title: Relation of inflammatory status to major adverse cardiac events and reverse remodeling in patients undergoing cardiac resynchronization therapy.
abstract: BACKGROUND
  Inflammatory markers are involved in heart failure (HF) pathophysiology. However, the link between these markers and reverse remodeling as well as major adverse cardiac events (HF death, sudden death, and unplanned cardiac rehospitalizations) in patients who undergo cardiac resynchronization therapy (CRT) has not been evaluated.
  
  
  RESULTS
  We recorded major adverse cardiac events of 140 patients (on optimized medical therapy, left ventricular ejection fraction 29.9 +/- 9.6%, New York Heart Association Class III-IV, with intraventricular dyssynchrony) who underwent CRT (enrolled since April 2004). Moreover, we evaluated before and after 6 months of CRT: interleukin-6, high-sensitivity C-reactive protein, New York Heart Association class, quality of life (score on Minnesota Living with Heart Failure questionnaire), 6-minute walking test, left ventricular end-diastolic and end-systolic volumes (nonindexed and indexed by body surface area), and left ventricular ejection fraction. Adverse cardiac events were observed in 40 patients (28.6%): 22 deaths and 18 cardiac unplanned rehospitalizations. Only patients without adverse events during follow-up showed a significant reduction of inflammatory markers and left ventricular volumes (reverse remodeling), despite a significant improvement of clinical status observed in both groups of patients.
  
  
  CONCLUSIONS
  The reduction of inflammatory status seems to be linked to reverse remodeling as well as to a better clinical prognosis in patients with HF who underwent CRT.
authors: Department of Medical and Surgical Critical Care, University of Florence, Florence, Italy.
authors: Antonio
authors: A
authors: Michelucci
authors: Giuseppe
authors: G
authors: Ricciardi
authors: Francesco
authors: F
authors: Sofi
authors: Anna Maria
authors: AM
authors: Gori
authors: Francesca
authors: F
authors: Pirolo
authors: Paolo
authors: P
authors: Pieragnoli
authors: Marzia
authors: M
authors: Giaccardi
authors: Andrea
authors: A
authors: Colella
authors: Maria Cristina
authors: MC
authors: Porciani
authors: Luigi
authors: L
authors: Di Biase
authors: Luigi
authors: L
authors: Padeletti
authors: Rosanna
authors: R
authors: Abbate
authors: Gian Franco
authors: GF
authors: Gensini
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002304:Cardiac Pacing, Artificial; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D006334:Heart Function Tests; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D020257:Ventricular Remodeling
chemical_list: D015415:Biomarkers