Cardiac resynchronization induces favorable neurohumoral changes.
OBJECTIVE
The aim of this article is to examine whether cardiac resynchronization therapy (CRT) induces improvements in the neurohumoral system.


RESULTS
Thirteen patients with HF (left ventricular (LV) ejection fraction <35%) were included. Before and after 6 months of CRT, myocardial (123)I-metaiodobenzylguanidine ((123)I-MIBG) uptake indices, used as an index of neural norepinephrine reuptake and retention, and brain natriuretic peptide (BNP) levels, used as an index of LV end-diastolic pressure, NYHA classification and echocardiographic indices were assessed. Six months of CRT resulted in significant improvement in (1) NYHA classification and reduction in QRS width (P < 0.001), (2) decrease of LV end-diastolic diameter (P = 0.005), LV end-systolic diameter (P = 0.005), septal to lateral delay (P = 0.01) and mitral regurgitation (MR, P = 0.04), (3) delayed (123)I-MIBG heart/mediastinum ratios improved (P = 0.03) and (123)I-MIBG washout decreased (P = 0.001), and (4) BNP levels decreased (P = 0.001).


CONCLUSIONS
Parallel to significant functional improvement and echocardiographic reverse remodeling and resynchronization, our data indicate that CRT induces favorable changes in the neurohumoral system.
Erol-Yilmaz
Ayten
A
Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands. a.yilmaz@amc.uva.nl
Verberne
Hein J
HJ
Schrama
Tim A
TA
Hrudova
Jana
J
De Winter
Robbert J
RJ
Van Eck-Smit
Berthe L F
BL
De Bruin
Rianne
R
Bax
Jeroen J
JJ
Schalij
Martin J
MJ
Wilde
Arthur A
AA
Tukkie
Raymond
R
D019797:3-Iodobenzylguanidine; D002304:Cardiac Pacing, Artificial; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals
D019275:Radiopharmaceuticals; D020097:Natriuretic Peptide, Brain; D019797:3-Iodobenzylguanidine