BNP and Cardiac Resynchronization Therapy Interview with: Andrew Brenyo MD
Greenville University Health System
Greenville SC What are the main findings of the study?

Dr. Brenyo: We found that BNP values at the time of CRT implant and during follow up predict response to CRT and subsequent risk of heart failure admission and death. BNP at implant and at subsequent times was strongly correlated with echocardiographic response to CRT-D along with predicting clinical outcome. Were any of the findings unexpected?

Dr. Brenyo: We were surprised to find the predictive value of baseline BNP on subsequent outcome and its value independent of device received (CRT vs. ICD). Our expectation had been that patients with reductions in BNP during follow up were CRT-D responders and likely to be at lower risk of heart failure admission or death. However, patients with elevated baseline or follow up BNP were at much higher risk of subsequent events independent of the device they received. Meaning that BNP likely represents a surrogate marker of the state of cardiovascular fitness and likelihood of response to CRT. What should clinicians and patients take away from your report?

Dr. Brenyo: Baseline and follow up BNP can be used to predict subsequent outcome and, when echocardiography is not readily available, can be used as a surrogate for echocardiographic response to CRT. What recommendations do you have for future research as a result of this study?

Dr. Brenyo: Future studies targeting patients with either persistently elevated or newly elevated BNP upon follow up are needed to determine if either revision of their CRT system or increasingly aggressive medical therapy will affect their outcome.


Brain Natriuretic Peptide and Cardiac Resynchronization Therapy in Patients with Mildly Symptomatic Heart Failure

Brenyo A, Barsheshet A, Rao M, Huang DT, Zareba W, McNitt S, Hall WJ, Peterson DR, Solomon SD, Moss AJ, Goldenberg I.

1University of Rochester Medical Center, Rochester, NY.
Circ Heart Fail. 2013 Jun 25. [Epub ahead of print