Novel Heart Failure Biomarkers Predict Improvement of Mitral Regurgitation in Patients Receiving Cardiac Resynchronization Therapy-The BIOCRT Study.

Journal Article

Cardiac resynchronization therapy (CRT) improves mitral regurgitation (MR) in a subset of patients. We hypothesized that biomarkers (amino-terminal pro-B type natriuretic peptide, high-sensitivity troponin I, galectin-3 [gal-3], and soluble ST2) might predict MR response after CRT.We measured levels of biomarkers during CRT implantation in 132 patients with a subsequent 2-year follow-up. MR was graded as no-trace, mild, moderate, or severe at baseline and at 6 months.In patients with baseline at least mild MR, 56% had improvement at 6 months, with lower 2-year mortality vs patients without improvement (0% vs 18%; P = 0.002). At baseline, patients with MR improvement had lower high-sensitivity troponin I and gal-3 levels compared with those without improvement (19 vs 40 pg/L; P = 0.01; 14 vs 18 ng/mL; P = 0.007). In multivariable analyses, higher log-transformed gal-3 (odds ratio, 0.15; 95% confidence interval, 0.04-0.65; P = 0.01) remained an independent predictor for MR nonimprovement. Levels of pro-B type natriuretic peptide and soluble ST2 were lower at follow-up in patients with MR improvement (potentially reflecting reduced myocardial stretch and stress) without reaching statistical significance.Higher galectin levels at the time of CRT implantation are associated with MR nonresponse.

Full Text

Duke Authors

Cited Authors

  • Beaudoin, J; Singh, JP; Szymonifka, J; Zhou, Q; Levine, RA; Januzzi, JL; Truong, QA

Published Date

  • December 2016

Published In

Volume / Issue

  • 32 / 12

Start / End Page

  • 1478 - 1484

PubMed ID

  • 27527259

Electronic International Standard Serial Number (EISSN)

  • 1916-7075

International Standard Serial Number (ISSN)

  • 0828-282X

Digital Object Identifier (DOI)

  • 10.1016/j.cjca.2016.05.013

Language

  • eng