TY - JOUR
T1 - A new biomarker of cardiac resynchronization therapy response
T2 - cGMP to mature BNP ratio
AU - Yokoyama, Yasuhiro
AU - Kataoka, Naoya
AU - Nakai, Michikazu
AU - Matsuo, Ayaka
AU - Fujiwara, Akihiro
AU - Wakamiya, Akinori
AU - Ueda, Nobuhiko
AU - Nakajima, Kenzaburo
AU - Kamakura, Tsukasa
AU - Wada, Mitsuru
AU - Yamagata, Kenichiro
AU - Ishibashi, Kohei
AU - Inoue, Yuko
AU - Miyamoto, Koji
AU - Nagase, Satoshi
AU - Noda, Takashi
AU - Aiba, Takeshi
AU - Takahama, Hiroyuki
AU - Izumi, Chisato
AU - Kinugawa, Koichiro
AU - Minamino, Naoto
AU - Kusano, Kengo
N1 - Funding Information:
This work was partly supported by the Intramural Research Fund of the National Cerebral and Cardiovascular Center of Japan (grants 22-1-4 and 27-1-5 to N.M.) and JSPS KAKENHI Grant Number JP19K20724 to N.K.
Publisher Copyright:
© 2022
PY - 2022/6
Y1 - 2022/6
N2 - Background: Biomarkers that can predict cardiac resynchronization therapy (CRT) response have not yet been identified. The purpose of this study was to assess whether individual measurements of four brain/B-type natriuretic peptide (BNP) forms, coupled with cyclic guanosine monophosphate (cGMP) might contribute to the prediction of echocardiographic CRT responders. Methods: A BNP precursor (proBNP) and total BNP (= proBNP + mature BNP) were measured with newly developed kits, while an N-terminal fragment of proBNP (NT-proBNP) and cGMP were measured with commercial kits on the day before CRT implantation. Estimated mature BNP (emBNP = total BNP–proBNP), and the ratio of cGMP to each BNP form, as well as the concentrations of three other BNP forms, were prospectively investigated for their capability in predicting a response to CRT. A CRT responder was defined as an improvement in left ventricular ejection fraction >10% and/or a reduction in left ventricular end-systolic volume >15% at 6-month follow-up. Results: Out of 77 patients, 46 (60%) were categorized as CRT responders. Among the measurement parameters, only the highest quartile of the cGMP to emBNP ratio was an independent predictor of CRT responders (odds ratio 4.87, 95% confidence interval 1.25-18.89, p = 0.02). The cGMP to emBNP ratio was associated with the cumulative events of heart failure hospitalization within one year following CRT implantation (log-rank p = 0.029). Conclusions: The cGMP to emBNP ratio could be utilized as a predictive biomarker of CRT responders. (Clinical Study on Responder Prediction in Cardiac Resynchronization Therapy Using Individual Molecular Measurement of Natriuretic Peptide: UMIN R000038927).
AB - Background: Biomarkers that can predict cardiac resynchronization therapy (CRT) response have not yet been identified. The purpose of this study was to assess whether individual measurements of four brain/B-type natriuretic peptide (BNP) forms, coupled with cyclic guanosine monophosphate (cGMP) might contribute to the prediction of echocardiographic CRT responders. Methods: A BNP precursor (proBNP) and total BNP (= proBNP + mature BNP) were measured with newly developed kits, while an N-terminal fragment of proBNP (NT-proBNP) and cGMP were measured with commercial kits on the day before CRT implantation. Estimated mature BNP (emBNP = total BNP–proBNP), and the ratio of cGMP to each BNP form, as well as the concentrations of three other BNP forms, were prospectively investigated for their capability in predicting a response to CRT. A CRT responder was defined as an improvement in left ventricular ejection fraction >10% and/or a reduction in left ventricular end-systolic volume >15% at 6-month follow-up. Results: Out of 77 patients, 46 (60%) were categorized as CRT responders. Among the measurement parameters, only the highest quartile of the cGMP to emBNP ratio was an independent predictor of CRT responders (odds ratio 4.87, 95% confidence interval 1.25-18.89, p = 0.02). The cGMP to emBNP ratio was associated with the cumulative events of heart failure hospitalization within one year following CRT implantation (log-rank p = 0.029). Conclusions: The cGMP to emBNP ratio could be utilized as a predictive biomarker of CRT responders. (Clinical Study on Responder Prediction in Cardiac Resynchronization Therapy Using Individual Molecular Measurement of Natriuretic Peptide: UMIN R000038927).
KW - Brain/B-type natriuretic peptide
KW - Cardiac resynchronization therapy
KW - Heart failure
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U2 - 10.1016/j.jjcc.2021.12.015
DO - 10.1016/j.jjcc.2021.12.015
M3 - Article
C2 - 35016810
AN - SCOPUS:85122509717
SN - 0914-5087
VL - 79
SP - 727
EP - 733
JO - Journal of Cardiology
JF - Journal of Cardiology
IS - 6
ER -