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Impact of Cardiac Resynchronization Therapy on Inflammatory Biomarkers and Cardiac Remodeling: The Paradox of Functional and Echocardiographic Response

2018-02Journal article Open access
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dc.contributor.authorAlmeida-Morais, L
dc.contributor.authorAbreu, A
dc.contributor.authorOliveira, MM
dc.contributor.authorSilva Cunha, P
dc.contributor.authorRodrigues, I
dc.contributor.authorPortugal, G
dc.contributor.authorRio, P
dc.contributor.authorSoares, RM
dc.contributor.authorMota Carmo, M
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2018-12-19T12:26:41Z
dc.date.available2018-12-19T12:26:41Z
dc.date.issued2018-02
dc.description.abstractINTRODUCTION: Response to cardiac resynchronization therapy (CRT) can currently be assessed by clinical or echocardiographic criteria, and there is no strong evidence supporting the use of one rather than the other. Reductions in B-type natriuretic peptide (BNP) and C-reactive protein (CRP) have been shown to be associated with CRT response. This study aims to assess variation in BNP and CRP six months after CRT and to correlate this variation with criteria of functional and echocardiographic response. METHODS: Patients undergoing CRT were prospectively enrolled between 2011 and 2014. CRT response was defined by echocardiography (15% reduction in left ventricular end-systolic volume) and by cardiopulmonary exercise testing (10% increase in peak oxygen consumption) from baseline to six months after device implantation. RESULTS: A total of 115 patients were enrolled (68.7% male, mean age 68.6±10.5 years). Echocardiographic response was seen in 51.4% and 59.2% were functional responders. There was no statistical correlation between the two. Functional response was associated with a significantly greater reduction in BNP (-167.6±264.1 vs. -24.9±269.4 pg/ml; p=0.044) and CRP levels (-1.6±4.4 vs. 2.4±9.9 mg/l; p=0.04). Nonetheless, a non-significant reduction in BNP and CRP was observed in echocardiographic responders (BNP -144.7±260.2 vs. -66.1±538.2 pg/ml and CRP -7.1±24.3 vs. 0.8±10.3 mg/l; p>0.05). CONCLUSION: An increase in exercise capacity after CRT implantation is associated with improvement in myocardial remodeling and inflammatory biomarkers. This finding highlights the importance of improvement in functional capacity after CRT implantation, not commonly considered a criterion of CRT response.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018 Feb;37(2):105-113.pt_PT
dc.identifier.doi10.1016/j.repc.2017.06.017pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3138
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSociedade Portuguesa de Cardiologiapt_PT
dc.subjectHSM CARpt_PT
dc.subjectBiomarkers/bloodpt_PT
dc.subjectC-Reactive Protein/analysispt_PT
dc.subjectCardiac Resynchronization Therapypt_PT
dc.subjectEchocardiographypt_PT
dc.subjectHeart Failure/blood
dc.subjectHeart Failure/diagnostic imaging
dc.subjectHeart Failure/physiopathology
dc.subjectHeart Failure/therapy
dc.subjectInflammation/blood
dc.subjectNatriuretic Peptide, Brain/blood
dc.subjectProspective Studies
dc.subjectVentricular Remodeling
dc.titleImpact of Cardiac Resynchronization Therapy on Inflammatory Biomarkers and Cardiac Remodeling: The Paradox of Functional and Echocardiographic Responsept_PT
dc.title.alternativeImpacto da Ressincronização Cardíaca nos Biomarcadores Inflamatórios e de Remodelagem Cardíacapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage113pt_PT
oaire.citation.issue2pt_PT
oaire.citation.startPage105pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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