Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy
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...
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Meshalkin National Medical Research Center
2015-10-01
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Series: | Патология кровообращения и кардиохирургия |
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Online Access: | http://journalmeshalkin.ru/index.php/heartjournal/article/view/26 |
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author | В. А. Кузнецов Т. Н. Енина П. В. Шебеко А. Ю. Рычков Т. И. Петелина Н. Н. Мельников Т. О. Виноградова |
author_facet | В. А. Кузнецов Т. Н. Енина П. В. Шебеко А. Ю. Рычков Т. И. Петелина Н. Н. Мельников Т. О. Виноградова |
author_sort | В. А. Кузнецов |
collection | DOAJ |
description | 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. |
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issn | 1681-3472 2500-3119 |
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spelling | doaj.art-ddc411ecbf1d46268bfa47d5fbdf2fa62023-09-02T16:48:43ZengMeshalkin National Medical Research CenterПатология кровообращения и кардиохирургия1681-34722500-31192015-10-0118415115710.21688/1681-3472-2014-4-151-157746Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathyВ. А. КузнецовТ. Н. ЕнинаП. В. ШебекоА. Ю. РычковТ. И. ПетелинаН. Н. МельниковТ. О. ВиноградоваThe 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.http://journalmeshalkin.ru/index.php/heartjournal/article/view/26ИШЕМИЧЕСКАЯ КАРДИОМИОПАТИЯФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙКАРДИОРЕСИНХРОНИЗИРУЮЩАЯ ТЕРАПИЯСИСТЕМНОЕ ВОСПАЛЕНИЕНЕЙРОГУМОРАЛЬНАЯ РЕГУЛЯЦИЯ |
spellingShingle | В. А. Кузнецов Т. Н. Енина П. В. Шебеко А. Ю. Рычков Т. И. Петелина Н. Н. Мельников Т. О. Виноградова Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy Патология кровообращения и кардиохирургия ИШЕМИЧЕСКАЯ КАРДИОМИОПАТИЯ ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ КАРДИОРЕСИНХРОНИЗИРУЮЩАЯ ТЕРАПИЯ СИСТЕМНОЕ ВОСПАЛЕНИЕ НЕЙРОГУМОРАЛЬНАЯ РЕГУЛЯЦИЯ |
title | Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy |
title_full | Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy |
title_fullStr | Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy |
title_full_unstemmed | Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy |
title_short | Influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro-immuno-humoral status of patients with ischemic cardiomyopathy |
title_sort | influence of cardiac resynchronisation therapy combined with other interventional methods on the neuro immuno humoral status of patients with ischemic cardiomyopathy |
topic | ИШЕМИЧЕСКАЯ КАРДИОМИОПАТИЯ ФИБРИЛЛЯЦИЯ ПРЕДСЕРДИЙ КАРДИОРЕСИНХРОНИЗИРУЮЩАЯ ТЕРАПИЯ СИСТЕМНОЕ ВОСПАЛЕНИЕ НЕЙРОГУМОРАЛЬНАЯ РЕГУЛЯЦИЯ |
url | http://journalmeshalkin.ru/index.php/heartjournal/article/view/26 |
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