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. 2024 Feb 8;14(2):188.
doi: 10.3390/jpm14020188.

The Prognostic Role of Global Longitudinal Strain and NT-proBNP in Heart Failure Patients Receiving Cardiac Resynchronization Therapy

Nikolaos P E Kadoglou  1 , Sjoerd Bouwmeester  2 , Anouk G W de Lepper  2 , Marloes C de Kleijn  2 , Ingeborg H F Herold  2 , Arthur R A Bouwman  2 , Ioannis Korakianitis  1 , Tim Simmers  2 , Franke A L E Bracke  2 , Patrick Houthuizen  2
Affiliations

The Prognostic Role of Global Longitudinal Strain and NT-proBNP in Heart Failure Patients Receiving Cardiac Resynchronization Therapy

Nikolaos P E Kadoglou et al. J Pers Med. .

Abstract

Background: We aimed to evaluate whether baseline GLS (global longitudinal strain), NT-proBNP, and changes in these after cardiac resynchronization therapy (CRT) can predict long-term clinical outcomes and the echocardiographic-based response to CRT (defined by 15% relative reduction in left ventricular end-systolic volume).

Methods: We enrolled 143 patients with stable ischemic heart failure (HF) undergoing CRT-D implantation. NT-proBNP and echocardiography were obtained before and 6 months after. The patients were followed up (median: 58 months) for HF-related deaths and/or HF hospitalizations (primary endpoint) or HF-related deaths (secondary endpoint).

Results: A total of 84 patients achieved the primary and 53 the secondary endpoint, while 104 patients were considered CRT responders and 39 non-responders. At baseline, event-free patients had higher absolute GLS values (p < 0.001) and lower NT-proBNP serum levels (p < 0001) than those achieving the primary endpoint. A similar pattern was observed in favor of CRT responders vs. non-responders. On Cox regression analysis, baseline absolute GLS value (HR = 0.77; 95% CI, 0.51-1.91; p = 0.002) was beneficially associated with lower primary endpoint incidence, while baseline NT-proBNP levels (HR = 1.55; 95% CI, 1.43-2.01; p = 0.002) and diabetes presence (HR = 1.27; 95% CI, 1.12-1.98; p = 0.003) were related to higher primary endpoint incidence.

Conclusions: In HF patients undergoing CRT-D, baseline GLS and NT-proBNP concentrations may serve as prognostic factors, while they may predict the echocardiographic-based response to CRT.

Keywords: cardiac resynchronization therapy—CRT; global longitudinal strain—GLS; heart failure; natriuretic peptides.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Receiver-operating characteristic (ROC) curve of global longitudinal strain (GLS) for the prediction of the primary endpoint (HF-related deaths and/or hospitalizations).
Figure 2
Figure 2
Kaplan–Meier survival curve between responders and non-responders from 6 months to the end of follow-up.
Figure 3
Figure 3
A representative example of GLS improvement in a patient after CRT-D implantation.
See this image and copyright information in PMC

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