Usefulness of plasma B type natriuretic peptide as a predictor to identify responders following CRT

• Main Authors: Amr Nawar, Wael Samy, Hisham Elaasar, Amal Rizk, Sherif Mokhtar
• Format: Article
• Language: English
• Published: Wolters Kluwer 2016-08-01
• Series: Egyptian Journal of Critical Care Medicine
• Subjects: BNP; CRT; Heart failure
• Online Access: http://www.sciencedirect.com/science/article/pii/S2090730316300251

It has been shown that patients with heart failure have high levels of brain or type B natriuretic peptide (BNP), and that there is a correlation between these and the severity of their condition. Many studies report that monitoring BNP levels could be a sensitive method for diagnosing heart failure and performing risk stratification, and that they could act as an independent predictor of adverse events helping clinicians arrive at a prognosis. To achieve this purpose we studied 30 patients with CHF (27 males, mean age 57 years) undergoing CRT implantation. The main finding of our study was that CRT exerted a substantial reduction in plasma BNP levels among responders, but no significant change in nonresponders after 3 months follow-up, only responders showed a significant decrease in plasma BNP levels (229.64 pg/ml ± 111) as compared to non-responders (468 pg/ml ± 96) P value <0.01. Response could be predicted with a cut-off value of 360 pg/ml, with a sensitivity and specificity of 90.9% and 87.5%, respectively. In conclusion, BNP monitoring is potentially a good prognostic indicator of LV functional recovery and reverse remodeling after CRT can accurately identify echocardiographic responders after CRT. Percentage change in plasma BNP levels from baseline to 3 months was the strongest predictor of long-term response to CRT and may have potential to predict outcome.