ABSTRACT
Objective To observe the clinical effect of Levosimendan for treatment of patients with refractory heart failure in order to provide a reference for doctors treating this disease. Methods One hundred and eighty patients with refractory heart failure were admitted to Tongde Hospital of Zhejiang Province from February 2014 to December 2017, and they were divided into two groups by random number table method: a western medicine routine treatment group (western control group) and a Levosimendan group, each group 90 cases. The patients in western control group were given conventional anti-cardiac failure drugs ; and those in Levosimendan group were treated with the therapies as above group, and additionally Levosimendan continuous intravenous infusion for 24 hours was given. The clinical efficacy of the two groups was evaluated after 3 days of treatment. After treatment, the differences of ejection fraction (EF), stroke volume (SV), end-systolic volume (ESV), end-diastolic volume (EDV) and the levels of N-terminal brain natriuretic peptide precursor (NT-proBNP) and cardiac troponin I (cTnI) were compared between the two groups. Results After treatment, the EF and SV levels were significantly increased, while the ESV, EDV, NT-proBNP and cTnI levels were decreased obviously compared with those before treatment in the two groups (all P <0.05); the changes of the levels of EF, SV and NT-proBNP and cTnI of Levosimendan group were more significant than those of the western control group [EF: 0.49±0.06 vs. 0.44±0.06, SV (mL): 86.54±17.63 vs. 81.48±18.46, NT-proBNP (μg/L): 5.50±1.28 vs. 6.64±1.54, cTnI (μg/L): 0.08±0.01 vs. 0.14±0.13, all P < 0.05], while there were no significant differences of the levels of ESV and EDV between the two groups [ESV (mL): 111.56±32.53 vs. 128.76±32.13, EDV (mL): 187.95±39.28 vs. 185.06±41.23, both P > 0.05]. The total effective rate of the Levosimendan group was obviously higher than that of the western control group [97.78% (88/90) vs. 78.89% (71/90), P < 0.05]. Conclusion Levosimendan can effectively improve the hemodynamics in patients with refractory heart failure, the elevation of patients' heart function, and the short-term therapeutic effect is very remarkable.
ABSTRACT
Objective: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. Setting: Christian Medical College Hospital, Vellore, India. Participants: Patients undergoing elective coronary artery bypass surgery on CPB. Intervention: Anesthesia was maintained with 0.8–1.2 end tidal concentrations of isoflurane in the isoflurane group and in the propofol group, anesthesia was maintained with propofol infusion as described by Roberts et al. Measurements: Hemodynamic data were recorded at frequent intervals during the surgery and up to 24 h in the Intensive Care Unit (ICU). The other variables that were measured include duration of mechanical ventilation, dose and duration of inotropes in ICU, (inotrope score), duration of ICU stay, NT proBNP levels before induction and 24 h postoperatively, creatine kinase-MB levels in the immediate postoperative, first and second day. Results: Mean heart rate was significantly higher in propofol group during sternotomy, (P = 0.021). Propofol group had a significantly more number of patients requiring nitroglycerine in the prebypass period (P = 0.01). The increase in NT proBNP from preoperative to postoperative value was lesser in the isoflurane group compared to propofol even though the difference was not statistically significant. The requirement of phenylephrine to maintain mean arterial pressure within 20% of baseline, mechanical ventilation duration, inotrope use, duration of ICU stay and hospital stay were found to be similar in both groups. Conclusion: Propofol exhibit comparable myocardial protective effect like that of isoflurane in patients undergoing coronary artery bypass graft surgery. Considering the unproven mortality benefit of isoflurane and the improved awareness of green OT concept, propofol may be the ideal alternative to volatile anesthetics, at least in patients with good left ventricular function.
ABSTRACT
Objective: To study the correlations between galectin-3, soluble ST2 (sST2) levels and chronic heart failure (CHF) classiifcation, traditional HF indicator and short-term death in relevant patients. Methods: This research included 2 groups: CHF group, containing 142 relevant patients treated in our hospital from 2014-02 to 2015-10 and Control group, containing 85 normal subjects from physical examination at the same period of time. Based on NYHA criterion, the patients were classiifed in NYHA grade II, III and IV respectively. Blood levels of N-terminal brain natriuretic peptide (NT-ProBNP), high-sensitivity C reactive protein (hs-CRP) and ultrasonic morphology were examined upon admission; protein expressions of galectin-3 and sST2 were assessed by ELISA. Results: The patients with NYHA grade III and IV had increased levels of galectin-3 and soluble sST2; galectin-3, sST2 were positively related to NT-ProBNP, hs-CRP and LVEDD, while negatively related to LVEF. Logistic regression analysis indicated that galectin-3 and sST2 were related to short-term death in CHF patients,P<0.05. Area under ROC curve of galectin-3 and sST2 for diagnosing CHF were 0.738 and 0.771,P<0.01. Conclusion: Galectin-3 and sST2 levels were related to traditional HF indicator and could be used for CHF diagnosis in relevant patients.
ABSTRACT
Objective To investigate the healthy adults in Heyuan area of serum N terminal pro brain natriuretic peptide (N‐proBNP) concentration distribution and the preliminary investigation on the normal reference range .Methods From 2010 Novem‐ber to 2012 November in the physical examination ,laboratory examination center of our hospital indicators ,ECG ,B ultrasound ex‐amination showed no abnormalities of the healthy people 1 017 ,according to the different gender and age :A group less than 25 years ,group B was 25- <35 years ,35- <45 years ,group C ,group D 45- <55 years ,55- <65 years of E group ,F group for over 65 years a total of 6 age groups ,content determination of serum N‐proBNP by Roche chemical instrument light .Results age ,gen‐der can affect the distribution of N‐proBNP level ,and with the increase of age ,adjacent to the age groups (except F group) to com‐pare the serum levels of N‐proBNP ,the difference was statistically significant (P<0 .05);Compared with the F group in each age group was significantly increased(P<0 .05) ,there was statistical significance compared with the group ;the serum N‐proBNP level of different sex ,the difference was statistically significant (P<0 .05) .Conclusion age ,gender and other physiological factors can affect the distribution of N‐proBNP levels ,should establish the corresponding reference interval according to the different age ,gen‐der ,provide the corresponding parameters for the diagnosis and treatment of related diseases .
ABSTRACT
Objective:To investigate the best preservation conditions of N-terminal pro-brain natriuretic peptide( NT-proBNP) and provide detection references with stable performance for detection kits.Methods: ELISA was used to quantitatively detect the changes in NT-proBNP contents in various preservation solutions.The effects of basic buffer system, preservative Proclin300 and antibiotics on the preservation of NT-proBNP were analyzed using univariate analysis.The combination of various factors was then optimized using orthogonal experiments, to identify the best preservation system for NT-proBNP.Results: The univariate analysis determined that the basic buffer system for NT-proBNP was 0.02 mol/L phosphate buffered saline(PBS) at pH7.2,the addition of pre-servative Proclin300 could extend the preservation time of NT-proBNP at 37℃ by one day, the combined addition of penicillin and streptomycin prolonged the preservation time of NT-proBNP by one day compared with individually adding penicillin or streptomycin.The orthogonal experiments identified a preservation solution for NT-proBNP as 20%calf serum,1/1 000 Proclin300,120 U/ml penicillin and 80 U/ml streptomycin in a basic buffer system of 0.02 mol/L PBS at pH7.2.This solution was used to preserve an NT-proBNP reference sample at 37℃.Seven days later,the calibrated fixed-value of the sample at 37℃was only 1.3%lower than that at 4℃.Conclusion:Optimized NT-proBNP serum preservation solution could preserve NT-proBNP standard sample at 37℃ for seven days.
ABSTRACT
Objective To investigate the relationship between serum homocysteine (Hcy)and N -terminal brain natriuretic peptide (NT -proBNP)and the severity of coronary artery disease in elderly patients with coronary heart disease (CHD).Methods 129 cases of inpatient with concurrent coronary angiography whose age was over 60 years old were selected as the research object.Serum Hcy and NT proBNP level were detected,and parallel coronary angiography were administrated.Angiography was normal in 24 cases (CONTROL group),while 28 cases were stable angina pectoris(SAP group),non ST segment elevation acute coronary artery comprehensive syndrome group (NSTEACS group)had 47 cases,acute ST segment elevation myocardial infarction group had 30 cases(AMI group).was used to The severity of coronary artery lesions were assessed by Gensini score and the relationship be-tween serum Hcy and NT proBNP levels and coronary angiography in the diagnosis of coronary artery disease severity were analyzed.Results AMI group,the mean serum Hcy and NT proBNP levels[(18.13 ±8.26)μmol/L,(450.45 ± 230.45)pg/mL]were significantly higher than those of NSTEACS group [(16.96 ±9.04)μmol/L,(300.96 ± 170.94)pg/mL],SAP group[(14.35 ±5.31)μmol/L,(130.35 ±85.31)pg/mL]and control group[(10.19 ± 3.18)μmol/L,(65.19 ±40.18)pg/mL](t =5.73、3.64;t =5.53、3.23;t =4.96、3.46;P <0.05).In NSTEACS group,average of Hcy and NT proBNP levels were significantly higher than those of SAP group and control group (t =5.06,3.54;t =4.79,3.25;P <0.05).In SAP group,the average of Hcy and NT proBNP levels were higher than those in the control group (t =5.89,4.23;P <0.05).The levels of serum Hcy and NT -proBNP in patients with cor-onary artery stenosis,double vessel disease and single vessel disease were(16.13 ±7.26)mol/L,(7.29 ±14.35)mol/L, (12.67 ±6.48)pg/mL,(210.45 ±416.45)pg/mL and (160.71 ±140.57)pg/mL,the difference was statistically significant (F =140.25,F =13.15;P <0.05,P <0.01).The levels of serum Hcy and NT -proBNP were signifi-cantly correlated with Gensini score (r =0.342,P <0.05;r =0.962,P <0.01).Conclusion Correlation between serum Hcy,NT -proBNP levels in elderly patients with coronary heart disease and the severity of coronary artery disease and stenosis count is positive.Determining the levels of serum Hcy and NT -proBNP in patients with coronary heart disease and the assessment of the severity of the disease has important clinical significance.
ABSTRACT
Objective To explore the hypersensitive c‐reactive protein(hs‐CRP) combined N‐brain natriuretic peptide precursor application value in heart failure .Methods 50 cases of heart failure patients of our hospital as research object ,this group of patients as experimental group .In order to make the research more persuasive ,in addition to select 50 cases of healthy people as control group .Experimental group patients to standards as set by the u .s .New York heart association ,according to the grouping of 24 pa‐tients with rank Ⅱ ,Ⅲ level 15 patients ,11 patients with Ⅳ level .Using colloidal gold method of N‐terminal patients plasma brain natriuretic peptide precursor concentration and left ventricular ejection fraction ,the concentrations of plasma brain natriuretic pep‐tide precursor N‐end needs were determined and the concentration of the hospital for five days prior to admission .Measurement by scattering turbidimetry ,and also need the hs‐CRP serum levels .Results Compare two groups of measuring results were found that the experimental group than the control group of N‐the brain natriuretic peptide precursor level obviously higher ,and the left ven‐tricular ejection fraction was lower than the control group .For the hs‐CRP serum levels of the experimental group is significantly higher than the control group ,cardiac function classification as the increasing of the number of this gap is widening .At levels Ⅱ -Ⅳ obvious the differences between the three ,with statistical significance(P<0 .05) .Conclusion hs‐CRP and N‐brain natriuretic peptide precursor concentration can be as an important indicator of heart failure determination ,has united both in clinical can more effectively to diagnosis heart failure .hs‐CRP in combination with N‐terminal brain natriuretic peptide precursor obvious effects of application in heart failure ,is worth popularizing in clinical use .
ABSTRACT
Objective To investigate the effects of benazepril on plasma copeptin and N terminal brain natriuretic peptide (NT-proBNP) in the patients with chronic heart failure (CHF) in order to explore the mechanism of benazepril on ventricular remodeling.Methods Two hundred and thirty-eight patients with CHF were randomized into control group (n =118) and therapy group (n =120).Patients in control group were received regular treatment including medicine of treating cardiotonic diuretic and vasodilator for 6 months,while in therapy group were given benazepril beside regular treatment.The levels of copeptin,NT-proBNP were measured before and after treatment.The left ventricular ejection fraction (LVEF),left ventricular end systolic diameter(LVESD) and left ventricular end diastole diameter(LVEDD) were recorded and compared before and after treatment.Results In treatment group,the levels of copeptin and NT-pro BNP,LVEF,LVEDD,LVESD were (4.9 ± 1.3) pmol/L and (327.8 ± 226.8) ng/L,(33.5 ± 6.2) ％,(47.6 ± 8.9) mm,(60.2 ± 7.1) mm before treatment,different from that after treatment ((17.8 ± 7.9) pmol/L,t =7.331,P =0.008 ; (1 779.6±838.3) pg/mL,t =10.236,P =0.002; (50.5 ±5.2)％,t =3.336,P=0.009;(32.9 ±5.7) mm,t =2.767,P =0.010 ; (43.2 ± 5.6) rmm,t =2.882,P =0.009).After treatment the levels of copeptin,NT-proBNP,LVEF,LVESD and LVEDD in treatment were lower than that of control group(control group:copeptin:(10.5 ± 2.4) nmol/L; NT-proBNP:(1076.6 ± 486.6) pg/L; LVEF:(36.6 ± 5.6) ％ ; LVESD:(45.9 ± 6.8)mm; LVEDD:(57.5 ± 5.4) mm),and there was significant difference between groups (P =0.049,0.010,0.035,0.038,0.048 respectively).Conclusion Benazepril treatment could decrease the level of plasma copeptin and NT-proBNP in CHF patients,inhibit neuroendocrine and the ventricular remodeling,and then improve the heart function.
ABSTRACT
Objective To investigate atorvastatin administration on osteopontin and cardiac function of patients with chronic heart failure(CHF).Methods Sixty CHF patients were randomly divided into control (30 cases) and atorvastatin groups (30 cases).Patients in control group were given regular treatment including conventional oxygen inhalation,digitalis,angiotensin converting enzyme inhibitors,β blockers,diuretics,vasodilator therapy.Patients in treatment group were given atorvastatin at dose of 20 mg/d for 2 months plus regular treatment.The NHYA cardiac function,echocardiography determination of left ventricular ejection fraction(LVEF) were recorded.The levels of plasma osteopontin,plasma N-terminal brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were measured.Results The levels of plasma osteopontin,NT-proBNP and CRP in atorvastatin group were (1 062.68 ± 130.63) ng/L,(609.00 ±62.39) ng/L and ((5.84 ± 0.70) mg/L respectively,lower than those of control group ((1609.94 ± 201.87) ng/L,(922.33 ± 108.68) ng/L,(8.90 ± 0.86) mg/L),and the differences were statistically significant (Z =-1.981,t =2.766,Z =-2.092,P ＜0.05).LVEF in atorvastatin group was (58.7 ± 1.2)％,higher than that in control group ((52.8 ± 1.6) ％ ; P ＜ 0.05).Conclusion Atorvastatin treatment can decrease plasma osteopontin density,alleviate the inflammatory response and inhibit cardiac remodeling in patients with heart failure,which was good for recovery of heart failure.
ABSTRACT
Objective To study the effect of carvedilol on heart rate variability and plasma N-terminal brain natriuretic peptide(NT-proBNP) in patients with chronic heart failure.Methods 106 patients with chronic heart fail-ure were randomly divided into the two groups ..53 patients in the control group were treated by the conventional ther-apy plus metoprolol ,while 53 patients in the observation group were treated by the conventional therapy plus carve -dilol.They were treated for six months .Heart rate variability and plasma NT-proBNP were measured before and after treatment in the two groups .Results The total effective rate of the control group was 83.0%,which was significantly lower than 94.3% of the observation group (χ2 =6.26,P0.05).After treatment,SDNN,SDANN,RMSSD and PNN50 were significantly increased (t=3.095,9.184,3.622,4.302,2.261, 4.522,2.921,2.992,P <0.05 or P <0.01).Compared with the control group,those in the observation group increased more significantly (t=8.065,3.116,3.209,2.171,P<0.05 or P<0.01).After treatment,plasma NT-proBNP were significantly decreased in the two groups (t=7.093,9.773,all P<0.01).Compared with the control group,plasma NT-proBNP of the observation group decreased more significantly (t=4.773,P<0.01).Conclusion Carvedilol can more significantly improve heart rate variability and plasma NT-proBNP in patients with chronic heart failure.
ABSTRACT
Objective To investigate the concentrations of serum N-terminal brain natriuretic peptide (NT-pm BNP) and high-sensitivity C-reactive protein (hs-CRP) of acute exacerbation of chronic obstrnctive pulmonary disease(AECOPD) patients treated by bi-level positive airway pressure(BiPAP) for with respiratory failure.Methods A total of 100 respiratory failure in patients with AECOPD were divided into study group and control group,and 50 cases of each group.Patients in study group were received the conventional treatment(anti infection,diastolic bronchial,cough and phlegm and oxygen therapy) combined with BiPAP therapy,while in control group were received the conventional treatment.Blood samples were drawn at beginning and 3 d later.Serum hs-CRP and NT-pro BNP levels were determined,and the expenses and duration of hospitalization of two groups were compared.Result After treatment,the level of serum NT-pro BNP in study group and control group were (105.79 ± 4.56) ng/L and (113.33 ± 3.26) ng/L,and the difference was statistically signifi cant (t =3.03,P ＜ 0.05).The serum hs-CRP levels were (10.83 ± 16.35) mg/L and (26.39 ± 26.87) mg/L in study and control group,and the differences were statistically significant (t =-3.44,P ＜ 0.05).The expenses and duration of hospitalization in study group were both less than those in control group((11.15 ± 1.86) d vs.(12.78±2.25) d;(6 659.11 ±1 609.49) yuan vs.(8 031.31 ±1 449.79) yuan;t=-3.87,-4.38;P ＜0.05).Conclusion Early BiPAP therapy in AECOPD patients with respiratory failure in patients is showed that NT-pro BNP and hs-CRP levels faster decrease and disease is recovery remission,which suggests that NTpro BNP or BNP for AECOPD patients and respiratory failure condition monitoring,clinical efficacy have some clinical value.
ABSTRACT
Brain natriuretic peptide(BNP) is a cardiac hormone mainly secreted by myocytes in the ventricular wall. It has strong action of natriuresis, diuresis, vasodilation, inhibition of renin-angiotensin-aldosterone system and sympathetic nervous system. The increased levels of BNP and NT-proBNP have been reported in children’s cardiovascular diseases in numerous stu-dies and can reflect cardiac function. This article simply reviews the BNP and NT-proBNP about its biology character, detection method, medical reference range and its progress in pediatric cardiovascular disease.
ABSTRACT
Objective To evaluate the effect of percutaneous closure of patent ductus arteriosus(PDA)on left ventricular size and function by measuring plasma N-terminal brain natriuretic peptide(NT-proBNP)level and using two-dimensional echocardiography.Methods According to the modified Ross score,55 children with PDA were divided into 3 groups,no congestive heart failure(CHF)group(31 cases),mild CHF group(14 cases)and moderate-severe CHF group(10 cases).Fifteen age-matched and weight-matched normal children were used as controls.Plasma NT-proBNP was measured using enzyme-linked immunosorbent assay(ELISA).All patients had complete echocardiographic study,including measurement of left ventricular end diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI),and left ventricular ejection fraction(LVEF),and left ventricular fractional shortening(LVFS).The correlation between plasma NT-proBNP level and echocardiographic cardiac functional indexes was determined.Results 1.Before operation LVEDVI and LVESVI in PDA patients were obviously higher than those in normal controls(Pa0.05).3.Three months after operation plasma NT-proBNP level,LVEDVI and LVESVI were significantly decreased(P