C Pujol, N Varo Cenarruzabeitia, M Rodríguez Mañero, J Barba, S Castaño Rodríguez, A Macías Gallego, M J Torres, I García Bolao
{"title":"Role of sCD40L in the prediction of super-response to cardiac resynchronization therapy.","authors":"C Pujol, N Varo Cenarruzabeitia, M Rodríguez Mañero, J Barba, S Castaño Rodríguez, A Macías Gallego, M J Torres, I García Bolao","doi":"10.23938/ASSN.0947","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.</p><p><strong>Methods: </strong>Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.</p><p><strong>Results: </strong>50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?<?0.0001) and lateral (0 vs. 18%, p?=?0.03), inferior (4 vs. 33%, p?=?0.01) and posterior infarction (0 vs. 22%, p?=?0.01); absence of mitral regurgitation (47% vs. 22%, p?=?0.04), wider QRS width (157.7?±?22.9 vs. 140.8?±?19.2ms, p?=?0.01), higher concentrations of sCD40L (6.9?±?5.1 vs. 4.4?±?3.3 ng/mL, p?=?0.02), and left ventricular lead more frequent in lateral medial position (69 vs. 26%, p?=?0.002). QRS width, lateral medial position of the lead and absence of mitral regurgitation were independent predictors of SR. sCD40L showed a moderate direct correla-tion with SR (r?=?0.39, p?=?0.02) and with the reduction of LVESV (r?=?0.44, p?=?0.02).</p><p><strong>Conclusions: </strong>sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.</p>","PeriodicalId":7775,"journal":{"name":"Anales Del Sistema Sanitario De Navarra","volume":"44 2","pages":"205-214"},"PeriodicalIF":1.0000,"publicationDate":"2021-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/e0/assn-44-02-205.PMC10019534.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anales Del Sistema Sanitario De Navarra","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.23938/ASSN.0947","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor a, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before.
Methods: Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV = 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed.
Results: 50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p?=?0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p?0.0001) and lateral (0 vs. 18%, p?=?0.03), inferior (4 vs. 33%, p?=?0.01) and posterior infarction (0 vs. 22%, p?=?0.01); absence of mitral regurgitation (47% vs. 22%, p?=?0.04), wider QRS width (157.7?±?22.9 vs. 140.8?±?19.2ms, p?=?0.01), higher concentrations of sCD40L (6.9?±?5.1 vs. 4.4?±?3.3 ng/mL, p?=?0.02), and left ventricular lead more frequent in lateral medial position (69 vs. 26%, p?=?0.002). QRS width, lateral medial position of the lead and absence of mitral regurgitation were independent predictors of SR. sCD40L showed a moderate direct correla-tion with SR (r?=?0.39, p?=?0.02) and with the reduction of LVESV (r?=?0.44, p?=?0.02).
Conclusions: sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.
背景:本文的目的是分析生物标志物白介素6、肿瘤坏死因子a、sCD40L、高敏肌钙蛋白T、高敏c反应蛋白和半乳糖凝集素-3在预测心脏再同步化治疗(CRT)超反应(SR)中的作用,因为这些标志物在该领域尚未被研究。方法:术前和术后1年的临床、心电图和超声心动图资料。SR定义为1年随访时LVESV降低= 30%。植入前提取血液样本。进行多因素logistic回归和ROC曲线分析。结果:纳入50例患者,23例(46%)为SR。SR相关特征为:女性(35例vs. 11%, p = 0.04),缺血性心肌病较少(13例vs. 63%, p = 0.04)。结论:sCD40L与SR与CRT有显著相关性。QRS宽度、二尖瓣不反流和导联外侧内侧位置是该队列中SR的独立预测因素。
期刊介绍:
La revista Anales del Sistema Sanitario de Navarra es una revista de contenido médico sanitario de carácter generalista. En ella tienen cabida artículos referidos a temas de salud/enfermedad en general, salud pública, administración y gestión sanitaria y Atención Primaria de salud.