The Research About The Levels Of Serum N-terminal Pro-brain Natriuretic Peptide, Growth Differentiation Factor15and Troponin In Preoperative And Postoperative Cardiac Resynch Ronization Therapy

Objective: To study the feasibility to observe and evaluate the curative effect about theheart failure patients with Cardiac Resynchronization Therapy (CRT), using theconcentration changes of serum N-terminal brain natriuretic peptide (NT-proBNP),growth differentiation factor15(GDF-15) and troponin T (TnT) before and after CRT.Methods: The patients were divided into responder group and no-responder groupaccording to the treatment effect after CRT/CRT-D.117patients of CRT/CRT-D groupreceived the three chamber pacemaker implanted into through left subclavian veinpunctured, all patients continue to use drugs to treat heart failure after implantedpacemaker. Before CRT/CRT-D and after treatment3months and6months, two groupsof patients with NYHA grading assessment; the parameters of left ventricular ejectionfraction (LVEF), left ventricular end-diastolic dimension (LVEDD) and left ventricularend systolic volume (LVESV) were measured using echocardiography in patients of thetwo groups with preoperative and postoperative3,6months; at the same time, theconcentration of NT-proBNP, GDF-15and TnT were measured in patients serum of the two groups, using Enzyme-Linked Immunosorbnent Assay (ELISA) before and aftertreatment. Results: The patients of two groups had no statistical difference with cardiacfunction NYHA grading before CRT treatment; LVEF increased, LVEDD and LVESVdecreased in responder group of CRT/CRT-D group after treatment3months and6months, compared with the no-responder group significantly (p<0.05); and the functionof left ventricular had no significant statistical difference in two groups of preoperative(p>0.05). In the responder group, the function of left ventricular has improvesignificantly in postoperative3months and6months compared with preoperative (p <0.05), confirming the cardiac function in patients with heart failure can be able toimprove through CRT/CRT-D. The concentration of NT-proBNP, GDF-15and TnTdetection by ELISA in serum of two groups of patients, were reduced significantly inresponder group compared with no-responder group in3months and6months afterCRT/CRT-D, and in the responder group of CRT/CRT-D group, these datas had alsoreduced significantly compared with preoperative (p <0.05), and the changes hadsignificant statistical difference in the effective group after CRT/CRT-D3monthscompared with6months. Conclusion: CRT/CRT-D can improve cardiac function inpatients as the effective treatment of chronic heart failure. Serum concentration ofNT-pro-BNP, GDF-15and TnT can evaluate clinical curative effect of CRT by ELISA atbefore and after CRT.