scholarly journals Cardiac Resynchronization Therapy in the Cardiorenal Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Margot K. Davis ◽  
Sean A. Virani
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Cardiac Resynchronization Therapy ◽  
Cardiorenal Syndrome ◽  
Clinical Syndrome ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Patients With Heart Failure ◽  
Potential Risks ◽  
The Impact

The cardiorenal syndrome (CRS) is a complex clinical syndrome in which dysfunction of either the heart or the kidneys affects the functioning of the other organ system. Many therapies used in heart failure have further detrimental effects on renal function. Cardiac resynchronization therapy (CRT) is a relatively new form of device therapy that reduces morbidity and mortality in patients with heart failure. This review will discuss the effects of CRT on renal function in patients with CRS, the impact of baseline renal function on response to CRT, and potential risks associated with CRT in this unique population.

scholarly journals Biomarkers to Predict the Renal Response to Cardiac Resynchronization Therapy During a Three-Month Follow-Up: Prospective Clinical Trial

2020 ◽  
Author(s):  
Agnieszka Gala-Bladzinska ◽  
Tomasz Kubrak ◽  
Joanna Czech ◽  
David Aebisher ◽  
Krzysztof Gargasz ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiac Resynchronization Therapy ◽  
Cardiorenal Syndrome ◽  
Cardiac Resynchronization ◽  
Prostaglandin D2 ◽  
Resynchronization Therapy ◽  
Patients With Heart Failure ◽  
Artery Disease ◽  
Neutrophil Gelatinase

Abstract BackgroundChronic cardiorenal syndrome type 2 (CRS-T2) has a complex pathophysiology. The objective of this study was to assess renal function using biomarkers associated with nephron injury sites in patients with CRS-T2 following cardiac resynchronization therapy (CRT). MethodsThe research included patients with heart failure in NYHA classes II-IV, in whom CRT devices had been implanted. After 3 months of follow-up, the research group was divided into CRT responders and CRT non-responders. Prior to CRT and after 3 months, renal function was assessed using biomarkers measured in urine and blood samples.ResultsCRT was implanted in 56 patients (aged 66 ± 10 years) with CRS-T2 in the course of coronary artery disease (n = 38; 67.9%) or dilated cardiomyopathy (n = 18). Estimated glomerular filtration rate (eGFRCKD-EPI) was 68.55 ± 20.34 mL/min/1.73m2. After three months follow-up CRT responder group were assessed showing a significant decrease in serum prostaglandin D2 synthase (sPGD2S) and albuminuria (uACR) concentrations. Urine samples of the CRT non-responder group showed significant (p <0.05) increases in lipocalin associated with neutrophil gelatinase (uNGAL) concentrations, and a decrease in cystatin C (uCysC) concentration. There were no significant changes in the concentration of serum creatinine (sCr), CysC and eGFRCKD-EPI between the CRT responders and CRT non - responders groups.ConclusionsThe sCr and eGFRCKD-EPI assessment are useless in evaluation of renal function three months after CRT implantation. Biomarkers that account for the pathophysiology of nephron injury in CRS-T2 and change significantly after CRT are: sPGD2S, uACR, uCysC, and uNGAL. Trial registrationThis study is registered with ClinicalTrials.gov, Identifier: NCT04516525. Registered 15 August 2020 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04516525.

scholarly journals MP161IMPROVEMENT OF RENAL FUNCTION AFTER CARDIAC RESYNCHRONIZATION THERAPY IMPLANTATION IN PATIENTS WITH HEART FAILURE

2017 ◽  
Vol 32 (suppl_3) ◽  
pp. iii488-iii488
Author(s):  
Luis Guillermo Piccone Saponara ◽  
Nancy Giovanna Uribe Heredia ◽  
Maria Carmen Vozmediano Poyatos ◽  
Agustín Carreño Parrilla ◽  
Ramón Arroyo Espliguero ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Patients With Heart Failure ◽  
Cardiac Resynchronization Therapy Implantation

Abstract 17471: Cardiorenal Syndrome Patients With High NT-proBNP and Cystatin C Levels and Patients With Irreversible Cardiorenal Syndrome Identified by Persistently High Levels of Cystatin C Have Worse Outcomes in Cardiac Resynchronization Therapy: The BIOCRT Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jigar Contractor ◽  
Jackie Szymonifka ◽  
Roderick C Deano ◽  
Neal A Chatterjee ◽  
James L Januzzi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Cardiac Resynchronization Therapy ◽  
Cystatin C ◽  
Cardiorenal Syndrome ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Cardiac Transplant ◽  
Resynchronization Therapy ◽  
Amino Terminal

Introduction: Cardiorenal syndrome comprises of a heterogeneous group of acute and chronic cardiac and renal dysfunction. We examine the association of a dual marker strategy using amino-terminal pro brain natriuretic peptide (NT-proBNP, heart failure) and cystatin C (CysC, renal function) with major adverse cardiac events (MACE) in cardiac resynchronization therapy (CRT) patients. Methods: In 92 patients (age 66±13; 80% male; ejection fraction 26±7%), NT-proBNP and CysC levels were measured at CRT implantation, and 1 month. NT-proBNP>1000 pg/mL and CysC>1mg/L were considered high. At baseline, cardiorenal patients were defined as having high NT-proBNP and CysC. One month after implant, we categorized CRT patients as (1) irreversible cardiorenal if CysC was persistently high, (2) progressive cardiorenal with low transition to high CysC, (3) reversible cardiorenal with high transition to low CysC, and (4) "normal" with stable low CysC. MACE was defined as death, cardiac transplant, left ventricular assist device, and heart failure hospitalization by 2 years. Results: There were 25 (27%) MACE. Prior to CRT, 34 (37%) patients had cardiorenal syndrome. Compared to patients with low NT-proBNP and CysC levels, cardiorenal patients had >6-fold risk of MACE (adjusted HR 6.3, p=0.02) with an estimated 52% probability of having MACE (Figure A). One month after CRT, 33 (36%) patients were irreversible, 15 (16%) progressive, 7 (8%) reversible, and 37 (40%) "normal". Compared to "normal" and reversible patients (referent), irreversible patients had >4-fold risk of MACE (adjusted HR 4.7, p=0.002) with an estimated 52% probability of having MACE (Figure B) while progressors had similar MACE risk (adjusted HR 1.0, p=1.0). Conclusions: CRT patients with cardiorenal syndrome, especially irreversible, have worse prognosis compared to those with acute renal injury or "normal" renal function. Cardiorenal status by NT-proBNP and CysC can identify high-risk CRT patients.

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