Forty-two patients with heart failure with QRS of >120 msec were recruited; their serial N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels were measured at baseline and at 1 and 3 months after CRT. There was a reduction in NT-proBNP level 1 month after CRT (2655 ± 2242 pg/mL vs 2149 ± 2033 pg/mL; P = .03), which was further reduced at 3 months (1473 ± 1786 pg/mL; P < .001 vs baseline). The reduction of NT-proBNP correlated with the change of left ventricular (LV) end-systolic volume (r = 0.53; P = .001) or LV ejection fraction (r = −0.49; P = .002) and with improvement in exercise capacity after CRT for 3 months (r = 0.50; P = .002). The patients were classified by the degree of reduction in NT-proBNP as group 1 (reduction of ≥50 % vs baseline; n = 19) and group 2 (reduction of <50 % vs baseline; n = 23). The degree of LV reverse remodeling (–31.8 ± 24.7 mL vs −12.6 ± 19.2 mL; P = .007) and gain in LV ejection fraction (+12.5 % ± 8.8 % vs +4.6 % ± 5.8 % ; P = .002) were significantly better in group 1 than group 2. Both the all-cause mortality rate (Log-rank χ2 = 4.01; P = .04) and the composite end-point of mortality rate or hospitalization rate for cardiovascular causes (Log-rank χ2 = 4.31; P = .02) were significantly lower in group 1 than in group 2.
Serial monitoring of NT-proBNP may be helpful to predict a favorable outcome after CRT. Those who had a reduction of NT-proBNP level of ≥50 % were more likely to exhibit a favorable response.