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Prognostic value of brain natriuretic peptide in the management of patients receiving cardiac resynchronization therapy
Author(s) -
Pitzalis Maria Vittoria,
Iacoviello Massimo,
Di Serio Francesca,
Romito Roberta,
Guida Pietro,
De Tommasi Elisabetta,
Luzzi Giovanni,
Anaclerio Matteo,
Varraso Lucia,
Forleo Cinzia,
Pansini Nicola
Publication year - 2006
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2005.10.013
Subject(s) - medicine , cardiac resynchronization therapy , brain natriuretic peptide , heart failure , cardiology , natriuretic peptide , intensive care medicine , ejection fraction
Objective: To evaluate the role of brain natriuretic peptide (BNP) in predicting the progression of heart failure (HF) after cardiac resynchronization therapy (CRT). Background: It has been shown that BNP predicts the prognosis and can guide the treatment of HF. Methods: We studied 50 consecutive patients (61±10 years, 23 male) with HF (8 with ischaemic cardiomyopathy), NYHA class III, left bundle branch block, left ventricular ejection fraction (LVEF) ≤35% (mean 24±6%) who underwent CRT. All patients were taking conventional HF therapy and were clinically stable. Plasma BNP levels were evaluated by two‐site dual‐monoclonal immunochemiluminescent assay before, and 1 month after CRT. The predictive value of BNP was assessed using univariate and multivariate regression analyses. Results: During follow‐up (mean 19±12 months), HF progression was observed in 14 patients (11 were hospitalised and 3 died after worsening of HF). Multivariate analysis showed that BNP levels before (HR: 2.07; CI: 1.19–3.62; p =0.01) and 1 month after CRT (HR: 2.23; CI: 1.26–3.94; p =0.006) were significantly related to events. At 1 month, a BNP level >91.5 pg/ml had 89% sensitivity, 59% specificity, and negative and positive predictive values of 96% and 33%, respectively, for HF progression after 12 months. Conclusions: HF patients with high BNP values after 1 month of CRT have worse prognosis during follow‐up. Therefore, in these patients other therapeutic options should be considered.