title: Brain natriuretic peptide levels and response to cardiac resynchronization therapy in heart failure patients.
abstract: The authors used brain natriuretic peptide (BNP) as a reliable marker to identify nonresponders to cardiac resynchronization therapy (CRT) in patients with advanced heart failure. The study included 70 patients with left ventricular dysfunction (mean ejection fraction, 21+/-4%) and left bundle branch block (QRS duration, 164+/-25 milliseconds) treated with CRT. The authors reviewed data on New York Heart Association functional class, baseline ejection fraction, sodium, creatinine, QRS duration, and BNP levels 3 months before and after CRT therapy. The authors compared results of 42 patients who survived (973+/-192 days) after CRT implantation (responders) to those of 28 patients (nonresponders) who either expired (n=21) or underwent heart transplantation (n=5) or left ventricular assist device implantation (n=2) after an average of 371+/-220 days. Mean BNP levels after 3 months of CRT decreased in responders from 758+/-611 pg/mL to 479+/-451 pg/mL (P=.044), while in nonresponders there was increase in BNP levels from 1191+/-466 pg/mL to 1611+/-1583; P=.046. A rise in BNP levels was associated with poor response (death or need for transplantation or left ventricular assist device and impaired long-term outcome), which makes it a good predictor to identify such patients.
authors.affiliation: Center for Cardiac Support, Texas Heart Institute at St Luke's Episcopal Hospital, Houston, TX 77225-0345, USA.
authors.forename: Reynolds M
authors.initials: RM
authors.lastname: Delgado
authors.forename: Nanthini
authors.initials: N
authors.lastname: Palanichamy
authors.forename: Rajko
authors.initials: R
authors.lastname: Radovancevic
authors.forename: Bojan
authors.initials: B
authors.lastname: Vrtovec
authors.forename: Bojan
authors.initials: B
authors.lastname: Vrtotec
authors.forename: Branislav
authors.initials: B
authors.lastname: Radovancevic
mesh_terms: D000368:Aged; D015415:Biomarkers; D002037:Bundle-Branch Block; D002304:Cardiac Pacing, Artificial; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain