Effect of Cardiac Resynchronization Therapy on Cardiac Sympathetic Nervous Dysfunction and Serum C-reactive Protein Level

• Published in: Pacing and clinical electrophysiology 2011-10, Vol.34 (10), p.1225-1230
• Main Authors: SHINOHARA, TETSUJI, TAKAHASHI, NAOHIKO, SAITO, SYOTARO, OKADA, NORIHIRO, WAKISAKA, OSAMU, YUFU, KUNIO, HARA, MASAHIDE, NAKAGAWA, MIKIKO, SAIKAWA, TETSUNORI, YOSHIMATSU, HIRONOBU
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; C-reactive protein; C-Reactive Protein - metabolism; cardiac MIBG scintigraphy; Cardiac Resynchronization Therapy; cardiac sympathetic nervous dysfunction; Cardiology. Vascular system; Chronic Disease; Female; Heart; Heart - innervation; Heart - physiopathology; heart failure; Heart Failure - blood; Heart Failure - diagnostic imaging; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Male; Medical sciences; Middle Aged; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Stroke Volume - physiology; Sympathetic Nervous System - physiopathology; Treatment Outcome; Ultrasonography; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Ventricular Dysfunction, Left - therapy
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/j.1540-8159.2011.03156.x

Background:  Cardiac autonomic dysfunction is associated with a poor prognosis in patients with heart failure (HF). Systemic inflammation is elevated in patients with HF. We hypothesized that cardiac resynchronization therapy (CRT) improves cardiac sympathetic nervous dysfunction and systemic inflammation. To test our hypothesis, we evaluated cardiac sympathetic activity and serum levels of high sensitive C‐reactive protein (hs‐CRP) before and after CRT. Methods:  Twenty‐seven patients with chronic HF (19 men, eight women; mean age 67 ± 10 years) with nonischemic cardiomyopathy who underwent CRT were evaluated. Each patient was evaluated before and 6 months after CRT. Responders were defined as patients showing ≥15% absolute decrease in left ventricular end‐systolic volume. Cardiac sympathetic activity was estimated with cardiac 123I‐metaiodobenzylguanidine (MIBG) scintigrams. Results:  Patients were categorized as responders (n = 19) and nonresponders (n = 8) according to echocardiographic findings. In responders, the mean heart‐to‐mediastinum (H/M) ratio at the delayed phase in cardiac 123I‐MIBG scintigraphic findings was significantly increased (P