Myocardial gene expression in heart failure patients treated with cardiac resynchronization therapy responders versus nonresponders.

摘要: Objectives We studied whether functional improvement after cardiac resynchronization therapy (CRT) is associated with reversal of the heart failure (HF) gene program. Background Cardiac improves exercise tolerance and survival in patients advanced congestive HF dyssynchrony. Methods Twenty-four referred for CRT underwent left ventricular (LV) endomyocardial biopsies immediately before implantation (baseline). In addition, 17 them LV biopsy procurement 4 months later (follow-up). 6 control normal function, were obtained at time coronary artery bypass grafting. The messenger ribonucleic acid (mRNA) levels contractile calcium regulatory genes measured by quantitative real polymerase chain reaction normalized glyceraldehyde 3-phosphate dehydrogenase (GAPDH). showing an New York Heart Association (NYHA) class >1 score a relative increase ejection fraction ≥25% considered as responders. Results characterized lower mRNA α-myosin heavy (α-MHC), β-myosin (β-MHC), sarcoplasmic reticulum ATPase 2α (SERCA), phospholamban (PLN), higher brain natriuretic peptide (BNP) compared subjects. Responders to (n = 11) showed LVEF (p Conclusions electromechanical dyssynchrony, related favorable changes established molecular markers HF, including that regulate function pathologic hypertrophy.