open access

Vol 16, No 6 (2009)
Original articles
Published online: 2009-11-19
Submitted: 2013-01-14
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Effects of cardiac resynchronization therapy on systemic inflammation and neurohormonal pathways in heart failure

Roberto Tarquini, Cristina Tosti Guerra, Maria Cristina Porciani, Antonio Michelucci, Margherita Padeletti, Giuseppe Ricciardi, Marco Chiostri, Sania Jelic, Luigi Padeletti
Cardiol J 2009;16(6):545-552.

open access

Vol 16, No 6 (2009)
Original articles
Published online: 2009-11-19
Submitted: 2013-01-14

Abstract

Background: The effect of cardiac resynchronization therapy (CRT) on systemic inflammation and neurohormonal alterations associated with heart failure is not well characterized. Accordingly, we aimed to assess the long term effects of CRT on systemic inflammation and neurohormonal factors in heart failure patients.
Methods and results: In 47 HF patients (NYHA III–IV) we evaluated, at baseline and after one year of CRT: TNF-α, TNF soluble receptors (sTNFR1 and sTNFR2), insulin-like growth factor-1α (IGF-1α), adiponectin, norepinephrine, pro-atrial natriuretic peptide (pro-ANP), N-terminal-pro-brain natriuretic peptide (NT-proBNP) and angiotensin II, NYHA functional class, quality of life (the Minnesota Living with Heart Failure questionnaire), a 6-minute walk test and an echocardiogram. Long-term CRT decreased activation of renin–angiotensin system (RAS) only in patients with reverse remodelling. It failed to prevent a decline in adiponectin levels, regardless of reverse remodelling. NT-proBNP remained unchanged in patients with reverse remodelling, whereas its levels increased in those without reverse remodelling. IGF-1α increased with CRT, whereas CRT had no effect on pro-ANP and inflammatory markers. Conclusions: Long-term CRT is associated with decreased RAS activation and stabilization of NT-proBNP in heart failure patients with reverse remodelling. Long-term CRT, with or without reverse remodelling, does not affect systemic inflammation and fails to prevent a decline in adiponectin.

Abstract

Background: The effect of cardiac resynchronization therapy (CRT) on systemic inflammation and neurohormonal alterations associated with heart failure is not well characterized. Accordingly, we aimed to assess the long term effects of CRT on systemic inflammation and neurohormonal factors in heart failure patients.
Methods and results: In 47 HF patients (NYHA III–IV) we evaluated, at baseline and after one year of CRT: TNF-α, TNF soluble receptors (sTNFR1 and sTNFR2), insulin-like growth factor-1α (IGF-1α), adiponectin, norepinephrine, pro-atrial natriuretic peptide (pro-ANP), N-terminal-pro-brain natriuretic peptide (NT-proBNP) and angiotensin II, NYHA functional class, quality of life (the Minnesota Living with Heart Failure questionnaire), a 6-minute walk test and an echocardiogram. Long-term CRT decreased activation of renin–angiotensin system (RAS) only in patients with reverse remodelling. It failed to prevent a decline in adiponectin levels, regardless of reverse remodelling. NT-proBNP remained unchanged in patients with reverse remodelling, whereas its levels increased in those without reverse remodelling. IGF-1α increased with CRT, whereas CRT had no effect on pro-ANP and inflammatory markers. Conclusions: Long-term CRT is associated with decreased RAS activation and stabilization of NT-proBNP in heart failure patients with reverse remodelling. Long-term CRT, with or without reverse remodelling, does not affect systemic inflammation and fails to prevent a decline in adiponectin.
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Keywords

resynchronization therapy; heart failure; neuro-hormonal pattern

About this article
Title

Effects of cardiac resynchronization therapy on systemic inflammation and neurohormonal pathways in heart failure

Journal

Cardiology Journal

Issue

Vol 16, No 6 (2009)

Pages

545-552

Published online

2009-11-19

Bibliographic record

Cardiol J 2009;16(6):545-552.

Keywords

resynchronization therapy
heart failure
neuro-hormonal pattern

Authors

Roberto Tarquini
Cristina Tosti Guerra
Maria Cristina Porciani
Antonio Michelucci
Margherita Padeletti
Giuseppe Ricciardi
Marco Chiostri
Sania Jelic
Luigi Padeletti

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