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.
Journal:
Anales del sistema sanitario de Navarra

ISSN: 1137-6627

Year of publication: 2021

Issue Title: 44 (2); mayo - agosto 2021

Volume: 44

Issue: 2

Pages: 205-214

Type: Article

DOI: 10.23938/ASSN.0947 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Anales del sistema sanitario de Navarra

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Abstract

  Background. The aim of this paper is to analyze the role of the biomarkers Interleukin 6, Tumoral Necrosis Factor α, sCD40L, high sensitive Troponin T, high sensitive C-Reactive Protein and Galectin-3 in predicting super response (SR) to Cardiac Resynchronization Therapy (CRT), as they have not been studied in this field before. Methods. Clinical, electrocardiographic and echocardiographic data was obtained preimplant and after one year. SR was defined as reduction in LVESV ≥ 30% at one year follow-up. Blood samples were extracted preimplant. Multivariate logistic regression and ROC curves were performed. Results. 50 patients were included, 23 (46%) were SR. Characteristics related to SR were: female (35 vs. 11%, p = 0.04), suffering from less ischemic cardiomyopathy (13 vs. 63%, p < 0.0001) and lateral (0 vs. 18%, p = 0.03), inferior (4 vs. 33%, p = 0.01) and posterior infarction (0 vs. 22%, p = 0.01); absence of mitral regurgitation (47% vs. 22%, p = 0.04), wider QRS width (157.7 ± 22.9 vs. 140.8 ± 19.2ms, p = 0.01), higher concentrations of sCD40L (6.9 ± 5.1 vs. 4.4 ± 3.3 ng/mL, p = 0.02), and left ventricular lead more frequent in lateral medial position (69 vs. 26%, p = 0.002). QRS width, lateral medial position of the lead and absence of mitral regurgitation were independent predictors of SR. sCD40L showed a moderate direct correlation with SR (r = 0.39, p = 0.02) and with the reduction of LVESV (r = 0.44, p = 0.02). Conclusion. sCD40L correlates significantly with SR to CRT. QRS width, absence of mitral regurgitation and lateral medial position of the lead are independent predictors of SR in this cohort.

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Funding information

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.

Funders

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