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https://doi.org/10.15836/ccar2022.258

Echocardiographic optimization of cardiac resynchronization therapy device contributes to a greater reduction of heart failure biomarker compared to the electrocardiographic method

Marija Brestovac orcid id orcid.org/0000-0003-1542-2890
Martina Lovrić Benčić orcid id orcid.org/0000-0001-8446-6120
Blanka Glavaš Konja orcid id orcid.org/0000-0003-1134-4856
Vlatka Rešković Lukšić orcid id orcid.org/0000-0002-4721-3236
Sandra Jakšić Jurinjak orcid id orcid.org/0000-0002-7349-6137
Kristina Gašparović orcid id orcid.org/0000-0002-1191-4831
Zvonimir Ostojić orcid id orcid.org/0000-0003-1762-9270
Joško Bulum orcid id orcid.org/0000-0002-1482-6503
Jadranka Šeparović Hanževački orcid id orcid.org/0000-0002-3437-6407


Puni tekst: engleski pdf 176 Kb

str. 258-258

preuzimanja: 125

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Sažetak

Ključne riječi

cardiac resynchronization therapy; NTproBNP

Hrčak ID:

287726

URI

https://hrcak.srce.hr/287726

Datum izdavanja:

8.12.2022.

Posjeta: 413 *



Introduction: Resynchronization therapy is an effective method for treating advanced heart failure that contributes to echocardiographic, clinical and laboratory favorable outcomes. (1-4) This study was aimed to compare the dynamics in the reduction of heart failure biomarker (NTproBNP) between two groups of patients whose resynchronization device (CRT) was optimized by a) echocardiographic and b) electrocardiographic method.

Patients and Methods: A total of 146 patients with implanted CRT according to the guidelines for resynchronization therapy were included in this randomized study. The examined population was divided into two groups depending on the method used for CRT optimization. In the first group (US) the echocardiographic method was used, correcting the parameters of cardiac mechanical dyssynchrony, and in the second group (ECG) an electrocardiographic method that corrects the parameters of CRT according to QRS width. NTproBNP values were determined before and 6 months after the implantation of CRT and compared with each other.

Results: The results are shown inFigure 1. In both groups there was a significant reduction in NTproBNP (p<0.001) over a period of 6 months, but in the US group this decrease was even more significant (p=0.037).

FIGURE 1 Difference in NT-proBNP reduction between the echocardiographic and electrocardiographic optimization groups. NTproBNP - N-terminal pro B-type natriuretic peptide; CRT = cardiac resynchronization therapy; US = echocardiography group; ECG = electrocardiography group
CC202217_9-10_258-f1

Conclusion: Echocardiographic optimization of CRT leads to a significant decrease in NTproBNP compared to electrocardiographic optimization over a period of six months.

LITERATURE

1 

Bakos Z, Chatterjee NC, Reitan C, Singh JP, Borgquist R. Prediction of clinical outcome in patients treated with cardiac resynchronization therapy - the role of NT-ProBNP and a combined response score. BMC Cardiovasc Disord. 2018 April 24;18(1):70. https://doi.org/10.1186/s12872-018-0802-8 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/29699498

2 

Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L, et al. Cardiac Resynchronization-Heart Failure (CARE-HF) Study Investigators. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005 April 14;352(15):1539–49. https://doi.org/10.1056/NEJMoa050496 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/15753115

3 

Pujol-López M, San Antonio R, Mont L, Trucco E, Tolosana JM, Arbelo E, et al. Electrocardiographic optimization techniques in resynchronization therapy. Europace. 2019 September 1;21(9):1286–96. https://doi.org/10.1093/europace/euz126 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31038177

4 

Roubicek T, Stros J, Kucera P, Nedbal P, Cerny J, Polasek R, et al. Combination of left ventricular reverse remodeling and brain natriuretic peptide level at one year after cardiac resynchronization therapy predicts long-term clinical outcome. PLoS One. 2019 July 17;14(7):e0219966. https://doi.org/10.1371/journal.pone.0219966 PubMed: http://www.ncbi.nlm.nih.gov/pubmed/31314790


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