Bakos Z, et al. - Researchers assessed the link between clinical, echocardiographic, and natriuretic peptide response to cardiac resynchronization therapy (CRT). Additionally, the relation of an integrated response score to long-term clinical outcomes was also studied. A reduction in left ventricular end-systolic volume (LVESV) ≥ 15% was defined as echocardiographic response (E+). Clinical response was defined as an improvement of ≥ 1 New York Heart Association (NYHA) class (C+), and biomarker response as a ≥ 25% reduction in NT-proBNP(B+). Landmarked Cox models were used to evaluate the association of response measures (E+, B+, C+; response score range 0–3) and clinical endpoints at 3 years. Serial changes in NT-proBNP were found to be related to clinical outcomes following CRT implant. A clinically meaningful as well as more accurate discrimination of CRT responders vs non-responders could be achieved by combining biomarker, clinical, and echocardiographic response.