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Open Access Research

Usefulness of NT-pro BNP monitoring to identify echocardiographic responders following cardiac resynchronization therapy

Julien Magne, Michelle Dubois, Jean Champagne, Jean G Dumesnil, Philippe Pibarot, François Philippon, Gilles O'Hara and Mario Sénéchal*

Author Affiliations

Institut Universitaire de Cardiologie et de Pneumologie de Québec, Department of Cardiology, Quebec, Canada

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Cardiovascular Ultrasound 2009, 7:39  doi:10.1186/1476-7120-7-39

Published: 20 August 2009

Abstract

Background

Cardiac resynchronization therapy (CRT) improves left ventricular (LV) volumes, mitral regurgitation (MR) severity and symptoms of patients with heart failure (HF). However, ≥ 30% of patients have no significant clinical or echocardiographic improvement following CRT. Reverse remodeling after CRT correlates with improved clinical outcomes. We hypothesized that in NT-pro BNP monitoring is accurate to identify responders following CRT.

Methods

42 consecutive patients (mean age 66 ± 12 years, male 68%) with HF undergoing CRT were prospectively enrolled. Responders at follow-up were defined by echocardiography (decrease in LV end systolic volume ≥ 15%). Echocardiography and NT-pro BNP measurement were performed at baseline and repeated 3 to 6 month after CRT.

Results

There was no significant difference between responders (n = 29, 69%) and non-responders (n = 13, 31%) regarding baseline NT-pro BNP level. Responders had significantly higher decrease in NT-pro BNP levels during follow-up than non-responders (absolute: -1428 ± 1333 pg.ml-1 vs. -61 ± 959 pg.ml-1, p = 0.002; relative: -45 ± 28% vs. 2 ± 28%, p < 0.0001). A decrease of ≥ 15% in NT-pro BNP 3–6 months after CRT identifies echocardiographic responders with a sensitivity of 90% and a specificity of 77%.

Conclusion

NT-pro BNP monitoring can accurately identify echocardiographic responders after CRT.