Usefulness of NT-pro BNP monitoring to identify echocardiographic responders following cardiac resynchronization therapy

作者：Magne Julien; Dubois Michelle; Champagne Jean; Dumesnil Jean G; Pibarot Philippe; Philippon Francois; O'Hara Gilles; Senechal Mario^*

来源：Cardiovascular Ultrasound, 2009, 7(1): 39.

DOI：10.1186/1476-7120-7-39

Background: Cardiac resynchronization therapy (CRT) improves left ventricular (LV) volumes, mitral regurgitation (MR) severity and symptoms of patients with heart failure (HF). However, >= 30% of patients have no significant clinical or echocardiographic improvement following CRT. Reverse remodeling after CRT correlates with improved clinical outcomes. We hypothesized that in NT-pro BNP monitoring is accurate to identify responders following CRT.
Methods: 42 consecutive patients (mean age 66 +/- 12 years, male 68%) with HF undergoing CRT were prospectively enrolled. Responders at follow-up were defined by echocardiography (decrease in LV end systolic volume >= 15%). Echocardiography and NT-pro BNP measurement were performed at baseline and repeated 3 to 6 month after CRT.
Results: There was no significant difference between responders (n = 29, 69%) and non-responders (n = 13, 31%) regarding baseline NT-pro BNP level. Responders had significantly higher decrease in NT-pro BNP levels during follow-up than non-responders (absolute: -1428 +/- 1333 pg.ml(-1) vs. -61 +/- 959 pg.ml(-1), p = 0.002; relative: -45 +/- 28% vs. 2 +/- 28%, p < 0.0001). A decrease of >= 15% in NT-pro BNP 3-6 months after CRT identifies echocardiographic responders with a sensitivity of 90% and a specificity of 77%.
Conclusion: NT-pro BNP monitoring can accurately identify echocardiographic responders after CRT.

• 出版日期2009-8-20