[Usefulness of brain natriuretic peptide to evaluate patients with heart failure treated with cardiac resynchronization].
OBJECTIVE
The aim of the present study was to document the evolution of the blood levels of brain natriuretic peptide (BNP) in patients with heart failure and their correlation with the clinical course after implantation of a biventricular pacemaker.


METHODS
Twenty-eight patients with heart failure associated to left bundle branch block and left ventricular systolic dysfunction were included in the study. In each patient we performed laboratory tests, chest X-ray, electrocardiogram and echocardiogram, and measured blood levels of BNP.


RESULTS
During follow-up (10 [6] months) functional capacity improved, decreasing from 3.3 (0.6) to 2.10 (0.4) (P=.03). The rate of hospitalizations for heart failure decreased from an average of 1.8 (0.7) (6 months before the procedure) to 0.8 (0.3) (6 months after the procedure; P=.04). The basal value of BNP decreased from 193 (98) pg/mL to 52 (14) at the end of the follow-up in the responder group (22 patients) and increased from 564 (380) to 650 (80) pg/mL in the nonresponder group (6 patients). Patients who responded showed significant clinical improvement and decreasing levels of BNP, which reached a plateau an average of 6 months after implantation. Multivariate logistic regression analysis identified lower levels of BNP, idiopathic dilated cardiomyopathy, and functional class as independent predictors of response to therapy. Age, QRS width and left ventricular ejection fraction were not predictors of response.


CONCLUSIONS
Brain natriuretic peptide concentrations allowed us to monitor, in an objective manner, the clinical course of patients with biventricular resynchronization therapy.
Hernández Madrid
Antonio
A
Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Departamento de Medicina, Universidad de Alcalá, Madrid, España.
Miguelañez Díaz
Mercedes
M
Escobar Cervantes
Carlos
C
Blanco Tirados
Blanca
B
Marín
Irene
I
Bernal
Enrique
E
Zamora
Javier
J
Cordova González
Fernando J
FJ
Alfonso Pérez
Manuel
M
Limón
Lilianna
L
González Rebollo
José M
JM
Moya Mur
José L
JL
Moro
Concepción
C
D000368:Aged; D002304:Cardiac Pacing, Artificial; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000628:therapy; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*
D020097:Natriuretic Peptide, Brain