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Effect of Cardiac Resynchronization Therapy on Cardiac Sympathetic Nervous Dysfunction and Serum C‐reactive Protein Level
Author(s) -
SHINOHARA TETSUJI,
TAKAHASHI NAOHIKO,
SAITO SYOTARO,
OKADA NORIHIRO,
WAKISAKA OSAMU,
YUFU KUNIO,
HARA MASAHIDE,
NAKAGAWA MIKIKO,
SAIKAWA TETSUNORI,
YOSHIMATSU HIRONOBU
Publication year - 2011
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2011.03156.x
Subject(s) - medicine , cardiology , cardiac resynchronization therapy , heart failure , sympathetic nervous system , cardiomyopathy , systemic inflammation , autonomic nervous system , inflammation , ejection fraction , blood pressure , heart rate
Background: Cardiac autonomic dysfunction is associated with a poor prognosis in patients with heart failure (HF). Systemic inflammation is elevated in patients with HF. We hypothesized that cardiac resynchronization therapy (CRT) improves cardiac sympathetic nervous dysfunction and systemic inflammation. To test our hypothesis, we evaluated cardiac sympathetic activity and serum levels of high sensitive C‐reactive protein (hs‐CRP) before and after CRT.Methods: Twenty‐seven patients with chronic HF (19 men, eight women; mean age 67 ± 10 years) with nonischemic cardiomyopathy who underwent CRT were evaluated. Each patient was evaluated before and 6 months after CRT. Responders were defined as patients showing ≥15% absolute decrease in left ventricular end‐systolic volume. Cardiac sympathetic activity was estimated with cardiac 123 I‐metaiodobenzylguanidine (MIBG) scintigrams.Results: Patients were categorized as responders (n = 19) and nonresponders (n = 8) according to echocardiographic findings. In responders, the mean heart‐to‐mediastinum (H/M) ratio at the delayed phase in cardiac 123 I‐MIBG scintigraphic findings was significantly increased (P < 0.05) and serum levels of hs‐CRP were decreased (P <0.01). Such improvements were not observed in nonresponders. Stepwise multiple regression analysis showed that the reduction in hs‐CRP level was independently associated with the increase in the H/M ratio at delayed phase.Conclusions: Our results demonstrated that cardiac sympathetic nervous dysfunction and systemic inflammation were improved in responder HF patients to CRT. Furthermore, the reduction in systemic inflammation was associated with the improvement in cardiac sympathetic nervous dysfunction. (PACE 2011; 34:1225–1230)