PMID- 31314790
OWN - NLM
STAT- MEDLINE
DCOM- 20200302
LR  - 20200309
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 14
IP  - 7
DP  - 2019
TI  - Combination of left ventricular reverse remodeling and brain natriuretic peptide 
      level at one year after cardiac resynchronization therapy predicts long-term 
      clinical outcome.
PG  - e0219966
LID - 10.1371/journal.pone.0219966 [doi]
LID - e0219966
AB  - INTRODUCTION: The aim of this study was to investigate the predictors of 
      long-term clinical outcome of heart failure (HF) patients who survived first year 
      after initiation of cardiac resynchronization therapy (CRT). METHODS: This was a 
      single-center observational cohort study of CRT patients implanted because of 
      symptomatic HF with reduced ejection fraction between 2005 and 2013. Left 
      ventricle (LV) diameters and ejection fraction, New York Heart Association (NYHA) 
      class, and level of N-terminal fragment of pro-brain natriuretic peptide 
      (NT-proBNP) were assessed at baseline and 12 months after CRT implantation. Their 
      predictive power for long-term HF hospitalization and mortality, and cardiac and 
      all-cause mortality was investigated. RESULTS: A total of 315 patients with left 
      bundle branch block or intraventricular conduction delay who survived >1 year 
      after CRT implantation were analyzed in the current study. During a follow-up 
      period of 4.8+/-2.1 years from CRT implantation, 35.2% patients died from cardiac 
      (19.3%) or non-cardiac (15.9%) causes. Post-CRT LV ejection fraction and LV 
      end-systolic diameter (either 12-month value or the change from baseline) were 
      equally predictive for clinical events. For NT-proBNP, however, the 12-month 
      level was a stronger predictor than the change from baseline. Both reverse LV 
      remodeling and 12-month level of NT-proBNP were independent and comparable 
      predictors of CRT-related clinical outcome, while NT-proBNP response had the 
      strongest association with all-cause mortality. When post-CRT relative change of 
      LV end-systolic diameter and 12-month level of NT-proBNP (dichotomized at -12.3% 
      and 1230 ng/L, respectively) were combined, subgroups of very-high and very-low 
      risk patients were identified. CONCLUSION: The level of NT-proBNP and reverse LV 
      remodeling at one year after CRT are independent and complementary predictors of 
      future clinical events. Their combination may help to improve the risk 
      stratification of CRT patients.
FAU - Roubicek, Tomas
AU  - Roubicek T
AUID- ORCID: 0000-0001-8480-5110
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
AD  - Department of Cardiology, Institute for Clinical and Experimental Medicine, 
      Prague, Czech Republic.
AD  - Faculty of Health Studies, Technical University of Liberec, Liberec, Czech 
      Republic.
FAU - Stros, Jan
AU  - Stros J
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
FAU - Kucera, Pavel
AU  - Kucera P
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
FAU - Nedbal, Pavel
AU  - Nedbal P
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
FAU - Cerny, Jan
AU  - Cerny J
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
FAU - Polasek, Rostislav
AU  - Polasek R
AD  - Department of Cardiology, Regional Hospital Liberec, Liberec, Czech Republic.
AD  - Faculty of Health Studies, Technical University of Liberec, Liberec, Czech 
      Republic.
FAU - Wichterle, Dan
AU  - Wichterle D
AD  - Department of Cardiology, Institute for Clinical and Experimental Medicine, 
      Prague, Czech Republic.
AD  - Faculty of Health Studies, Technical University of Liberec, Liberec, Czech 
      Republic.
LA  - eng
PT  - Journal Article
DEP - 20190717
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - 0 (Biomarkers)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Biomarkers
MH  - Cardiac Resynchronization Therapy/adverse effects/methods
MH  - Female
MH  - Heart Failure/*metabolism/mortality/*pathology/therapy
MH  - Heart Function Tests
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*metabolism
MH  - Postoperative Period
MH  - Prognosis
MH  - ROC Curve
MH  - Time Factors
MH  - Treatment Outcome
MH  - *Ventricular Remodeling
PMC - PMC6636764
COIS- The authors have declared that no competing interests exist.
EDAT- 2019/07/18 06:00
MHDA- 2020/03/03 06:00
PMCR- 2019/07/17
CRDT- 2019/07/18 06:00
PHST- 2019/03/02 00:00 [received]
PHST- 2019/07/06 00:00 [accepted]
PHST- 2019/07/18 06:00 [entrez]
PHST- 2019/07/18 06:00 [pubmed]
PHST- 2020/03/03 06:00 [medline]
PHST- 2019/07/17 00:00 [pmc-release]
AID - PONE-D-19-06137 [pii]
AID - 10.1371/journal.pone.0219966 [doi]
PST - epublish
SO  - PLoS One. 2019 Jul 17;14(7):e0219966. doi: 10.1371/journal.pone.0219966. 
      eCollection 2019.