BACKGROUND: There are limited data on the prognostic implications of brain natriuretic peptide (BNP) assessment in patients with mildly symptomatic heart failure (HF) who receive cardiac resynchronization therapy with a defibrillator (CRT-D). METHODS AND RESULTS: The effect of elevated baseline and 1-year BNP levels (dichotomized at the upper tertile BNP of 120 pg/mL) on the risk of HF or death was assessed among the cohort of 1197 patients with baseline BNP data enrolled in MADIT (Multicenter Automated Defibrillator Implantation Trial)-CRT. Elevated baseline BNP was associated with a significant 68% (P=0.007) and 58% (P=0.02) increase in the risk of HF or death among MADIT-CRT patients allocated to CRT-D and implantable cardioverter defibrillator-only therapy, respectively. At 1 year of follow-up, patients allocated to CRT-D displayed significantly greater reductions in BNP (26% reduction) levels compared with implantable cardioverter defibrillator-only patients (8% increase; P=0.005). Patients with CRT-D in whom 1-year BNP levels were reduced or remained low experienced a significantly lower risk of subsequent HF or death as compared with patients in whom 1-year BNP levels were high. Similarly, the echocardiographic response to CRT-D was highest among those who maintained low BNP levels or in whom BNP level at 1-year was reduced. CONCLUSIONS: Our findings suggest that assessment of baseline and follow-up BNP provides important prognostic implications in patients with mildly symptomatic HF who receive CRT.
BACKGROUND: There are limited data on the prognostic implications of brain natriuretic peptide (BNP) assessment in patients with mildly symptomatic heart failure (HF) who receive cardiac resynchronization therapy with a defibrillator (CRT-D). METHODS AND RESULTS: The effect of elevated baseline and 1-year BNP levels (dichotomized at the upper tertile BNP of 120 pg/mL) on the risk of HF or death was assessed among the cohort of 1197 patients with baseline BNP data enrolled in MADIT (Multicenter Automated Defibrillator Implantation Trial)-CRT. Elevated baseline BNP was associated with a significant 68% (P=0.007) and 58% (P=0.02) increase in the risk of HF or death among MADIT-CRT patients allocated to CRT-D and implantable cardioverter defibrillator-only therapy, respectively. At 1 year of follow-up, patients allocated to CRT-D displayed significantly greater reductions in BNP (26% reduction) levels compared with implantable cardioverter defibrillator-onlypatients (8% increase; P=0.005). Patients with CRT-D in whom 1-year BNP levels were reduced or remained low experienced a significantly lower risk of subsequent HF or death as compared with patients in whom 1-year BNP levels were high. Similarly, the echocardiographic response to CRT-D was highest among those who maintained low BNP levels or in whom BNP level at 1-year was reduced. CONCLUSIONS: Our findings suggest that assessment of baseline and follow-up BNP provides important prognostic implications in patients with mildly symptomatic HF who receive CRT.
Authors: Alaa A Shalaby; William T Abraham; Gregg C Fonarow; Malcolm M Bersohn; John Gorcsan; Li-Yin Lee; Jasmina Halilovic; Samir Saba; Alan Maisel; Jagmeet P Singh; Ali Sonel; Alan Kadish Journal: Pacing Clin Electrophysiol Date: 2015-03-30 Impact factor: 1.976
Authors: Quynh A Truong; James L Januzzi; Jackie Szymonifka; Wai-ee Thai; Bryan Wai; Zachary Lavender; Umesh Sharma; Ryan M Sandoval; Zachary S Grunau; Sandeep Basnet; Adefolakemi Babatunde; Olujimi A Ajijola; James K Min; Jagmeet P Singh Journal: Heart Rhythm Date: 2014-07-08 Impact factor: 6.343
Authors: Chukwudiebube N Ajaero; Cher-Rin Chong; Nathan E K Procter; Saifei Liu; Yuliy Y Chirkov; Tamila Heresztyn; Wai Ping Alicia Chan; Margaret A Arstall; Andrew D McGavigan; Michael P Frenneaux; John D Horowitz Journal: ESC Heart Fail Date: 2017-10-13
Authors: Adam Ali Ghotbi; Mikael Sander; Lars Køber; Berit Th Philbert; Finn Gustafsson; Christoffer Hagemann; Andreas Kjær; Peter K Jacobsen Journal: PLoS One Date: 2015-09-18 Impact factor: 3.240