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

Published

Journal Article

BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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

Pubmed Central ID

  • 27527259

Electronic International Standard Serial Number (EISSN)

  • 1916-7075

Digital Object Identifier (DOI)

  • 10.1016/j.cjca.2016.05.013

Language

  • eng

Conference Location

  • England