Key result
Response to cardiac resynchronization therapy at 6 months was associated with significant decreases in circulating levels of TNC (p<0.01), MMP-9 (p<0.01), and NT-proBNP (p<0.001).
Why the study?
Does cardiac resynchronization therapy reduce circulating biomarkers of extracellular matrix metabolism in heart failure patients who experience reverse ventricular remodelling?
Observational (n=64)
Does cardiac resynchronization therapy reduce circulating biomarkers of extracellular matrix metabolism in heart failure patients who experience reverse ventricular remodelling?
Reverse ventricular remodelling following CRT is associated with significant reductions in biomarkers of extracellular matrix metabolism, suggesting ECM modulation plays a role in CRT response.
Answers are grounded in this paper and cite their sources.
CRT response links to ECM biomarker declines; hypothesis-generating for matrix modulation but leaves open clinical implications.
BACKGROUND: In heart failure patients, cardiac resynchronization therapy (CRT) leads to reverse ventricular remodelling. AIM: The aim of this study was to evaluate whether changes in levels of circulating biomarkers of extracellular matrix metabolism correlate with the response to CRT. METHODS AND RESULTS: Clinical parameters, left ventricular (LV) volumes, and circulating levels of tenascin-C (TNC), matrix metalloproteinase-2 (MMP-2), MMP-9, and amino-terminal propeptide of brain natriuretic peptide (NT-proBNP) were assessed in 64 patients at baseline and 6 months follow-up. The majority of patients (72%) showed a >10% reduction in LV end-systolic volume at follow-up, and were classified as responders to CRT. The remaining patients were classified as non-responders. In responders, a significant decrease in circulating levels of TNC (from 60+/-40 ng/mL to 47+/-30 ng/mL, p<0.01), MMP-9 (from 55+/-30 AU to 44+/-27 AU, p<0.01), and NT-proBNP (from 2106+/-1805 pg/mL to 1132+/-1289 pg/mL, p<0.001) were observed at follow-up; MMP-2 levels were unchanged. In non-responders TNC, NT-proBNP, MMP-9 and MMP-2 levels remained unchanged. CONCLUSION: At 6 months follow-up, CRT was associated with reverse LV remodelling, and a significant decrease in TNC, MMP-9, and NT-proBNP levels. This suggests an important role of ECM modulation in the process of reverse ventricular remodelling in patients responding to CRT.
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Hessel et al. (2007) conducted an observational in Heart failure (n=64). Response to cardiac resynchronization therapy (>10% reduction in LV end-systolic volume) vs. Non-response to cardiac resynchronization therapy was evaluated on Changes in circulating levels of TNC, MMP-2, MMP-9, and NT-proBNP (p=<0.01). Response to cardiac resynchronization therapy at 6 months was associated with significant decreases in circulating levels of TNC (p<0.01), MMP-9 (p<0.01), and NT-proBNP (p<0.001).
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