Anti‐Inflammatory Effect of Cardiac Resynchronization Therapy

Lappegård, Knut Tore; Bjørnstad, Hanne

doi:10.1111/j.1540-8159.2006.00430.x

Cited by 39 publications

(24 citation statements)

References 45 publications

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“…Data regarding the effect CRT on the concentration of proinflammatory cytokines have been conflicting. While some authors reported a decrease in proinflammatory cytokines (IL-6 and others) following CRT [13,14], other authors have not been able to confirm that finding [15,16]. In our study, the concentration of IL-6 decreased in CRT responders and remained unchanged in nonresponders.…”

Section: Discussionsupporting

confidence: 60%

Changes and Prognostic Impact of Apoptotic and Inflammatory Cytokines in Patients Treated with Cardiac Resynchronization Therapy

Osmančík

Heřman²,

Štros³

et al. 2013

Cardiology

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Objectives: In patients with heart failure, increased apoptosis, inflammation and activation of the transforming growth factor (TGF)-β cytokine system have been documented. The aim of the present study was to establish (i) whether cytokine concentrations decrease in patients who respond to cardiac resynchronization therapy (CRT), and (ii) whether pre-implant values have any prognostic value. Methods: Eighty-one CRT candidates were prospectively studied. The success of CRT was assessed based on clinical and echocardiographic improvement 6 months after implantation. Mortality was assessed 2 years after implantation. Blood samples were drawn before and 6 months after implantation. Serum concentrations of Fas, TNF-related apoptosis-inducing ligand, tumor necrosis factor (TNF)-α, TNF-receptor 1, TGF-β1 and interleukin (IL)-6 were measured using ELISA. Results: At 6 months, 46 (56.8%) patients were classified as responders and 35 (43.2%) as nonresponders. Neither group differed with respect to baseline characteristics. In responders, the concentrations of IL-6, TNF-α and TGF-β1 decreased significantly. In nonresponders, the concentration of TGF-β1 even increased significantly. In multivariate analysis, the concentration of TGF-β1 was a significant predictor of death during follow-up. Conclusions: The response to CRT implantation was associated with a decrease of TGF-β1, IL-6 and TNF-α. Higher pre-implant concentrations of TGF-1β were independently associated with a poor prognosis in CRT patients.

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Section: Discussionsupporting

confidence: 60%

Changes and Prognostic Impact of Apoptotic and Inflammatory Cytokines in Patients Treated with Cardiac Resynchronization Therapy

Osmančík

Heřman²,

Štros³

et al. 2013

Cardiology

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“…In clinical studies, cardiac resynchronization therapy has been shown to reduce interstitial remodeling, apoptotic cell death, and TNF-α expression [37]. Such decrease in inflammatory signals can attenuate post-infarct maladaptive signaling to native and transplanted cardiomyocytes, therefore providing a more conducive environment for regenerative therapy with stem cells to form more physiologically functional grafts [38].…”

Section: The Evidence For Electrical Stimulation To Promote a More Famentioning

confidence: 98%

The Role of Cardiac Electrophysiology in Myocardial Regenerative Stem Cell Therapy

Huang

Pashmforoush

Chung

et al. 2010

J. of Cardiovasc. Trans. Res.

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Recent advances in stem cell biology and tissue engineering have put forth new therapeutic paradigms for treatment of myocardial disease. The aim of stem cell therapy for myocardial regeneration has been directed to induce angiogenesis for ischemic heart disease and/or introduction of new cardiomyocytes to improve the mechanical function of the failing heart. Encouraged by positive preliminary results in mouse models of myocardial infarction, clinical trials have utilized autologous skeletal myoblasts and bone-marrow-derived stem cells to treat patients in various clinical settings including acute myocardial injury, chronic angina, and heart failure. These studies have collectively shown, at best, modest improvement in cardiac function. This may be due to the fact that there is little evidence to support actual formation and/or integration of transplanted cells into the recipient myocardium. More recent and emerging data supports the finding that electrical stimulation may be an effective catalyst for sustained functional organization, integration, and maturation of transplanted cell populations into the host myocardium. A therapeutic model that utilizes electrical stimulation and/or achieves cardiac resynchronization in conjunction with stem cell transplantation may be an effective means to achieve successful myocardial regenerative therapy.

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“…It is speculated that CRT reduces inflammation, which could be one of the many factors responsible for an improvement in HF symptoms. A few small studies have looked at the effect of CRT on inflammation [91–93], but they have been limited by either a small sample size or a short follow-up period. One of the larger studies [94] that followed 140 patients undergoing CRT over a median duration of 9 months showed that CRT-induced reverse remodeling (RR*) led to a decrease in inflammatory markers resulting in a reduction in adverse events.…”

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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Anti‐Inflammatory Effect of Cardiac Resynchronization Therapy

Abstract: Although based upon a limited number of patients, this report indicates that CRT reduces peripheral markers of immune activation in patients with CHF. Further large scale studies are warranted to verify these findings.

Cited by 39 publications

References 45 publications

Changes and Prognostic Impact of Apoptotic and Inflammatory Cytokines in Patients Treated with Cardiac Resynchronization Therapy

Changes and Prognostic Impact of Apoptotic and Inflammatory Cytokines in Patients Treated with Cardiac Resynchronization Therapy

The Role of Cardiac Electrophysiology in Myocardial Regenerative Stem Cell Therapy

Biomarkers in electrophysiology: role in arrhythmias and resynchronization therapy

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