THE DINAMIC OF NATRIURETIC PEPTIDE AND INFLAMMATORY MARKERS IN PATIENTS WITH IMPLANTED DEVICES FOR CARDIAC RESYNCHRONIZATION THERAPY
Kuznetsov V.A., Soldatova A.M., Enina T.N., Shebeko P.V., Petelina T.I., Rychkov A.Yu., Melnikov N.N.
The general pathology and pathological physiology
Abstract.
Background: Natriuretic peptides and inflammatory markers are elevated in patients with congestive heart failure (CHF) and reflect disease severity but the effect of cardiac resynchronization therapy (CRT) on systemic inflammation and neurohormonal alterations associated with heart failure is not well characterized.
The aim: To assess effects of CRT on systemic inflammation and N-terminal-pro-brain natriuretic peptide (NT-proBNP) level in CHF patients.
Materials and methods: In 30 patients (mean age 55,1±7,1 years, 81,1% men) with CHF (67,6% ischemic and 32,4% non-ischemic etiology) we evaluated at baseline and after 1 month of CRT: NT-proBNP, tumor necrosis factor-alpha, interleukine-1b (IL-1b), interleukin-6 (IL-6), C-reactive protein (CRP), a 6-minute walk test and an echocardiogram. According to dynamic of end systolic volume patients were divided in responders (>15%; n=17) and non-responders (<15%; n=13).
Results: In patients with reverse remodeling NT-proBNP decreased after 1 month of CRT (р=0,02), also a significant reduction of CRP (р=0,036) and IL-6 (p=0,041) was observed. In responders CRT had no effect on IL-1b and TNF-α. In non-responders levels of NT-proBNP remained unchanged and CRT didn’t affect on inflammatory markers. In non-responders myocardial infarction (MI) was observed more frequently (0,024).
Conclusion: Decrease of NT-proBNP and probably reduction of IL-6 and CRP can be used as a markers of the effects of CRT. Evidence of MI negatively affects on the response to CRT.
Key words:
heart failure, cardiac resynchronization therapy, cytokines.
Kuznetsov Vadim A.
Soldatova Anna M., e-mail: anna_zshurka@mail.ru
Enina Tatyana N.
Shebeko Polina V.
Petelina Tatyana I.
Rychkov Alexandr Yu.
Melnikov Nikolay N.
Tyumen Cardiology Сenter branch of Institute of Cardiology, Russian Academy of Medical Sciences Siberian Branch, Melnikaite st. 111, 625026 Tyumen, Russia