ABSTRACT
Objective To observe the effects of recombinant human B-type natriuretic peptide (rhBNP) on cardiac function and heart rate variability (HRV) in patients with heart failure after acute myocardial infarction (AMI). Methods One hundred and twenty patients with heart failure after AMI admitted to the Department of Cardiology of Cangzhou Central Hospital of Hebei Province from January 2015 to January 2018 were enrolled. The patients were divided into a conventional treatment group and an rhBNP treatment group according to random number table method, with 60 cases in each group. The two groups were treated according to the AMI guidelines, the conventional treatment group received west medicine anti-myocardial ischemia and anti-heart failure treatment; the rhBNP treatment group received rhBNP on the basis of routine treatment; the first load dose was 2 μg/kg intravenous injection impact treatment, followed by maintaining dose 8.5 ng·kg-1·min-1 intravenous drip for 7 days. The changes of hypersensitivity C-reactive protein (hs-CRP), N-terminal B-type natriuretic peptide precursor (NT-proBNP), left ventricular ejection fraction (LVEF) and HRV index were observed before and after treatment in the two groups [HRV indexes including the changes of average normal RR interval standard deviation (SDNN), the average value of the normal RR interval standard deviation (SDANN), the root mean square (RMSSD) of the adjacent RR interval difference, and the percentage of adjacent RR interval difference > 50 ms (PNN50)]; the incidences of adverse reactions in the two groups were observed. Results After treatment, the levels of hs-CRP and NT-proBNP in the two groups were significantly lower than those before treatment (all P < 0.05). LVEF, SDNN, SDANN, RMSSD and PNN50 were higher than those before treatment, and the changes of the above indicators in the rhBNP treatment group were more significant than those in the conventional treatment group [hs-CRP (mg/L): 6.2±3.3 vs. 11.8±5.5, NT-proBNP (ng/L): 2.5±2.0 vs. 6.4±4.3, LVEF: 0.49±0.02 vs. 0.44±0.04, SDNN (ms): 93.3±18.1 vs. 79.1±16.0, SDANN (ms): 87.3±17.8 vs. 70.9±14.9, RMSSD: 30.3±11.0 vs. 23.8±10.4, PNN50: (15.9±7.3)% vs. (9.6±5.5)%, all P < 0.05]; No significant adverse reactions occurred during the treatment of the two groups. Conclusion rhBNP can significantly improve the heart function of patients with heart failure after AMI, reduce the levels of inflammatory response indicators and improve HRV;since its clinical efficacy is good, and its application safe, it is worthy to promote its clinical use.
ABSTRACT
Objective To investigate the clinical efficacy and safety of recombinant human B-type natriuretic peptide(rhBNP)in treatreat of patients with acute myocardial infarction(AMI).Methods 80 patients with AMI were randomly divided into control and treatment group.The two groups were accepted the standard foundation treatment(ABCDE)defined by the WHO and PCI therapy.The treatment group was added the rhBNP on the basis.The rhBNP was uniformly injected by intravenous with 1.5 μg/kg in 90s,and then with 0.0075 μg · kg-1 · min-1 in 48h; To investigate the BNP and myocardiolysis maker(Troponin I,cTnI)levels in blood-serum before and after the treatment;To evaluate left cardiac functions and left ventricular remodeling by left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)and left ventricular ejection fraction(LVEF);To investigate the major cardiovascular events after treatment within 30 days.Results RhBNP could significantly reduce the concentration of the BNP and cTnI in blood-serum after treating one week(all P ＜ 0.05); It could remarkably deflate LV EDV and LVESV,improve LVEF(allP ＜0.05); It could reduce the incidence of major cardiovascular events(P ＜0.05)within 30 days(P ＜ 0.05).Conclusion The rhBNP could improve left ventricular pressure-phore and volume-phore,improve ventricular remodeling,improve myocardial ischemia and reduce major cardiovascular events within 30 days.It was proved that the rhBNP could improve AMI clinical prognosis.