Prognostic value of brain natriuretic peptide in the management of patients receiving cardiac resynchronization therapy
| Autor: | Pietro Guida, Massimo Iacoviello, Elisabetta De Tommasi, Francesca Di Serio, Lucia Varraso, M Anaclerio, Roberta Romito, Giovanni Luzzi, Cinzia Forleo, N Pansini, Mariavittoria Pitzalis |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Pacemaker Artificial medicine.medical_specialty Multivariate analysis medicine.medical_treatment Cardiac resynchronization therapy Ischaemic cardiomyopathy Risk Assessment Internal medicine Natriuretic Peptide Brain medicine Humans cardiovascular diseases Aged Proportional Hazards Models Heart Failure Ejection fraction Ventricular Remodeling Left bundle branch block business.industry Cardiac Pacing Artificial Middle Aged Prognosis Brain natriuretic peptide medicine.disease Survival Analysis Predictive value Echocardiography Doppler Heart failure Disease Progression cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology |
| Zdroj: | European Journal of Heart Failure. 8:509-514 |
| ISSN: | 1388-9842 |
| DOI: | 10.1016/j.ejheart.2005.10.013 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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