Impact of cardiac resynchronization therapy on inflammatory biomarkers and cardiac remodeling: The paradox of functional and echocardiographic response

Almeida-Morais, Luís; Abreu, Ana; Oliveira, Manuel Castanheira de; Cunha, Pedro Silva; Rodrigues, I.; Portugal, Guilherme; Rio, Pedro; Soares, Rui; Carmo, Miguel Mota; Ferreira, Rui Cruz

doi:10.1016/j.repce.2018.03.007

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…There are a number of studies where CRT reduces inflammatory reactions by decreasing concentrations of CRP, sTNFR-I, sTNFR-II, TNF-alfa, TGF-BETA1, IL-6, IL-1Beta, IL-8 and MCP-1, [38][39][40][41][42][43][44] . However, studies demonstrating unchanged levels of cytokines have also been reported, especially in reference to the non-responders [45] .…”

Section: Impact Upon Inflammationmentioning

confidence: 99%

Cardiac resynchronization therapy – beneficial alterations observed on molecular level – a review.

Rybak¹,

Kubik²,

Kowara³

et al. 2021

Heart Beat

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Section: Impact Upon Inflammationmentioning

confidence: 99%

Cardiac resynchronization therapy – beneficial alterations observed on molecular level – a review.

Rybak¹,

Kubik²,

Kowara³

et al. 2021

Heart Beat

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“…Based on biventricular pacing, CRT restores the electromechanical desynchrony of the heart, improving LV systolic function and reducing patient symptoms, re-hospitalizations and mortality. [4,17,18] Limited evidence suggests that CRT can reduce in ammatory mediators in HF patients [19] , but the association between CRT response, T cells and cardiac remodeling in CHF is far from being understood. [4] Therefore, we aimed to study the impact of CRT on T cell homeostasis, by evaluating the frequency of and functional activity of T cell subpopulations in CHF patients submitted to CRT.…”

Section: Introductionmentioning

confidence: 99%

Chronic heart failure hampers regulatory T cell homeostasis which is not restored by cardiac resynchronization therapy

Martins

António

Carvalheiro³

et al. 2022

Preprint

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Background: T cells have been implicated in the development and progression of inflammatory process in chronic heart failure (CHF). Cardiac resynchronization therapy (CRT) has beneficial effects on symptoms and cardiac remodeling in CHF. However, its impact on the inflammatory immune response remains controversial. We aimed to study the impact of CRT on T cells in heart failure patients (HFP). Methods: Thirty-nine HFP were evaluated before CRT (T0) and 6 months later (T6). Quantification of T cells, their subsets, and their functional characterization, after in vitro stimulation, were evaluated by flow cytometry. Results: T regulatory (Treg) cells were decreased in CHF patients (healthy group (HG): 1.08±0.50 versus HFP-T0: 0.69±0.40, P=0.022) and remaining diminished after CRT (HFP-T6: 0.61±0.29, P=0.003). Responders (R) to CRT presented a higher frequency of T cytotoxic (Tc) cells producing IL-2 at T0 compared with non-responders (NR) (R: 36.52±12.55 versus NR: 24.71±11.66, P=0.006). After CRT, HFP presented a higher percentage of Tc cells expressing TNF-α and IFN-γ (HG: 44.50±16.62 versus R: 61.47±20.54, P=0.014; and HG: 40.62±15.36 versus R: 52.39±18.66, P=0.049, respectively). Conclusion: The dynamic of different functional T cell subpopulations is significantly altered in CHF, which results in an exacerbated pro-inflammatory response, which could be due, at least in part, to the inability of CRT to restore Treg cells levels or inhibit Tc1 cell-mediated pro-inflammatory pathway.Trial registration: Retrospectively registered.

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Multimarker approach for assessing efficiency of cardiac resynchronization therapy in patients with sinus rhythm

Кузнецов

Enina

Солдатова

et al. 2021

Vestnik aritmologii

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Purpose. To design a mathematical model, that can predict a positive response to cardiac resynchronization therapy (CRT) in patients with congestive heart failure (CHF) and sinus rhythm, according to complex analysis of neurohumoral and immune activation biomarkers, fibrosis, renal dysfunction, echocardiography.Methods. Parameters of echocardiography, plasma levels of NT-proBNP, interleukins-1β, 6, 10, tumor necrosis factor α, С-reactive protein (СRP), matrix metalloproteinase-9 (ММР-9), tissue inhibitors of metalloproteinase 1 and 4, cystatin С (CYSTATIN) were studied in 40 CHF patients with sinus rhythm (65% coronary artery disease patients, 75% males, mean age 54.8±10.6 years old) during the period of maximum decrease of left ventricular end-systolic volume (LVESV) (mean duration 27.5 [11.1; 46.3] months). Responders (decrease in LVESV ≥15%) and non-responders (decrease in LVESV <15%) were identified.Results. The number of responders was 26 (65%). The initial set of variables included: age, left ventricular ejection fraction (EF), pulmonary artery systolic pressure, right ventricle size and NT-proBNP, СRP, ММР-9, CYSTATIN. According to logistic regression analysis, a prediction model of positive CRT response was created. The specificity of the model was 92.9%, sensitivity - 83.3%, AUC=0.952 (р˂0.001).Conclusion. The proposed model, based on the assessment of left ventricle EF and circulating biomarkers of inflammation, fibrosis, and renal function, strongly suggests a higher possibility of response to CRT.

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Impact of cardiac resynchronization therapy on inflammatory biomarkers and cardiac remodeling: The paradox of functional and echocardiographic response

Cited by 3 publications

References 28 publications

Cardiac resynchronization therapy – beneficial alterations observed on molecular level – a review.

Cardiac resynchronization therapy – beneficial alterations observed on molecular level – a review.

Chronic heart failure hampers regulatory T cell homeostasis which is not restored by cardiac resynchronization therapy

Multimarker approach for assessing efficiency of cardiac resynchronization therapy in patients with sinus rhythm

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