Decrease of plasma N-terminal pro beta-type natriuretic peptide as a predictor of clinical improvement after cardiac resynchronization therapy for heart failure.
BACKGROUND
N-terminal pro beta-type natriuretic peptide (NT pro BNP) has been shown to predict the prognosis and could guide the treatment of heart failure. We aimed to investigate the values of NT pro BNP in predicting the clinical response to cardiac resynchronization therapy (CRT).


METHODS
A total of 44 patients with chronic heart failure (34 male and 10 female, mean age of (58 +/- 13) years, New York Heart Association (NYHA) class 3.3 +/- 0.5, QRS duration (150 +/- 14) milliseconds) who underwent successful implantation of a CRT system were enrolled in this study. Pharmacotherapy remained stable during the first 3 months of follow-up. Plasma levels of NT pro BNP were evaluated before and 3 months after implantation. Clinical, echocardiographic and exercise parameters were monitored at each clinical visit after CRT implantation. Receiver operating characteristic analysis and a paired t test were performed to analyze the data.


RESULTS
After a mean of (16.3 +/- 5.5) months of follow-up, 11 nonresponders were identified. CRT resulted in a significant reduction in NT pro BNP ((1.70 +/- 1.28) vs (1.07 +/- 0.88) pmol/ml, P < 0.001) in responders. Percentage change in NT pro BNP level (DeltaBNP%) was a statistically significant predictor of long term clinical improvement at 3 months of follow-up.


CONCLUSIONS
DeltaBNP% from baseline to 3 months of follow-up is a predictor of long term response to CRT. NT pro BNP may be a simple method for monitoring the effects of CRT.
Ding
Li-Gang
LG
Centre of Arrhythmia Diagnosis and Treatment, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy and Medical Sciences & Peking Union Medical College, Beijing 100037, China.
Hua
Wei
W
Zhang
Shu
S
Chu
Jian-Min
JM
Chen
Ke-Ping
KP
Wang
Yang
Y
Wang
Fang-Zheng
FZ
Chen
Xin
X