心脏再同步治疗后，心室间电极分离对于降低N末端脑钠肽前体（NT-proBNP）至关重要。

Interventricular lead separation is critical for NT-proBNP reduction after cardiac resynchronization therapy.

作者信息

Lang Ninian N, Badar Athar A, Pettit Stephen J, Templeton Sheena, Connelly Derek T, Gardner Roy S

机构信息

Scottish Advanced Heart Failure Service, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, Glasgow, G81 4DY, UK.

出版信息

Biomark Med. 2014;8(6):797-806. doi: 10.2217/bmm.13.159.

DOI:10.2217/bmm.13.159

PMID:25224936

Abstract

AIMS

Effective cardiac resynchronization therapy may depend upon the distance between left ventricular (LV) and right ventricular (RV) pacing leads. We assessed the influence of lead separation upon circulating NT-proBNP.

MATERIALS & METHODS: In total, 132 patients underwent assessment, including NT-proBNP assay, before and after cardiac resynchronization therapy. 3D lead separation was calculated from postero-anterior and lateral chest radiography.

RESULTS

Lead separation correlated with NT-proBNP reduction (r = 0.25; p = 0.004). Circulating NT-proBNP only fell in those with lead separation in the upper two quartiles. Deteriorating NT-proBNP occurred in 44 patients. Lead separation was less in these patients compared with those with an improvement (corrected 3D lead separation: 148.0 ± 5.38 and 170.5 ± 4.21 mm, respectively; p = 0.0018).

CONCLUSION

Left ventricular-right ventricular lead separation correlates with postcardiac resynchronization therapy improvements in circulating NT-proBNP, a powerful marker of heart failure status and prognosis. Attention should be paid to achieving maximal lead separation at implantation.

摘要

目的

有效的心脏再同步治疗可能取决于左心室（LV）和右心室（RV）起搏导线之间的距离。我们评估了导线间距对循环中N末端脑钠肽前体（NT-proBNP）的影响。

材料与方法

共有132例患者在心脏再同步治疗前后接受了评估，包括NT-proBNP检测。通过后前位和侧位胸部X线片计算三维导线间距。

结果

导线间距与NT-proBNP降低相关（r = 0.25；p = 0.004）。仅在导线间距处于上两个四分位数的患者中，循环NT-proBNP下降。44例患者的NT-proBNP恶化。与病情改善的患者相比，这些患者的导线间距更小（校正后的三维导线间距分别为：148.0±5.38和170.5±4.21mm；p = 0.0018）。