Published in:
01-02-2014 | IM - ORIGINAL
Effect of cardiac resynchronization therapy on cardiotrophin-1 circulating levels in patients with heart failure
Authors:
Giuseppe Limongelli, Teo Roselli, Giuseppe Pacileo, Paolo Calabró, Valeria Maddaloni, Daniele Masarone, Lucia Riegler, Rita Gravino, Raffaella Scarafile, Gemma Salerno, Tiziana Miele, Antonello D’Andrea, Lucio Santangelo, Massimo Romano, Giovanni Di Salvo, Maria Giovanna Russo, Raffaele Calabró
Published in:
Internal and Emergency Medicine
|
Issue 1/2014
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Abstract
Cardiotrophin-1 (CT-1) is a member of the interleukin (IL-6) family of cytokines. Plasma CT-1 levels correlate with the left ventricle mass index in patients with dilatated cardiomyopathy and congestive heart failure (CHF). The aim of this paper was to evaluate CT-1 plasma levels, before and after cardiac resynchronization therapy CRT, and to characterizeits prognostic role in patients with CHF. Fifty-two consecutive patients (M/F = 39/13; 56 ± 11 years old) underwent clinical and echocardiographic evaluation, and blood sample collection at baseline. The same evaluation was repeated 6.4 ± 0.79 months after CRT. Patients with a decreased LV end-systolic volume by at least 15% (reverse remodeling) were considered echo responders to CRT. Twenty-nine patients (56%) were responders to CRT. After CRT, only 15 patients (29%) showed increased CT-1 after CRT. They were all non responders to CRT. A multivariate, logistic modelshowed CT-1 as an independent predictor of CRT echo response (p = 0.005; OR 0.97). During follow-up (18 ± 7 months), 21 cardiac events in 18 patients occurred. A Cox multivariable model showed plasma BNP pre-CRT (p = 0.02; CI 1.2–5.6; OR 3.1) and CT1 post-CRT (p = 0.01; CI 1.4–4.3; OR 2.7) as independent predictors of cardiac events. Analysis of CT-1 plasma levels deserves future consideration for larger, longitudinal studies in patients with CHF.