Brain natriuretic peptide (BNP) as prognostic marker on patients with resynchronization therapy.

Pettinati G., Melissano D., Fe Santis F., Manca L.

Division of Cardiology – “Ferrari F.” Hospital – Casarano (Italy)

Mediterranean Journal Pacing and Electrophysiology.

Volume 8 n. 1 -2 January - June 2006

The cardiac resynchronization therapy (CRT) improves clinical parameters in patients with severe heart failure (HF), but it’s unknown as prognostic marker on follow up of HF.

Aim of study

was to assess BNP parameters as predictive value on follow up of heart failure patients with CRT.

Materials and methods

We studied, from October 2003 to Yanuary 2006, 50 patients ( 36 M – main age 71 ± 10, ischemic cardiomiopathy 27 (54%) non ischemic cardiomiopathy 23 (46%), NYHA Class III – IV, QRS > 120 ms, EF < 35%). We considered NT Pro BNP by Elecsys Immunoassay method (normal range < 125 pg/ml), on follow up 12 ± 5 month, before CRT and on 3, 6, 12, month after implantation of biventricular pace maker with ICD backup.

Results

We obtained clinical improvement on 37/50 p. (72%) (Group I) an no improvement on 13/50 p. (28%) (Group II). On all patients NHYA class was 3,5, EF was 28 ± 5%, Pro BNP 3580 ± 900. Group I patients demonstred clinical improvement and NYHA class from 3,4 to 2,1, EF 29% to 40%, Pro BNP 2970 ± 1800 to 380 ± 100. Group II patients demostred no evident clinical improvement and NYHA class from 3,5 to 3,1 EF 26% to 29% , Pro BNP 3550 ± 1760 to 2120 ± 260.

We verified appropriate shock of ICD on 14/50 patient (28%) 8 p. Group I, 6 patients Group II. 4 patients died by pumpe failure, all on Group II.

Conclusion
The non responder patients RCT has no decrease or decrease < 50% of basal Pro BNP. The Pro BNP can be a important prognostic marker on follow up of CRT patients.