PMID- 30364565 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220323 IS - 2053-3624 (Print) IS - 2053-3624 (Electronic) IS - 2053-3624 (Linking) VI - 5 IP - 2 DP - 2018 TI - Characterisation of circulating biomarkers before and after cardiac resynchronisation therapy and their role in predicting CRT response: the COVERT-HF study. PG - e000899 LID - 10.1136/openhrt-2018-000899 [doi] LID - e000899 AB - AIMS: Cardiac resynchronisation therapy (CRT) is effective treatment for selected patients with heart failure (HF) but has ~30% non-response rate. We evaluated whether specific biomarkers can predict outcome. METHODS: A prospective single-centre pilot study of consecutive unselected patients undergoing CRT for HF between November 2013 and December 2015 evaluating cardiac extracellular matrix biomarkers and micro-ribonucleic acid (miRNA) expression before and after CRT assessing ability to predict functional response and survival. Each underwent three assessments (pre-implant, 6 weeks and 6 months postimplant) including: New York Heart Association (NYHA) class, echocardiography, electrocardiography, 6 min walk test (6MWT), Minnesota Living with Heart Failure Questionnaire (MLHFQ) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP). Plasma markers of cardiac fibrosis assessed were: N-terminal pro-peptides of collagen I and III, collagen I C-terminal telopeptides (CTx) and matrix metalloproteinases (MMP-2 and MMP-9) as well as a panel of miRNAs (miRNA-21, miRNA-30d, miRNA-122, miRNA-133a, miRNA-210 and miRNA-486). RESULTS: A total of 52 patients were recruited; mean age (+/-SD) was 72.4+/-9.4 years; male=43 (82.7%), ischaemic aetiology=30 (57.7%), mean QRS duration=166.4+/-23.5 ms, left bundle branch block (LBBB) morphology = 39 (75.0%), mean NYHA=2.7+/-0.6, 6MWT=238.8+/-130.6 m, MLHFQ=46.4+/-21.3 and left ventricular ejection fraction (LVEF)=24.3%+/-8.0%. Mean follow-up=1.7+/-0.3 and 5.8+/-0.7 months. There were 27 (55.1%) functional responders (3 no definable 6-month response; 2 missed assessments and 1 long-term lead displacement). No marker predicted response, however, CTx and LBBB trended most towards predicting functional response. CONCLUSION: No specific biomarkers reached significance for predicting functional response to CRT. CTx showed a trend towards predicting response and warrants further study. TRIAL REGISTRATION NUMBER: NCT02541773. FAU - McAloon, Christopher J AU - McAloon CJ AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. AD - Warwick Medical School, University of Warwick, Coventry, UK. FAU - Barwari, Temo AU - Barwari T AD - King's British Heart Foundation Centre, King's College London, London, UK. FAU - Hu, Jimiao AU - Hu J AD - Warwick Medical School, University of Warwick, Coventry, UK. FAU - Hamborg, Thomas AU - Hamborg T AD - Warwick Medical School, University of Warwick, Coventry, UK. FAU - Nevill, Alan AU - Nevill A AD - Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK. FAU - Hyndman, Samantha AU - Hyndman S AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. FAU - Ansell, Valerie AU - Ansell V AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. FAU - Musa, Anntoniette AU - Musa A AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. FAU - Jones, Julie AU - Jones J AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. FAU - Goodby, Julie AU - Goodby J AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. FAU - Banerjee, Prithwish AU - Banerjee P AUID- ORCID: 0000-0001-7793-1733 AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. AD - Warwick Medical School, University of Warwick, Coventry, UK. AD - Faculty of Health and Life Sciences, University of Coventry, Coventry, UK. FAU - O'Hare, Paul AU - O'Hare P AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. AD - Warwick Medical School, University of Warwick, Coventry, UK. FAU - Mayr, Manuel AU - Mayr M AD - King's British Heart Foundation Centre, King's College London, London, UK. FAU - Randeva, Harpal AU - Randeva H AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. AD - Warwick Medical School, University of Warwick, Coventry, UK. FAU - Osman, Faizel AU - Osman F AD - Department of Cardiology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK. AD - Warwick Medical School, University of Warwick, Coventry, UK. LA - eng SI - ClinicalTrials.gov/NCT02541773 GR - CH/16/3/32406/BHF_/British Heart Foundation/United Kingdom GR - RG/16/14/32397/BHF_/British Heart Foundation/United Kingdom GR - SP/12/5/29574/BHF_/British Heart Foundation/United Kingdom GR - SP/17/10/33219/BHF_/British Heart Foundation/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20181018 PL - England TA - Open Heart JT - Open heart JID - 101631219 PMC - PMC6196945 OTO - NOTNLM OT - cardiac resynchronization therapy OT - heart failure OT - micro-RNAs OT - non-response OT - vascular biomarkers COIS- Competing interests: None declared. EDAT- 2018/10/27 06:00 MHDA- 2018/10/27 06:01 PMCR- 2018/10/18 CRDT- 2018/10/27 06:00 PHST- 2018/07/06 00:00 [received] PHST- 2018/09/05 00:00 [revised] PHST- 2018/09/20 00:00 [accepted] PHST- 2018/10/27 06:00 [entrez] PHST- 2018/10/27 06:00 [pubmed] PHST- 2018/10/27 06:01 [medline] PHST- 2018/10/18 00:00 [pmc-release] AID - openhrt-2018-000899 [pii] AID - 10.1136/openhrt-2018-000899 [doi] PST - epublish SO - Open Heart. 2018 Oct 18;5(2):e000899. doi: 10.1136/openhrt-2018-000899. eCollection 2018.