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Erschienen in: Heart and Vessels 5/2013

01.09.2013 | Original Article

Inflammatory activation following interruption of long-term cardiac resynchronization therapy

verfasst von: Andrzej Rubaj, Piotr Ruciński, Krzysztof Oleszczak, Michał K. Trojnar, Maciej Wójcik, Andrzej Wysokiński, Andrzej Kutarski

Erschienen in: Heart and Vessels | Ausgabe 5/2013

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Abstract

Previous observations suggest that cardiac resynchronization therapy (CRT) may exert an anti-inflammatory effect. The objective of this study was to evaluate the effect of temporary interruption of long-term CRT on plasma concentrations of proinflammatory cytokines and brain natriuretic peptide (BNP). The study group consisted of 54 patients (32 male and 22 female, mean age 64 years) with chronic heart failure (HF) treated with CRT. BNP, high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and neopterin were measured three times: after 26–28 weeks of continuous CRT (CRT-on), 48 h after its cessation (CRT-off), and 48 h after switching the CRT-on again. CRT interruption resulted in a significant worsening of left ventricular systolic function: reduction of cardiac output (CO), dP/dt, and left ventricular ejection fraction (LVEF), as well as deterioration of mitral regurgitation in the CRT responder group. A significant increase in serum concentrations of hs-CRP, neopterin, IL-6, and BNP was noted in this subpopulation. In CRT nonresponders, no significant changes were observed. In responders the changes in serum concentrations of hs-CRP, IL-6, neopterin, and BNP, following CRT interruption, significantly correlated with the respective changes in thoracic fluid content (TFC) and inversely correlated with LVEF changes. Even short (48 h) interruption of long-term CRT led to a significant increase of proinflammatory cytokines and BNP concentrations in responders. The changes in hs-CRP, IL-6, neopterin, and BNP concentrations correlated with the change in TFC-marker of pulmonary congestion and inversely correlated with the change in LVEF.
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Metadaten
Titel
Inflammatory activation following interruption of long-term cardiac resynchronization therapy
verfasst von
Andrzej Rubaj
Piotr Ruciński
Krzysztof Oleszczak
Michał K. Trojnar
Maciej Wójcik
Andrzej Wysokiński
Andrzej Kutarski
Publikationsdatum
01.09.2013
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 5/2013
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-012-0285-y

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