A. Magalhães, N. Cortez-Dias, D. Silva, C. Jorge, P. Carrilho-Ferreira, A. Bernardes, C. Coelho, P. Marques, J. Sousa

Cardiology Department, Hospital de Santa Maria, Lisbon, Portugal


Introduction: The role of NT-proBNP in diagnosis and prognosis in heart failure (HF) patients (pts) is well established. We aimed to assess the relation between NT-proBNP and response to CRT and evaluate its prognostic value in this group of pts.
Methods: Prospective study of consecutive pts proposed for CRT. NT-proBNP was measure prior to implantation. Echocardiogram was performed at baseline, 3, 6 and 12 months after CRT. Prognosis was assessed by the combined endpoint of death or hospitalization for HF during the follow-up.
Results: We studied 50 pts, 69±8years. At baseline, ejection fraction (EF) was 28±10% and NT-proBNP was 2751±3602 pg/mL. NT-proBNP did not predict the EF reduction during the follow-up. The endpoint occurred in 12% of pts. NT-proBNP was significantly higher in those pts (p=0.017) and showed moderate accuracy in predicting an adverse outcome (AUC=0.80, 95%CI:0.66-0.94, p=0.017). Elevation of NT-proBNP was associated with a lower event-free survival (p=0.026) and with a higher risk of unfavorable outcome (HR:5.5, 95%CI:1.01-30.2; p=0.049).
Conclusions: NT-proBNP did not predict echocardiographic response to CRT. As in general HF population is a predictor of unfavorable outcome.