Role of sCD40L in the prediction of super-response to cardiac resynchronization therapy

  1. Pujol, C.
  2. Varo Cenarruzabeitia, N.
  3. Rodríguez Mañero, M.
  4. Barba, J.
  5. Castaño Rodríguez, S.
  6. Macías Gallego, A.
  7. Torres, M.J.
  8. García Bolao, I.
Revista:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Año de publicación: 2021

Título del ejemplar: 44 (2); mayo - agosto 2021

Volumen: 44

Número: 2

Páginas: 205-214

Tipo: Artículo

DOI: 10.23938/ASSN.0947 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Anales del sistema sanitario de Navarra

Objetivos de desarrollo sostenible

Resumen

Fundamento. Analizar los biomarcadores Interleuquina 6, factor de necrosis tumoral α, sCD40L, troponina T hipersensible, proteína C-reactiva hipersensible y galectina-3 en la predicción de súper-respuesta (SR) a la terapia de resincronización cardiaca (TRC), ya que no han sido valorados con anterioridad. Material y métodos. Se recopilaron datos clínicos, electrocardiográficos y ecocardiográficos preimplante y al año. Se definió SR como disminución del VTSVI ≥ 30% al año de seguimiento. Las muestras sanguíneas fueron extraídas preimplante. Se realizó regresión logística multivariante y curvas ROC. Resultados. Se incluyeron 50 pacientes, 23 (46%) fueron SR.Las características relacionadas con la SR fueron: ser mujer (35 vs. 11%, p = 0,04), sufrir menos cardiopatía isquémica (13 vs. 63%, p < 0,0001) e infarto lateral (0 vs. 18%, p = 0,03), inferior (4 vs. 33%, p = 0,01) y posterior (0 vs. 22%, p = 0,01); ausencia de insuficiencia mitral (47% vs. 22%, p = 0,04), mayor anchura del QRS (157,7 ± 22,9 vs. 140,8 ± 19,2 ms, p = 0,01), mayor concentración de sCD40L (6,9 ± 5,1 vs. 4,4 ± 3,3 ng/mL, p = 0,02), y electrodo ventricular izquierdo más frecuentemente en posición lateral media (69 vs. 26%, p = 0,002). El QRS, la posición lateral media del electrodo y la ausencia de insuficiencia mitral fueron predictores independientes de SR. sCD40L mostró una correlación moderada directa con SR (r = 0,39, p = 0,02) y con la disminución del VTSVI (r = 0,44, p = 0,02). Conclusiones. sCD40L se correlaciona significativamente con SR a la TRC. El QRS, la ausencia de insuficiencia mitral y la posición lateral media del electrodo son predictores independientes de SR en esta cohorte.

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Información de financiación

José Ignacio García Bolao Department of Cardiology Clínica Universidad de Navarra Avda. Pío XII 36 31008 Pamplona Spain E-mail: igarciab@unav.es Funding: this work was supported by a grant of the Working Group of Cardiac Resynchronization Therapy of the Spanish Society of Cardiology 2009 (Grupo de Trabajo de Resincronización Cardiaca de la Sociedad Española de Cardiología), Madrid, Spain.

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Fuente de los datos: Dialnet