Changes Of Serum NT-proBNP And RDW Before And After Cardiac Resynchronization Therapy

Objective: We observe the serum N-terminal pro brain natriuretic peptide(NT-proBNP)and red cell distribution width(RDW)concentration in patients with congestive heart failure(CHF)before and after cardiac resynchronization therapy(CRT)to investigate the prognostic value of RDW and NT-proBNP on response to CRT.Methods: The object of this reaserch is 20 patients with chronic heart failure(CHF)in our hospital who was implanted cardiac resynchronization therapy from 2015 to2016.There were 9 males and 11 females,aged from 53 to 78(68.3±7.81)years old.The blood parameters and echocardiographic parameters were measured before and 6 months after CRT.The end point was defined as all-cause death(including heart transplantation)or heart failure readmission.The CRT reaction for 6 months after operation is defined that echocardiography in detecting left ventricular end systolic volume was more than15%.Deal those dates with SPSS16.0 statistical software,measurement data to the mean±standard deviation.Comparisons between groups were performed using an independent sample t test.Paired samples t test was used in the comparison;Count data is used Fisher exact probability method,two variables are used Linear correlation analysis(R).P < 0.05 was considered statistically significant.Results:All patients were operated successfully.There was no acute left heart failure or arrhythmia.After the program,the state of regular programmed pacemaker is normal.The patients were divided into CRT response group and CRT non response group according to the cardiac hyper index,including 14 cases in the response group and 6 cases in the nonresponse group.The two groups had no significant difference in age,gender,etiology of heart failure,history of smoking,hypertension,diabetes,hyperlipidemia,NYHA cardiac function classification,clinical medica-tion(class of ARB/ACEI,diuretics,beta blockers,digitalis)(p>0.05).There was no significant difference in left ventricular function parameters(LVEF,LVESV,LVEDD),serum NT-pro BNP and RDW levels before cardiac resynchronization therapy(P>0.05).Six months after CRT treatment,the above parameters were significantly different(p<0.05).In the CRT group,the left ventricular function parameters(LVEF,LVESV,LVEDV),serum NT-pro BNP,RDW level,before and after treatment,the difference was statistically significant(P<0.05).In the response group,the left ventricular function parameters(LVEF,LVESV,LVEDV)and serum NT-pro BNP levels were statistically significant before and after treatment(P<0.05).There was no significant change in RDW level(p>0.05).There was no difference in the left ventricular function parameters(LVEF,LVESV,LVEDV)and serum NT-pro BNP levels before and after treatment in the non response group(P>0.05).The level of RDW was significantly higher than that before operation,the difference was statistically significant(p<0.05).Serum NT-pro BNP levels were positively correlated with LVESV and LVEDD(r = 0.719,0.923;p<0.01),and negatively correlated with LVEF(r= 0.897;p<0.01).Serum RDW level was positively correlated with LVESV and LVEDD(r = 0.759,0.617;p<0.01),and negatively correlated with LVEF(r= 0.740;p<0.01).Serum RDW level was positively correlated with NT-proBNP(r=0.513;p<0.01).Conclusions: The clinical efficacy of cardiac resynchronization therapy can be evaluated by detecting the changes of serum RDW and NT-pro BNP before and after operation.