Adrenomedullin Plasma Levels Predict Left Ventricular Reverse Remodeling after Cardiac Resynchronization Therapy

Morales, Maria‐Aurora; Maltinti, Maristella; Piacenti, Marcello; Turchi, S.; Giannessi, Daniela; Ry, Silvia Del

doi:10.1111/j.1540-8159.2010.02723.x

Cited by 8 publications

(4 citation statements)

References 46 publications

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“…It appears to have prognostic value in patients with chronic HF [40]. Morales et al [105] showed that elevated levels of ADM at baseline were indicative of RR* after CRT. Larger studies are necessary to fully evaluate the prognostic potential of this biomarker.…”

Section: Biomarkers In Cardiac Resynchronization Therapymentioning

confidence: 99%

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

Bose

Truong

Singh

2015

J Interv Card Electrophysiol

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Circulating biomarkers related to inflammation, neurohormones, myocardial stress, and necrosis have been associated with commonly encountered arrhythmic disorders such as atrial fibrillation (AF) and more malignant processes including ventricular arrhythmias (VA) and sudden cardiac death (SCD). Both direct and indirect biomarkers implicated in the heart failure cascade have potential prognostic value in patients undergoing cardiac resynchronization therapy (CRT). This review will focus on the role of biomarkers in AF, history of SCD, and CRT with an emphasis to improve clinical risk assessment for arrhythmias and patient selection for device therapy. Notably, information obtained from biomarkers may supplement traditional diagnostic and imaging techniques, thus providing an additional benefit in the management of patients.

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Section: Biomarkers In Cardiac Resynchronization Therapymentioning

confidence: 99%

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

Bose

Truong

Singh

2015

J Interv Card Electrophysiol

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“…Plasma ADM concentrations were found elevated in patients with hypertension [5], renal failure [5], heart failure [6][7][8], shock [9] and diabetes mellitus [10]. ADM exhibits protective effects on heart and vasculature by inducing vasodilation and natriuresis, improving vascular endothelial function, increasing…”

Section: Introductionmentioning

confidence: 98%

Mid-regional-pro-adrenomedullin plasma levels are increased in obese adolescents

Cabiati

Bianchi

et al. 2015

Eur J Nutr

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“…The definition of LV reverse remodeling is highly variable in literature and changes in LV volumes or diameters have been considered by different AA [29-33]. In line with previously published papers from our group [39] we defined reverse remodelling as a >10% reduction in LVESD; low reproducibility and inaccuracy of the methods commonly used for volume calculations by 2D echocardiography are known, possibly due to the inadvertent use of foreshortened views of the left ventricle and the reliance on geometric modeling [40]. End systolic diameter measurement of is then more reliable, in particular in patients with ischemic dysfunction.…”

Section: Discussionmentioning

confidence: 56%

Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

Morales

Startari

Rossi

et al. 2011

Cardiovasc Ultrasound

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BackgroundChronic right ventricular (RV) apical pacing may lead to left ventricular (LV) dyssynchrony and LV dysfunction. In heart failure due to RV pacing, upgrading to biventricular stimulation (CRT) can improve NYHA Class and LV function. A proportion of patients do not respond to upgrading. Aim was to assess whether etiology of LV dysfunction accounts for responses to CRT in RV-paced patients.MethodsSixty-two patients treated by CRT, under RV pacing from 50.2 ± 5.4 months, were studied. Cause of LV dysfunction was non-ischemic (NIC) in 28 and ischemic cardiomyopathy (IC) in 34 patients. Clinical and conventional echocardiographic parameters were available within 1 month before RV pacing, within 1 month before CRT and at 12 ± 2 months of follow-up (FU).ResultsDecreased LVEF (from 37.0 ± 8.8 to 25.6 ± 6.1%, p <0.001), increased LV end-systolic dimensions (LVESD) (from 48.1 ± 8.6 to 55.2 ± 7.9 mm, p <0.001) and worsened NYHA Class (from 1.9 ± 1.1 to 3.2 ± .6, p < 0.005) were found before CRT, compared to pre RV-pacing. After CRT, 44/62 patients showed a ≥ 1 NYHA Class improvement; >10% decrease in LVESD was observed in 24 patients: 5 with IC, 19 with NIC (p < .0.001). The association between cause of LV dysfunction with >10% decrease in LVESD remained highly significant (p < 0.001) adjusting for pre-CRT QRS duration, NYHA Class, LVEF, LVESD, treatment or RV pacing duration.ConclusionsCRT improves functional class even after long-lasting pacing. Reverse remodeling is evident in a small population, more likely with NIC.

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Adrenomedullin Plasma Levels Predict Left Ventricular Reverse Remodeling after Cardiac Resynchronization Therapy

Abstract: Significantly higher ADM levels indicate a subgroup of patients in whom reverse remodeling can be observed after CRT. Patients with lower ADM basal values before CRT could represent a group in whom the dysfunction is so advanced that no improvement can be expected.

Cited by 8 publications

References 46 publications

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

Mid-regional-pro-adrenomedullin plasma levels are increased in obese adolescents

Reverse left ventricular remodeling is more likely in non ischemic cardiomyopathy patients upgraded to biventricular stimulation after chronic right ventricular pacing

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