Biomarkers to Predict the Response to Cardiac Resynchronization Therapy

Ward Heggermont; Angelo Auricchio; Marc Vanderheyden


Europace. 2019;21(11):1609-1620. 

In This Article


Apelin is the endogenous ligand for a G-protein-coupled apelin receptor and is investigated as an important regulator of cardiovascular homeostasis. There are several cleaved shorter peptides (apelin-36, apelin-13, etc.) originating from the 77-amino acid preproapelin, and these shorter peptides are grouped as carboxyterminal apelin fragments (CT-apelin).[45,46] In 81 patients with severe HF and implantation of a CRT device, CT-apelin was measured at baseline and 6 months after implantation. A total of 18.5% were non-responders, whereas the rest were CRT responders. At baseline, there was no difference in CT-apelin levels in both groups, but after 6 months, CT-apelin was significantly lower in the responders (P < 0.001).[47] Based on multivariate analysis, CT-apelin was judged superior to NT-pro-BNP in association with responder status. However, both markers cannot be considered predictors of CRT response as there were no baseline differences.