Neurohormones and inflammatory mediators in patients with heart failure undergoing cardiac resynchronization therapy: Time courses and prediction of response

Giuseppe Boriani, François Regoli, Davide Saporito, Cristian Martignani, Tiziano Toselli, Mauro Biffi, Gloria Francolini, Igor Diemberger, Letizia Bacchi, Claudio Rapezzi, Roberto Ferrari, Angelo Branzi

Research output: Contribution to journalArticlepeer-review

Abstract

Despite interest in neurohormonal activation as a determinant of prognosis in chronic heart failure (CHF) and as a target for pharmacological treatments, data are lacking on the time-related effects of electrical cardiac resynchronization therapy (CRT) on a broad spectrum of neurohormones and cytokines. The aim of this study was to assess time-courses and extents of changes within the neurohormonal profile of CHF patients treated with CRT. We performed a prospective follow-up study in 32 patients with NYHA class III-IV CHF to investigate the effects of CRT on a broad panel of neurohormones proposed for characterization of CHF patients. Levels of atrial and brain natriuretic peptides (ANP, BNP), epinephrine, norepinephrine, aldosterone, plasma renin activity, IL-6, TNF, soluble receptors sTNFR1 and 2, and chromogranin A were assessed before implantation and after 3 months of CRT; when feasible, measurements were also performed at 1 week, 1 month and 12 months (clinical evaluation, echocardiography and ECG were also performed at each time-point). The results showed that at 3 months improvement in NYHA class and echographically assessed left ventricular (LV) reverse structural remodeling were accompanied by significant reductions versus baseline in ANP and BNP, but not in other neurohormones. Moreover a baseline ANP concentration ≤150 pg/ml was a good predictor of response to CRT in terms of NYHA class reduction and reverse LV remodeling. In conclusion 3 months of CRT significantly reduce natriuretic peptides concentrations, while values of other neurohormones and inflammatory cytokines are relatively unvaried. A baseline ANP concentration ≤150 pg/ml might be a clinically useful predictor of medium-term response to CRT.

Original languageEnglish
Pages (from-to)1776-1786
Number of pages11
JournalPeptides
Volume27
Issue number7
DOIs
Publication statusPublished - Jul 2006

Keywords

  • Cardiac resynchronization therapy
  • Cytokines
  • Heart failure
  • Natriuretic peptides
  • Neurohormones
  • Sudden death

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology
  • Physiology
  • Cellular and Molecular Neuroscience

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