Objectives To study the feasibility to observe and evaluate the curative effect about the heart failure patients with Cardiac Resynchronisation Therapy (CRT), using the concentration changes of serum N-terminal brain natriuretic peptide (NT-proBNP), growth differentiation factor 15 (GDF-15) and troponin T (TnT) before and after CRT.
Methods According to whether the CRT/CRT-D, the patients were divided into CRT/CRT-D group and medication therapy group, and the CRT/CRT-D group were divided into responder group and no-responder group according to the treatment effect. 117 patients of CRT/CRT-D group received the three chamber pacemaker implanted into through left subclavian vein punctured, all patients continue to use drugs to treat heart failure after implanted pacemaker. 59 cases of medication therapy group were treated activly by given effective anti heart failure drugs. Before CRT/CRT-D and after treatment 3 months and 6 months, two groups of patients with NYHA grading assessment; the parameters of left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and left ventricular end systolic volume (LVESV) were measured using echocardiography in patients of the two groups with preoperative and postoperative 3, 6 months; at the same time, the concentration of NT-proBNP, GDF-15 and TnT were measured in patients serum of the two groups, using Enzyme - Linked Immunosorbnent Assay (ELISA) before and after treatment.
Results The patients of CRT/CRT-D group and medication therapy group had no statistical difference with cardiac function NYHA grading before CRT treatment; LVEF increased, LVEDV and LVESV decreased in responder group of CRT/CRT-D group after treatment 3 months and 6 months, compared with the no-responder group and drug therapy group significantly (p< 0.05); and the function of left ventricular had no significant statistical difference in all groups of preoperative (p > 0.05). In the responder group of CRT/CRT-D group, the function of left ventricular has improve significantly in postoperative 3 months and 6 months compared with preoperative (p < 0.05), confirming the cardiac function in patients with heart failure can be able to improve through CRT/CRT-D. The concentration of NT-proBNP, GDF-15 and TnT detection by ELISA in serum of all groups of patients, were reduced significantly in responder group compared with no-responder group and medication therapy group in 3 months and 6 months after CRT/CRT-D, and in the responder group of CRT/CRT-D group, these datas had also reduced significantly compared with preoperative (p < 0.05), and the changes had significant statistical difference in the effective group after CRT/CRT-D 3 months compared with 6 months.
Conclusions CRT/CRT-D can improve cardiac function in patients as the effective treatment of chronic heart failure. Serum concentration of NT-pro-BNP, GDF-15 and TnT can evaluate clinical curative effect of CRT by ELISA at before and after CRT.