Predicting Patients’ Response to Cardiac Resynchronization Therapy

Predicting Patients’ Response to Cardiac Resynchronization Therapy

Cardiac resynchronization therapy (CRT) is a standard treatment for heart failure (HF), but not all patients respond to it. Glycation (i.e., attachment of sugar particles to other molecules) of the Ryanodine receptor (RyR) is known to occur in the skeletal muscle and circulating lymphocytes of patients with advanced HF.

In a study published online on December 26 in the Journal of Heart and Lung Transplantation, Gaetano Santulli, M.D., Ph.D., and colleagues investigated whether RyR glycation in circulating lymphocytes could predict HF patients’ response to CRT. After enrolling 94 HF patients who underwent CRT and 30 people without HF, the researchers assessed RyR glycation of lymphocytes at baseline and after one year. Baseline RyR glycation was found to independently predict CRT response at the one-year mark. In addition, RyR glycation correlated significantly with pathologic intracellular calcium leakage in HF patients. Taken together, the results show for the first time that RyR glycation in circulating lymphocytes represents a novel and reliable biomarker for predicting outcomes for HF patients following CRT.

Dr. Santulli is an associate professor of medicine and of molecular pharmacology at Einstein.