Effect of cardiac resynchronization therapy on broad neurohormone biomarkers in heart failure.

Ying Xue Dong, John C Jr. Burnett, Horng Haur Chen, Sharon Sandberg, Yan Zhong Yang, Yanhua Zhang, Peng Sheng Chen, Yong-Mei Cha

Research output: Contribution to journalArticle

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Abstract

Neurohormonal dysregulation contributes to heart failure (HF) progression. We sought to determine the effect of cardiac resynchronization therapy (CRT) on nerve growth factor (NGF), a biomarker that promotes the maturation and survival of sympathetic nerve endings, and amino-terminal propeptide of type III procollagen (PIIINP), a marker of type III collagen synthesis. This prospective study consisted of 45 consecutive patients who received cardiac resynchronization therapy defibrillator for advanced HF and 20 healthy age-matched controls. New York Heart Association class, distance of 6-min walk, echocardiography and plasma concentrations of NGF, PIIINP, b-type natriuretic peptide (BNP), norepinephrine, and epinephrine were measured before and 6 months after CRT. Response to CRT was defined as 15% or greater reduction in left ventricular end-systolic volume index at 6-month follow-up. The baseline BNP (2.61±0.51 vs. 1.53±0.44 ug/L, P<0.01) and PIIINP (0.88±0.21 vs. 0.71±0.14 μg/L, P=0.01), but not other biomarkers, were elevated in HF compared to controls. Twenty-two of 45 patients (49%) responded to CRT. The responder group demonstrated significant decrease only in BNP level from 2.61±0.51 to 2.31±0.41 μg/L (P=0.04) at 6-month follow-up, paralleling the clinical improvements. The baseline PIIINP, rather than the other biomarkers, was lower in CRT responders than non-responders (0.80±0.20 vs. 0.96±0.19 μg/L, P=0.03). Univariate and multivariate analysis showed that less elevated plasma PIIINP level in HF might be an independent biomarker predicting better response to CRT (odds ratio=0.20, 95% CI=0.03-1.17, P=0.07). The less elevated PIIINP level in HF, which is suggestive of a lesser amount of cardiac fibrosis, has a trend in association with a favorable response to CRT. Contrary to previous reports, NGF levels are not reduced during HF with optimal medical therapy, and there is no NGF rebound in CRT responders.

Original languageEnglish (US)
Pages (from-to)241-249
Number of pages9
JournalJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
Volume30
Issue number3
DOIs
StatePublished - Apr 2011

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Cardiac Resynchronization Therapy
Neurotransmitter Agents
Heart Failure
Biomarkers
Nerve Growth Factor
Natriuretic Peptides
Collagen Type III
Defibrillators
Nerve Endings
Stroke Volume
Epinephrine
Echocardiography
procollagen Type III-N-terminal peptide
Norepinephrine
Fibrosis
Multivariate Analysis
Odds Ratio
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of cardiac resynchronization therapy on broad neurohormone biomarkers in heart failure. / Dong, Ying Xue; Burnett, John C Jr.; Chen, Horng Haur; Sandberg, Sharon; Yang, Yan Zhong; Zhang, Yanhua; Chen, Peng Sheng; Cha, Yong-Mei.

In: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, Vol. 30, No. 3, 04.2011, p. 241-249.

Research output: Contribution to journalArticle

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