Cardiac Resynchronization Therapy Modifies the Neurohormonal Profile, Hemodynamic and Functional Capacity in Heart Failure Patients

Background c resynchronization therapy (CRT) has been shown to improve the clinical status and survival in congestive heart failure (CHF) patients, but little is known about its influence on neurohormonal profile. s failure patients treated with CRT for moderate/severe heart failure were studied with echocardiography, cardiopulmonary test, and neurohormonal profile [brain natriuretic peptide (BNP), endothelin (END), big endothelin (big-END), epinephrine (EPI), tumor necrosis factor-alpha (TNF-α)] at baseline and after 1 year from the pacemaker implantation. s HA II–IV patients entered this study, all with an indication to CRT; 100 agreed to be implanted (group A), whereas 20 refused, identifying a control group (group B). In group A NYHA class (from 3.15 ± 0.49–1.15 ± 0.49, p = 0.001), left ventricular ejection fraction (from 19.6 ± 4.95–35.6 ± 5.95%, p = 0.001), severity of mitral regurgitation (from 13.3 ± 4.19–6.09 ± 4.11 cmq, p = 0.001), and peak VO2 (from 9.68 ± 4.61–13.35 ± 3.32 mL/kg/min, p = 0.001) improved at 1-year follow-up. In the neurohormonal profile only plasma BNP (from 185.1 ± 185.9–110.2 ± 137.5 pg/mL, p = 0.03) and big-END (from 1.8 ± 1.5–0.87 ± 0.7 fmol/mL, p = 0.007) were reduced significantly. None of these parameters significantly changed in the control group at 1-year follow-up. sions ients with moderate/severe heart failure, CRT improved clinical status and the functional parameters modifying the neurohormonal profile at 1-year follow-up.