Advertisement

 

 

Evaluating the effects of cardiac resynchronization therapy on pathophysiological pathways of heart failure using surrogate biomarkers.

Evaluating the effects of cardiac resynchronization therapy on pathophysiological pathways of heart failure using surrogate biomarkers.
Author Information (click to view)

Sunman H, Özkan A, Yorgun H, Canpolat U, Karabulut E, Bayrak T, Kaya EB, Tokgözoğlu L, Özer N, Özkara A, Aytemir K, Oto A,


Sunman H, Özkan A, Yorgun H, Canpolat U, Karabulut E, Bayrak T, Kaya EB, Tokgözoğlu L, Özer N, Özkara A, Aytemir K, Oto A, (click to view)

Sunman H, Özkan A, Yorgun H, Canpolat U, Karabulut E, Bayrak T, Kaya EB, Tokgözoğlu L, Özer N, Özkara A, Aytemir K, Oto A,

Advertisement

Cardiology journal 2017 10 05() doi 10.5603/CJ.a2017.0111
Abstract
BACKGROUND
Several studies have investigated the effects of cardiac resynchronization therapy (CRT) on heart failure (HF), but none have evaluated the pathophysiological pathways involved in a single group of patients. Therefore, this study aims to assess the long-term effects of CRT on six different pathophysiological pathways involved in the process of HF by the use of surrogate biomarkers.

METHODS
In a group 44 patients with HF, six groups of biomarkers were measured, both at baseline and 1 year after CRT implantation: Inflammation (interleukin [IL]-4, IL-6, tumor necrosis factor [TNF]-α, high sensitive C-reactive protein [hsCRP]); oxidative stress (myeloperoxidase, oxidized low-density lipoprotein [oxLDL], uric acid); extracellular matrix (ECM) remodeling (matrix metalloproteinase [MMP]-2 and -9, galectin-3, procollagen III N-terminal propeptide [prokol-3NT]); neurohormonal pathways (endothelin-1, chromogranin-A); myocyte injury (troponin T, creatine kinase MB fraction [CK-MB]), myocyte stress (B-type natriuretic peptide [BNP]). CRT responders were defined as patients with ≥ 15% reduction in left ventricular end-systolic volume at 12 months post-CRT.

RESULTS
At 1-year follow-up, 72.7% (n = 32) of the patients were categorized as CRT responders. In these patients, the levels of IL-6, MPO, oxLDL, MMP-2, galectin-3, troponin T, and BNP were significantly reduced as compared to baseline values. While the biomarkers for myocyte stress (effect size = 0.357; p = 0.001), ECM remodeling (effect size = 0.343; p = 0.015) and oxidative stress (effect size = 0.247; p = 0.039) showed a significant change in the CRT responders during follow-up, the biomarkers for other pathophysiological pathways did not show a significant alteration.

CONCLUSIONS
In the present study, a significant reduction was only observed in the biomarkers of myocardial stress, ECM remodeling, and oxidative stress among all the CRT responder subjects.

Submit a Comment

Your email address will not be published. Required fields are marked *

19 − 3 =

[ HIDE/SHOW ]