0.51 to 2.31 ± 0.41 μg/L (P = 0.04) at 6-month follow-up, paralleling the clinical improvements. The baseline PIIINP, rather than the other biomarkers, was lower in CRT responders than non-responders (0.80 ± 0.20 vs. 0.96 ± 0.19 μg/L, P = 0.03). Univariate and multivariate analysis showed that less elevated plasma PIIINP level in HF might be an independent biomarker predicting better response to CRT (odds ratio = 0.20, 95% CI = 0.03–1.17, P = 0.07).ConclusionThe less elevated PIIINP level in HF, which is suggestive of a lesser amount of cardiac fibrosis, has a trend in association with a favorable response to CRT. Contrary to previous reports, NGF levels are not reduced during HF with optimal medical therapy, and there is no NGF rebound in CRT responders. More... »

PAGES

241-249

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s10840-011-9551-7

DOI

http://dx.doi.org/10.1007/s10840-011-9551-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1002497082

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/21336616


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83 fibrosis
84 good response
85 greater reduction
86 group
87 growth factor
88 healthy age-matched controls
89 heart failure
90 heart failure progression
91 improvement
92 independent biomarker
93 index
94 left ventricular end-systolic volume index
95 lesser amounts
96 levels
97 markers
98 maturation
99 medical therapy
100 months
101 multivariate analysis
102 natriuretic peptide
103 nerve endings
104 nerve growth factor
105 neurohormone biomarkers
106 norepinephrine
107 optimal medical therapy
108 patients
109 peptides
110 plasma PIIINP levels
111 plasma concentrations
112 previous reports
113 procollagen
114 progression
115 propeptide
116 prospective study
117 reduction
118 report
119 responder group
120 responders
121 response
122 resynchronization therapy
123 resynchronization therapy defibrillator
124 significant decrease
125 study
126 survival
127 sympathetic nerve endings
128 synthesis
129 therapy
130 therapy defibrillator
131 trends
132 type III collagen synthesis
133 type III procollagen
134 type natriuretic peptide
135 ventricular end-systolic volume index
136 volume index
137 walk
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