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B-type natriuretic peptide reduced with use of CRT-D

Issue: November 2011

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Heart Failure Society of America 15th Annual Scientific Meeting

Cardiac resynchronization therapy plus implantable cardioverter defibrillator reduced B-type natriuretic peptide more than the use of an implantable cardioverter defibrillator alone, according to an abstract from the 15th Annual Scientific Meeting of the Heart Failure Society of America.

To assess whether improvement in cardiac size and function in parallel with improvement outcomes were related to changes in B-type natriuretic peptide (BNP), researchers randomly assigned patients to cardiac resynchronization therapy plus ICD (CRT-D) or ICD alone. Echocardiographic and laboratory studies were obtained for 784 patients at baseline and 12 months, according to the abstract. Left ventricular ejection fraction and BNP changes and related changes in ventricular size and function were compared by researchers between both groups.

Researchers found a greater reduction of BNP in the CRT-D group vs. ICD-alone group (P<.00001), and that change in ejection fraction and left ventricular end-diastolic volume were associated with changes in BNP. According to the abstract, “every 100-point decrease in BNP was associated with a 1% increase in LVEF (95% CI, –1.45 to –0.5), and a 5.5-mL reduction in end-diastolic volume (95% CI, 3-7.9).”

“I think what our findings highlight most is that despite a relatively low baseline BNP in this population, BNP at baseline is predictive of outcome, so that a low baseline BNP should not be a deterrent to considering CRT implantation in appropriate patients,” Patricia Campbell, MD, from the Cardiovascular Division at Brigham and Women’s Hospital, said. “Also, while some had marked changes in BNP after one year of therapy, others had not very striking reductions even in the highest quartile of change and that despite this had very significant improvement in left ventricular function, reduction in LV and LA volumes.”

Disclosure: Dr. Campbell reports no relevant financial disclosures.

For more information:

• Campbell P. #183. Presented at: 15th Annual Scientific Meeting of the Heart Failure Society of America; Sept. 18-21, 2011; Boston.

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