Article Text

Download PDFPDF
Atrial and brain natriuretic peptides as markers of response to resynchronisation therapy
  1. S G Molhoek1,
  2. J J Bax1,
  3. L van Erven1,
  4. M Bootsma1,
  5. P Steendijk1,
  6. E Lentjes1,
  7. E Boersma2,
  8. A van der Laarse1,
  9. E E van der Wall1,
  10. M J Schalij1
  1. 1Department of Cardiology, Leiden University Medical Center, The Netherlands
  2. 2Department of Epidemiology and Statistics, Erasmus University Rotterdam, The Netherlands
  1. Correspondence to:
    Dr Sander G Molhoek
    Albinusdreef 2 Leiden, 2300RC, The Netherlands;

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Cardiac resynchronisation therapy (CRT) has recently been introduced to treat patients with drug refractory heart failure.1,2 Studies have demonstrated immediate haemodynamic improvement after CRT, followed by improvement in symptoms, quality of life, and exercise capacity.1,2 Although the majority of patients respond well to CRT, in 20% of patients symptoms do not improve. The main problem is the lack of objective parameters to measure the effect of CRT.

Natriuretic peptides are now used in studies involving patients with heart failure.3 The value of these markers to objectively assess response to CRT was evaluated in this study.


Based on traditional selection criteria (New York Heart Association (NYHA) functional class III–IV, left ventricular ejection fraction (LVEF) < 35%, QRS duration > 120 ms, and left bundle branch block configuration), 30 consecutive patients, of whom 23 were men (mean (SD) age 65 (12) years), underwent biventricular pacemaker implantation; 13 had ischaemic and 17 had idiopathic dilated cardiomyopathy. Medication consisted of diuretics, angiotensin converting enzyme inhibitors, spironolactone, β blockers, and/or amiodarone, and remained unchanged during the entire study.

The day before implantation, echocardiography was performed in combination with tissue Doppler imaging (TDI) (to assess left ventricular dyssynchrony). Clinical evaluation included assessment of NYHA class, ECG (QRS duration, morphology), quality of life, and six minute walking distance. Blood samples were obtained for the analysis of atrial natriuretic peptide (ANP) …

View Full Text