Association between brain natriuretic peptide, markers of inflammation cross mark and the objective and subjective response to cardiac resynchronization therapy

C.J. Brouwers, Henneke Versteeg, Mathias Meine, Cobi J. Heijnen, Annemieke M. Kavelaars, Susanne S. Pedersen, Paula M. C. Mommersteeg

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Introduction: 
Studies suggest that cardiac resynchronization therapy (CRT) can induce a decrease in brain natriuretic peptide (BNP) and systemic inflammation, which may be associated with CRT-response. However, the evidence is inconclusive. We examined levels of BNP and inflammatory markers from pre-CRT implantation to 14 months follow-up in CRT-responders and nonresponders, defined by two response criteria. 
Methods: 
We studied 105 heart failure patients implanted with a CRT-defibrillator (68% men; age = 65.4 ± 10.1 years). The objective CRT-response was defined as a reduction of ⩾15% in left ventricular end systolic volume; subjective CRT-response was defined as an improvement of ⩾10 points in patient-reported health status assessed with the Kansas City Cardiomyopathy Questionnaire. Plasma BNP and markers of inflammation (CRP, IL-6, TNFα, sTNFr1 and sTNFr2) were measured at three time points. 
Results: 
Pre-implantation concentrations of TNFα were significantly lower for subjective responders compared to nonresponders (p = .05), but there was no difference in BNP and the other inflammatory markers at baseline. Objective CRT-response was significantly associated with lower BNP levels over time (F = 27.31, p < .001), and subjective CRT-response with lower TNFα levels (F = 5.67, p = .019). 
Conclusion: 
Objective and subjective response to CRT was associated with lower levels of BNP and TNFα, respectively, but not with other markers of inflammation. This indicates that response to CRT is not automatically related to a stronger overall decrease in inflammation. Large-scale studies are warranted that further examine the relation between the clinical effects of CRT on inflammatory markers, as the latter have been associated with poor prognosis in heart failure.Keywords: Cardiac resynchronization therapy, Heart failure, Cytokines, CRTResponse
Original languageEnglish
Pages (from-to)211-218
JournalBrain, Behavior, and Immunity: An international journal
Volume40
DOIs
Publication statusPublished - Aug 2014

Keywords

  • Cardiac resynchronization therapy
  • Heart failure
  • Cytokines
  • CRT
  • Response

Cite this

@article{3d5587f9980d4214a1361bbd1dff2fb5,
title = "Association between brain natriuretic peptide, markers of inflammation cross mark and the objective and subjective response to cardiac resynchronization therapy",
abstract = "Introduction: Studies suggest that cardiac resynchronization therapy (CRT) can induce a decrease in brain natriuretic peptide (BNP) and systemic inflammation, which may be associated with CRT-response. However, the evidence is inconclusive. We examined levels of BNP and inflammatory markers from pre-CRT implantation to 14 months follow-up in CRT-responders and nonresponders, defined by two response criteria. Methods: We studied 105 heart failure patients implanted with a CRT-defibrillator (68{\%} men; age = 65.4 ± 10.1 years). The objective CRT-response was defined as a reduction of ⩾15{\%} in left ventricular end systolic volume; subjective CRT-response was defined as an improvement of ⩾10 points in patient-reported health status assessed with the Kansas City Cardiomyopathy Questionnaire. Plasma BNP and markers of inflammation (CRP, IL-6, TNFα, sTNFr1 and sTNFr2) were measured at three time points. Results: Pre-implantation concentrations of TNFα were significantly lower for subjective responders compared to nonresponders (p = .05), but there was no difference in BNP and the other inflammatory markers at baseline. Objective CRT-response was significantly associated with lower BNP levels over time (F = 27.31, p < .001), and subjective CRT-response with lower TNFα levels (F = 5.67, p = .019). Conclusion: Objective and subjective response to CRT was associated with lower levels of BNP and TNFα, respectively, but not with other markers of inflammation. This indicates that response to CRT is not automatically related to a stronger overall decrease in inflammation. Large-scale studies are warranted that further examine the relation between the clinical effects of CRT on inflammatory markers, as the latter have been associated with poor prognosis in heart failure.Keywords: Cardiac resynchronization therapy, Heart failure, Cytokines, CRTResponse",
keywords = "Cardiac resynchronization therapy, Heart failure, Cytokines, CRT, Response",
author = "C.J. Brouwers and Henneke Versteeg and Mathias Meine and Heijnen, {Cobi J.} and Kavelaars, {Annemieke M.} and Pedersen, {Susanne S.} and Mommersteeg, {Paula M. C.}",
year = "2014",
month = "8",
doi = "10.1016/j.bbi.2014.03.017",
language = "English",
volume = "40",
pages = "211--218",
journal = "Brain, Behavior, and Immunity: An international journal",
issn = "0889-1591",
publisher = "Academic Press Inc.",

}

Association between brain natriuretic peptide, markers of inflammation cross mark and the objective and subjective response to cardiac resynchronization therapy. / Brouwers, C.J.; Versteeg, Henneke; Meine, Mathias; Heijnen, Cobi J.; Kavelaars, Annemieke M.; Pedersen, Susanne S.; Mommersteeg, Paula M. C.

In: Brain, Behavior, and Immunity: An international journal, Vol. 40, 08.2014, p. 211-218.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Association between brain natriuretic peptide, markers of inflammation cross mark and the objective and subjective response to cardiac resynchronization therapy

AU - Brouwers, C.J.

AU - Versteeg, Henneke

AU - Meine, Mathias

AU - Heijnen, Cobi J.

AU - Kavelaars, Annemieke M.

AU - Pedersen, Susanne S.

AU - Mommersteeg, Paula M. C.

PY - 2014/8

Y1 - 2014/8

N2 - Introduction: Studies suggest that cardiac resynchronization therapy (CRT) can induce a decrease in brain natriuretic peptide (BNP) and systemic inflammation, which may be associated with CRT-response. However, the evidence is inconclusive. We examined levels of BNP and inflammatory markers from pre-CRT implantation to 14 months follow-up in CRT-responders and nonresponders, defined by two response criteria. Methods: We studied 105 heart failure patients implanted with a CRT-defibrillator (68% men; age = 65.4 ± 10.1 years). The objective CRT-response was defined as a reduction of ⩾15% in left ventricular end systolic volume; subjective CRT-response was defined as an improvement of ⩾10 points in patient-reported health status assessed with the Kansas City Cardiomyopathy Questionnaire. Plasma BNP and markers of inflammation (CRP, IL-6, TNFα, sTNFr1 and sTNFr2) were measured at three time points. Results: Pre-implantation concentrations of TNFα were significantly lower for subjective responders compared to nonresponders (p = .05), but there was no difference in BNP and the other inflammatory markers at baseline. Objective CRT-response was significantly associated with lower BNP levels over time (F = 27.31, p < .001), and subjective CRT-response with lower TNFα levels (F = 5.67, p = .019). Conclusion: Objective and subjective response to CRT was associated with lower levels of BNP and TNFα, respectively, but not with other markers of inflammation. This indicates that response to CRT is not automatically related to a stronger overall decrease in inflammation. Large-scale studies are warranted that further examine the relation between the clinical effects of CRT on inflammatory markers, as the latter have been associated with poor prognosis in heart failure.Keywords: Cardiac resynchronization therapy, Heart failure, Cytokines, CRTResponse

AB - Introduction: Studies suggest that cardiac resynchronization therapy (CRT) can induce a decrease in brain natriuretic peptide (BNP) and systemic inflammation, which may be associated with CRT-response. However, the evidence is inconclusive. We examined levels of BNP and inflammatory markers from pre-CRT implantation to 14 months follow-up in CRT-responders and nonresponders, defined by two response criteria. Methods: We studied 105 heart failure patients implanted with a CRT-defibrillator (68% men; age = 65.4 ± 10.1 years). The objective CRT-response was defined as a reduction of ⩾15% in left ventricular end systolic volume; subjective CRT-response was defined as an improvement of ⩾10 points in patient-reported health status assessed with the Kansas City Cardiomyopathy Questionnaire. Plasma BNP and markers of inflammation (CRP, IL-6, TNFα, sTNFr1 and sTNFr2) were measured at three time points. Results: Pre-implantation concentrations of TNFα were significantly lower for subjective responders compared to nonresponders (p = .05), but there was no difference in BNP and the other inflammatory markers at baseline. Objective CRT-response was significantly associated with lower BNP levels over time (F = 27.31, p < .001), and subjective CRT-response with lower TNFα levels (F = 5.67, p = .019). Conclusion: Objective and subjective response to CRT was associated with lower levels of BNP and TNFα, respectively, but not with other markers of inflammation. This indicates that response to CRT is not automatically related to a stronger overall decrease in inflammation. Large-scale studies are warranted that further examine the relation between the clinical effects of CRT on inflammatory markers, as the latter have been associated with poor prognosis in heart failure.Keywords: Cardiac resynchronization therapy, Heart failure, Cytokines, CRTResponse

KW - Cardiac resynchronization therapy

KW - Heart failure

KW - Cytokines

KW - CRT

KW - Response

U2 - 10.1016/j.bbi.2014.03.017

DO - 10.1016/j.bbi.2014.03.017

M3 - Article

VL - 40

SP - 211

EP - 218

JO - Brain, Behavior, and Immunity: An international journal

JF - Brain, Behavior, and Immunity: An international journal

SN - 0889-1591

ER -