Open AccessBrain Natriuretic Peptide Levels and Response to Cardiac Resynchronization Therapy in Heart Failure Patients
Author(s) -
Delgado Reynolds M.,
Palanichamy Nanthini,
Radovancevic Rajko,
Vrtotec Bojan,
Radovancevic Branislav
Publication year - 2006
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1527-5299.2006.05469.x
Subject(s) - medicine , heart failure , cardiac resynchronization therapy , brain natriuretic peptide , cardiology , natriuretic peptide , ejection fraction
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/mLto 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.