title: Cardiac resynchronization induces favorable neurohumoral changes.
abstract: 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.
authors.affiliation: Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands. a.yilmaz@amc.uva.nl
authors.forename: Ayten
authors.initials: A
authors.lastname: Erol-Yilmaz
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.forename: Tim A
authors.initials: TA
authors.lastname: Schrama
authors.forename: Jana
authors.initials: J
authors.lastname: Hrudova
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: De Winter
authors.forename: Berthe L F
authors.initials: BL
authors.lastname: Van Eck-Smit
authors.forename: Rianne
authors.initials: R
authors.lastname: De Bruin
authors.forename: Jeroen J
authors.initials: JJ
authors.lastname: Bax
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Wilde
authors.forename: Raymond
authors.initials: R
authors.lastname: Tukkie
mesh_terms: 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
chemical_list: D019275:Radiopharmaceuticals; D020097:Natriuretic Peptide, Brain; D019797:3-Iodobenzylguanidine