Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy

• Published in: Patologii͡a︡ krovoobrashchenii͡a︡ i kardiokhirurgii͡a Vol. 18; no. 4; pp. 151 - 157
• Main Authors: Kuznetsov, V. A., Yenina, T. N., Shebeko, P. V., Rychkov, A. Yu, Petelina, T. I., Melnikov, N. N., Vinogradova, T. O.
• Format: Journal Article
• Language: English
• Published: Meshalkin National Medical Research Center 10-10-2015
• Subjects: ИШЕМИЧЕСКАЯ КАРДИОМИОПАТИЯ; КАРДИОРЕСИНХРОНИЗИРУЮЩАЯ ТЕРАПИЯ; НЕЙРОГУМОРАЛЬНАЯ РЕГУЛЯЦИЯ; СИСТЕМНОЕ ВОСПАЛЕНИЕ; ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ
• ISSN: 1681-3472; 2500-3119
• DOI: 10.21688/1681-3472-2014-4-151-157

The purpose of this research was to study the influence of cardiac resynchronisation therapy (CRT) in combination with other interventional techniques used during one hospital stay on systemic inflammation and neurohumoral status in patients with ischemic cardiomyopathy (ICMP). The best response to CRT was estimated in 59 patients with ICMP (mean age 588.3 years, 92% males).The patients were divided into 2 groups: Group I patients (n=48) included those with 'pure' CRT, while Group II patients (n=11) underwent CRT, coronary stenting (CS), radiofrequency atrioventricular node ablation (RFA). All interventions were performed during one hospital stay. There were no significant differences in demographic characteristics between the groups. Mean follow-up was 6.0 [2.0; 16.0] months. Plasma levels of Nt-proBNP, interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-alpha (TNF-), C-reactive protein (CRP), urinary levels of epinephrine and norepinephrine (NE) were measured. The patients with a decrease in left ventricular end-systolic volume 15% were classified as responders. There were no significant differences in responders between the groups and was equal to 32 (67%) and 9 (82%) respectively. At baseline the plasma levels of IL-6 and CRP were higher in Group II as compared with Group I: 9.3 [4.6; 14.8] vs 3.3 [1.9; 5.2] pg/ml, respectively (p=0.004) and 8.0 [6.0; 10.2] vs 3.2 [1.5; 5.1] mg/ml respectively (p=0.065). At baseline the urinary NE level was lower in Group II as compared with Group I: 30.0 [17.6; 34.4] vs 58.0 [38.5; 74.6] nmol/ml respectively (p=0.023). During follow-up in Group I only Nt-proBNP level (p=0.015) tended to decrease. In Group II the levels of IL-6 (p=0.038), TNF- (p=0.024), CRP (p=0.031) decreased and NE level increased (p=0.038). Thus, the combination of CRT with other interventions is associated with a decrease in systemic inflammation and an impact on the neurohumoral status of patients with ICMP as compared with 'pure' CRT.