Usefulness of plasma B type natriuretic peptide as a predictor to identify responders following CRT

摘要

It has been shown that patients with heart failure have high levels of brain or type B natriuretic peptide (BNP), and that there is a correlation between these and the severity of their condition. Many studies report that monitoring BNP levels could be a sensitive method for diagnosing heart failure and performing risk stratification, and that they could act as an independent predictor of adverse events helping clinicians arrive at a prognosis. To achieve this purpose we studied 30 patients with CHF (27 males, mean age 57years) undergoing CRT implantation. The main finding of our study was that CRT exerted a substantial reduction in plasma BNP levels among responders, but no significant change in nonresponders after 3months follow-up, only responders showed a significant decrease in plasma BNP levels (229.64pg/ml±111) as compared to non-responders (468pg/ml±96) P value <0.01. Response could be predicted with a cut-off value of 360pg/ml, with a sensitivity and specificity of 90.9% and 87.5%, respectively. In conclusion, BNP monitoring is potentially a good prognostic indicator of LV functional recovery and reverse remodeling after CRT can accurately identify echocardiographic responders after CRT. Percentage change in plasma BNP levels from baseline to 3months was the strongest predictor of long-term response to CRT and may have potential to predict outcome.