title: Usefulness of NT-pro BNP monitoring to identify echocardiographic responders following cardiac resynchronization therapy.
abstract: BACKGROUND
  Cardiac resynchronization therapy (CRT) improves left ventricular (LV) volumes, mitral regurgitation (MR) severity and symptoms of patients with heart failure (HF). However, >or= 30% of patients have no significant clinical or echocardiographic improvement following CRT. Reverse remodeling after CRT correlates with improved clinical outcomes. We hypothesized that in NT-pro BNP monitoring is accurate to identify responders following CRT.
  
  
  METHODS
  42 consecutive patients (mean age 66 +/- 12 years, male 68%) with HF undergoing CRT were prospectively enrolled. Responders at follow-up were defined by echocardiography (decrease in LV end systolic volume >or= 15%). Echocardiography and NT-pro BNP measurement were performed at baseline and repeated 3 to 6 month after CRT.
  
  
  RESULTS
  There was no significant difference between responders (n = 29, 69%) and non-responders (n = 13, 31%) regarding baseline NT-pro BNP level. Responders had significantly higher decrease in NT-pro BNP levels during follow-up than non-responders (absolute: -1428 +/- 1333 pg x ml-1 vs. -61 +/- 959 pg x ml-1, p = 0.002; relative: -45 +/- 28% vs. 2 +/- 28%, p < 0.0001). A decrease of >or= 15% in NT-pro BNP 3-6 months after CRT identifies echocardiographic responders with a sensitivity of 90% and a specificity of 77%.
  
  
  CONCLUSIONS
  NT-pro BNP monitoring can accurately identify echocardiographic responders after CRT.
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie de Québec, Department of Cardiology, Quebec, Canada. mario.senechal@criucpq.ulaval.ca
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.forename: Michelle
authors.initials: M
authors.lastname: Dubois
authors.forename: Jean
authors.initials: J
authors.lastname: Champagne
authors.forename: Jean G
authors.initials: JG
authors.lastname: Dumesnil
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.forename: François
authors.initials: F
authors.lastname: Philippon
authors.forename: Gilles
authors.initials: G
authors.lastname: O'Hara
authors.forename: Mario
authors.initials: M
authors.lastname: Sénéchal
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002304:Cardiac Pacing, Artificial; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
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