Abstract
Aim: To investigate the long term effects of CRT on systemic inflammation, ox- idative stress and galectin-3 level in heart failure patients. Methods and results: In 50 heart failure patients (NYHA II, III-IV), we evaluated interleukin-6, high sen- sitive C-reactive protein, myeloperoxidase, uric acid, total bilirubin and galectin-3. Following CRT implantation, patients were evaluated at twelfth months with echo- cardiographic evaluations defining responders by a 15% reduction in end-systolic volume. In addition, New York Heart Association class, distance of 6-min walk, the Minnesota Living with Heart Failure questionnaire, B-type natriuretic peptide (BNP) were measured before and 6 months after CRT. Twenty-two of 32 patients (71%) responded to CRT. The responder group demonstrated significant decrease in BNP level from 403671 to 227640 pg/ml, p50.007; in NYHA class from 2,86 0,3 to 2,260,3, p50,044 paralleling the clinical improvements. Namely, re- sponder patients showed greater improvement in the 6-min walk test (from 286658 to 305665m, p50,001) and the Minnesota score (from 3867,6 to 3467,4 points, p50,001) than non-responder patients at 1 year. Levels of MPO was significantly decreased in responder group (21,9 ng/ml (75,7-84,4) vs. 11,8 ng/ml (0,9-18,4), p50,001). Levels of MPO was significantly decreased and level of uric acid, level of total bilirubin was significantly increased in non-responder group (33,0 ng/ml (0,9-99,1) vs. 10,1 ng/ml (2,4-16,9), p50,040; 5,8261,93 mg/ dl vs. 7,2562,25 mg/dl, p50,030; 0,6160,23 mg/dl vs 0,9260,45 mg/dl, respec- tively). Level of interleukin-6, high sensitive C-reactive protein and galectin-3 were not significantly changed in both group of responder and non-responder pa- tients. Conclusion: It was showed that CRT improves oxidative stress in responder heart failure patients. However, CRT did not significantly reduce level of systemic inflammation markers and level of galectin-3 in responder or non-responder patients.
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