ABSTRACT
@#Objective To establish and verify a capillary isoelectric focusing-whole column imaging detection(CIEFWCID) method for the analysis of isoelectric point(pI) of recombinant human brain natriuretic peptide.Methods The ampholyte,space-occupying agent,protein concentration,focusing time were optimized by CIEF-WCID method,and the best condition for the detection of recombinant human brain natriuretic peptide was obtained.The repeatability,precision and durability of the developed method were verified,and three batches of recombinant human brain natriuretic peptide produced continuously were analyzed for pI.Results HR AESlyte 8-10.5 was selected as ampholyte,while 25 mmol/L sodium hydroxide as the space-occupying agent;The final concentration of the sample was 87.5 μg/mL and the focusing time was 8min.The relative standard deviation RSD of pI detection was 0.1% after six consecutive injections of the same sample;The RSD of pI detection of six samples was 0.1%;The pI RSD of the main peak was 0.1% at different final concentrations of the sample,and the pI RSD of the sample was 0.1% at different storage time,while the pI markers could not be changed arbitrarily.The pI was detected in three consecutive batches of recombinant human brain natriuretic peptide samples.Conclusion The developed CIEF-WCID method for pI analysis of recombinant human brain natriuretic peptide had good repeatability and precision and might be used for follow-up quality control of recombinant human brain natriuretic peptide.
ABSTRACT
OBJECTIVE：To observe the clinical effect and safety of recombinant human brain natriuretic peptide （rhBNP） combined with levosimendan in the treatment of acute decompensated heart failure （ADHF）complicated with renal insufficiency. METHODS：A total of 156 patients with ADHF complicated with renal insufficiency admitted to the Dept. of Cardiology in the Affiliated Hospital of Southwest Medical University during Jan.-Dec. 2019 were randomly divided into rhBNP group ，levosimendan group and combination group ，with 52 patients in each group. All patients received rountine treatment. On this basis ，rhBNP group was given rhBNP for injection [after 1.5 μg/kg intravenous pulse injection，intravenous dripping for 24 h with 0.007 5 μg（/ kg· min）]；leosimendan group was given Leosimendan injection 12.5 mg [intravenous dripping for 1 h with 6-12 μg（/ kg·min），then intravenous dripping for 23 h with 0.1 μg（/ kg·min）]. Combination group received drug combination according to the administration method of single drug group. Three groups received treatment for consecutive 7 d. Cardiac function indexes [heart rate （HR），left ventricular ejection fraction （LVEF），left ventricular end-diastolic diameter （LVEDD）]，mean arterial pressure （MAP），pulmonary capillary pressure （PCWP），renal function indexes [estimated glomerular filtration rate （eGFR），serum creatinine （Scr）]，serum levels of cystatin C （Cys-c）and amino-terminal brain natriuretic peptide precursor （NT-proBNP）were observed in 3 groups before and after treatment. Clinical efficacy and the occurrence of ADR were recorded. RESULTS ：Three cases withdrew from the study in rhBNP group and 1 case in levosimendan group ；152 cases completed the study. Before treatment ，there was no statistical significance in cardiac function indexes ，MAP，PCMP，renal function indexes or serum levels of Cys-C and NT-proBNP among 3 groups（P＞0.05）. After treatment ，the HP ，MAP，PCWP and serum level of NT-proBNP in 3 group as well as serum level of Cys-C in combination group were decreased significantly （P＜0.05）；the LVEF in 3 group as well as the eGFR and Scr level in levosimendan group and combination group were significantly increased （P＜0.05），compared with before treatment ；above indexes of combination group were significantly better than those of rhBNP group and levosimendan group （P＜0.05）. Total effective rate of combination group was 94.23％ ，which was significantly higher than those of rhBNP group （77.55％）and levosimendan group （76.47％）（P＜0.05）. There was no significant difference in the incidence of ADR among 3 groups（P＞ 0.05）. CONCLUSIONS ：rhBNP combined with levosimendan in the treatment of ADHF complicated with renal insufficiency can significantly increase the clinical efficacy ，and improve cardiac and renal function but don ’t increase the incidence of ADR.
ABSTRACT
Objective To investigate the clinical effects of levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in elderly patients with heart failure. Methods Eighty patients with heart failure diagnosed in our hospital from January 2015 to January 2018 were selected as subjects. According to the random number table prepared in Excel 2007,40 patients in the experimental group and the control group were given. For basic treatments such as diuresis,the experimental group was treated with levosimtan combined with lyophilized recombinant human brain natriuretic peptide,and the control group was treated with levosimtan and dobutamine. The left ventricle of the two groups before and after treatment was compared. End-diastolic period (LVEDD),left ventricular ejection fraction(LVEF),cardiac index(CI),stroke volume(SV),serum cystatin C (Cys-C),amino terminal brain natriuretic peptide precursor(NT-proBNP),mean arterial pressure(MAP), pulmonary capillary pressure(PCWP). Results Before treatment,the differences of LVEDD,LVEF,CI and SV levels between the experimental group and the control group were not statistically significant(P > 0.05). After treatment,the LVEDD of the experimental group was significantly lower than that of the control group(P < 0.05).The LVEF,CI and SV values in the experimental group were significantly higher than those in the control group (P < 0.05). There was no significant difference in serum Cys-C and NT-proBNP levels between the experimental group and the control group before treatment(P > 0.05). After treatment,the serum levels of Cys-C and NT-proB-NP in the experimental group were significantly lower than those in the control group(P < 0.05). Before treatment,the difference of MAP and PCWP levels between the experimental group and the control group was not statistically significant(P > 0.05). After treatment,the MAP and PCWP levels in the experimental group were significantly lower than those in the control group(P < 0.05). The incidence of adverse reactions in the experimental group was 10.00％ and the difference between the control group and the control group was not statistically significant(P > 0.05). Conclusions Levosimmentan combined with freeze-dried recombinant human brain natriuretic peptide in patients with senile heart failure can significantly improve cardiac function,reduce Cys-C,NT-proBNP levels,and improve hemodynamic parameters.
ABSTRACT
Objective:To explore and compare the clinical efficacy of lyophilized recombinant human brain natriuretic peptide (Lrh-BNP) and dobutamine (Dob) in the treatment of patients with acute heart failure (AHF) and impacts on the plasma galectin (Gal)-3,Cystatin C (CysC) and endothelin (ET-)-1 levels.Methods:114 cases of patients with AHF in our hospital from February 2015 to February 2017 were selected as the research objectives and randomly divided into two groups.Dob group was treated by Dob,while Lrh-BNP group was treated by Lrh-BNP.The cardiac function parameters,plasma Gal-3,CysC,ET-1 levels before and after treatment,clinical comprehensive efficacy and incidence of adverse reactions were compared between two groups.Results:The FS,LVEF levels of both groups at 72 hours after treatment were significantly higher than those before treatment (P＜0.01),but the LVEDD,plasma Gal-3,CysC,ET-1 levels were obviously decreased (P＜0.01),the index mentioned above of Lrh-BNP group improved more significantly than those of the Dob group(P＜0.01).The overall effective rate of Lrh-BNP group was 89.5 ％,which was significantly higher than that of the Dob group (73.7％,P＜0.05).No significant difference was found in the incidence of adverse reaction between two groups(P＞0.05).Conclusion:Lyophilized recombinant human brain natriuretic peptide was more effective in the treatment of AHF than Dobutamine with equal safety,which might be related to the decrease of plasma Gal-3,CysC,ET-1 levels.
ABSTRACT
Objective To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). Methods A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade overⅢ - Ⅳ , acute cardiac insufficiency and the acute exacerbation of chronic cardiac insufficiency admitted to intensive care unit/cardiovascular care unit (ICU/CCU) of 58 Hospitals in China were enrolled. On the basis of the conventional treatment, all patients would be given rhBNP (neo adjuvant) with a loading dose of 1.5 μg/kg for 3-5 minutes, and followed by a maintenance dose of 0.010-0.015 μg·kg-1·min-1 for 3-7 days. Before the treatment and 1, 3, 7 days after treatment, researchers detected indexes of cardiac and renal function, the levels of N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), central venous pressure (CVP), urea nitrogen (BUN), serum creatinine (SCr), and urine output; the renal function index was re-evaluated at 30 days after administration, and the time entering ICU again, re-admission, cardiovascular events were recorded. Results 408 patients were enrolled, with 241 males and 167 females. Age range was 28-95 years, the average age was (63.0±15.8) years, and 50-70 years old accounted for 46.8%. Compared with the data before treatment, NT-proBNP, PCWP and CVP significantly decreased at 6 hours after treatment [NT-proBNP (μg·kg-1·min-1): 4378.58±4082.29 vs. 6403.41±5759.48, PCWP (mmHg, 1 mmHg = 0.133 kPa):12.41±2.21 vs. 14.26±2.85 , CVP (mmHg): 10.63±2.62 vs. 11.45±3.45, all P < 0.05], and with the prolongation of injection, NT-proBNP, PCWP and CVP were gradually declined; CO 1 day after treatment (mL: 4.89±0.81 vs. 4.40±0.92) and LVEF 3 days after treatment (0.465±0.100 vs. 0.431±0.107) were significantly increased (both P < 0.05), and with the prolongation of injection, CO and LVEF were gradually increased. There were no obvious changes in BUN and SCr during the treatment, but 30 days after treatment, SCr was significantly lower than that pre-treatment (μmol/L: 110.98±47.40 vs. 132.62±75.60, P < 0.01). Compared with the data pre-treatment, urine output per hour was significantly increased at 3 hours after treatment (mL: 129.59±82.16 vs. 89.60±53.49, P =0.000); urine output every 24 hours was significantly increased at day 1 and day 2 after administration (mL: 2676.54± 1006.83, 2678.74±975.97 vs. 2150.36±283.76, both P < 0.01). In 7 days, the re-entry ICU rate was 2.7%, and the re-hospitalization rate was 2.88% within 30 days, re-cardiac failure rate was 1.43% in 30 days, and the overall fatality rate was 9.55% in 30 days. Conclusions The rhBNP can significantly improve heart function in patients with HF. And, it has a certain effect on renal function. The rhBNP is effective and safe for the treatment of cardiac insufficiency.
ABSTRACT
Objective To investigate the influence of BNP and heart and kidney function of recombinant human brain natriuretic peptide on acute heart failure treatment.Methods 120 cases from Jan.2011 to Dec.2016 in our hospital were chosen and randomly divided into two groups,the control group were given traditional treatment,the observation group were given brain natriuretic peptide on the basic of traditional treatment.The heart function,left ventricular ejection fraction,plasma BNP,urine output,serum creatinine,blood potassium concentration of two groups were compared.Results After 48 h,the total effective rate of the improvement of cardiac function in the observation group was 83.34％,which was significantly better than that of the control group 56.67％,the difference was statistically significant (P ＜ 0.05).After treatment,the heart function,left ventricular ejection fraction,plasma BNP,urine output of two groups after treatment were better than before treatment (P ＜ 0.05).And the heart function,LVEF ascending range,BNP concentration reduction and urine increased amount of observation group were better than control group (P ＜ 0.05).The serum creatinine concentration of two groups were slighter higher than before,the blood potassium concentration of observation group after treatment was slighter higher than before,the blood potassium concentration of control group was slighter lower than before,which had no significant difference,and after discontinuation which had no further intensified.Conclusion The recombinant human brain natriuretic peptide could be treating for acute heart failure treatment,and improve the heart function,decreased the plasma BNP level,dieresis and which had no adverse reaction on kidney function.
ABSTRACT
Objective To explore the clinical efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute heart failure(AHF) by observing the changes of hemodynamic parameters,cardiac function and inflammatory factors before and after treatment in the patients with AHF.Methods A total of 96 patients with AHF in our hospital from June 2012 to December 2015 were enrolled in this study and divided into the control group and observation group(n-48).The two groups were given the routine anti-heart failure treatment combined with sodium nitroprusside or rhBNP by intravenous dripping for 24 h.Fifteen cases were selected from each group for monitoring the hemodynamic change.The clinical effect was observed.The changes of heart rare,blood pressure,urine volume,cardiac function,plasma of NT-proBNP,IL-6 and hs-CRP before and after medication were observed.The occurrence of adverse reactions was also observed.Results The total effective rate of the observation group was significantly higher than that in the control group (P＜0.05).The PAP and PCWP at various time points after treatment in the observation group were significantly lower than those before treatment (P＜0.05).PAP and PCWP at various time points had statistical difference between two groups (P＜0.05).The levels of heart rate,systolic blood pressure,NT-proBNP,IL-6 and hsCRP levels after medication were significantly decreased in both groups,and the urine volume and LVEF were significantly increased (P＜0.05),and the difference between the two groups was statistically significant(P＜0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups (P＞0.05).Conclusion The short-term efficacy of rhBNP in treating AHF is better than sodium nitroprusside,which can improve hemodynamics and cardiac function,reduces the level of inflammatory factors.
ABSTRACT
Objective To explore the clinical efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute heart failure(AHF) by observing the changes of hemodynamic parameters,cardiac function and inflammatory factors before and after treatment in the patients with AHF.Methods A total of 96 patients with AHF in our hospital from June 2012 to December 2015 were enrolled in this study and divided into the control group and observation group(n-48).The two groups were given the routine anti-heart failure treatment combined with sodium nitroprusside or rhBNP by intravenous dripping for 24 h.Fifteen cases were selected from each group for monitoring the hemodynamic change.The clinical effect was observed.The changes of heart rare,blood pressure,urine volume,cardiac function,plasma of NT-proBNP,IL-6 and hs-CRP before and after medication were observed.The occurrence of adverse reactions was also observed.Results The total effective rate of the observation group was significantly higher than that in the control group (P＜0.05).The PAP and PCWP at various time points after treatment in the observation group were significantly lower than those before treatment (P＜0.05).PAP and PCWP at various time points had statistical difference between two groups (P＜0.05).The levels of heart rate,systolic blood pressure,NT-proBNP,IL-6 and hsCRP levels after medication were significantly decreased in both groups,and the urine volume and LVEF were significantly increased (P＜0.05),and the difference between the two groups was statistically significant(P＜0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups (P＞0.05).Conclusion The short-term efficacy of rhBNP in treating AHF is better than sodium nitroprusside,which can improve hemodynamics and cardiac function,reduces the level of inflammatory factors.
ABSTRACT
OBJECTIVE:To observe the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) combined with levosimendan in acute decompensated heart failure(ADHF). METHODS:In retrospective study,120 cases diagnosed as AD-HF were divided into observation group and control group according to treatment plan,with 60 cases in each group. The patients of control group received rhBNP on the basis of conventional treatment,intravenously pulsed with dose of 0.15 μg/kg firstly,then maintained dose of 0.007 5 μg/kg viacontinuous intravenous pumping for 24-72 h;On the basis of control group,treatment group received levosimendan with loading-dose of 12 μg/(kg·min)for 10 min,maintenance dose of 0.1 μg/(kg·min)via intravenous pump,for 24 h,adjusted according to clinical manifestations of patients. The vital signs,hemodynamic and UCG indexes,the rate of dyspnea recovery,plasma level of BNP,urine and the occurrence of ADR were recorded in 2 groups. RESULTS:The vital sign and hemodynamic indexes of control group had no significant change 1 h after treatment;the levels of HR,RR,SBP,MPAP and MPCWP in 2 groups after treatment were significantly lower than before,while the levels of SaO2 and CO were significantly higher than before,with statistical significance (P0.05). 48 h after treatment,LVEF of 2 groups were increased while plasma levels of BNP were decreased,compared to before treatment;the improvement of observation group was more significant than control group,with statistical significance(P0.05). CONCLU-SIONS:rhBNP combined with levosimendan could effectively improve vital sign,hemodynamic indexes,UCG indexes and dys-pnea,and decrease the plasma level of BNP with good safety.
ABSTRACT
OBJECTIVE:To observe therapeutic efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of acute decompensated heart failure (ADHF). METHODS:129 ADHF patients admitted in our hospital during Jul. 2013-Jul. 2015 were randomly divided into observation group(69 cases)and control group(60 cases). Control group was giv-en routine treatment. Observation group was additionally given rhBNP 1.5 μg/(kg·d)vein shock(d1),and then rhBNP 1 mg+5%Glucose injection 100 ml by 0.007 5 μg/(kg·min),ivgtt(d2-4). Treatment courses of 2 groups lasted for 7 d. Therapeutic efficacy and heart function indexes [left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVDd)] were observed in 2 groups as well as NT-proBNP level,medication fluid intake and urine volume 24 h after medication. The occurrence of ADR was observed. RESULTS:3 cases dropped out and 66 cases were included finally in doservation group. Total effective rate of AD-HF therapy in observation group (96.97%) was significantly higher than in control group (86.67%),with statistical significance (P0.05). Af-ter treatment,LVEF of 2 groups were increased significantly while LVDd were decreased significantly;LVEF of observation group [(42.3±3.6)%] was significantly higher than in control group[(37.9±3.3)%],while LVDd of observation group [(55.5± 3.6)%] was significantly lower than in control group[(61.3 ± 3.4)%]. NT-proBNP levels of 2 groups were decreased significant-ly,and the observation group [(1 389.5±29.6)pg/ml] was significantly lower than the control group [(2 778.0±26.8)pg/ml]. 24 h after medication,urine volume of 2 groups were significantly higher than medication fluid intake,and urine volume of observation group [(1 781.4 ± 89.7)ml] was significantly higher than that of control group [(1 372.6 ± 78.3)ml],with statistical significance (P0.05). CONCLUSIONS:rhBNP is significantly effective for ADHF,promotes heart function recovery and reduces renal function injury with good safety.
ABSTRACT
OBJECTIVE:To investigate the effects,prognosis and safery of recombinant human brain natriuretic peptide on the treatment of patients with acute decompensated heart failure. METHODS:90 inpatients with acute decompensated heart failure were divided into observation group and control group according to the use of recombinant human brain natriuretic peptide or not,with 45 cases in each group. Control group received rountine anti-heart failure therapy and intravenous dripping of Nitroglycerin injection at 20 μg/min continuously for 72 h. Observation group was additionally given Lyohilized recombinant human brain natriuretic peptide with initial loading amount of 1.5 μg/kg,iv,then intravenous dropping at 0.007 5 μg/(kg·min)continuously for 72 h,on the basis of control group. Hemodynamic parameters,brain natriuretic peptide level,the difference of liquid intake and output,dyspnea,lung rales,systemic edema,the improvement of cardiac function were observed and compared between 2 groups before and after treat-ment as well as re-hospitalization rate and surriral rate 30 d after medication,the occarrence of ADR. RESULTS:After treatment, left ventricular ejection fraction of observation group was significantly higher than that of control group,and central venous pressure and brain natriuretic peptide level were lower than those of control group,with statistically significance (P0.05). CONCLUSIONS:Recombinant human brain natriuretic peptide can significantly improve hemodynamic parameters and heart function of patients with acute decompensated heart failure,and effectively relieve dyspnea,lung rales and systemic edema. It is better than routine treatment in prognosis with good safety.
ABSTRACT
Objective:To evaluate the security of recombinant human brain natriuretic peptide (rhBNP)in the treatment of acute decompensated heart failure (ADHF ), and to provide the basis for its application.Methods:Both foreign language databases including PubMed,The Cochrane Library (Issue 1,2015),EMBase and Chinese databases involving CNKI,VIP and Wanfang Data were searched.Two reviewers independently extracted the data,and assessed the quality;then the Meta-analysis was performed by using RevMan 5.1 software and Stata 12.0 software.Results:A total of 35 randomized controlled trials (RCTs)involving 12 143 patients were included. The results of Meta-analysis showed that compared with control group the 1-month mortality (RR=1.01,95%CI:0.85-1.21,P =0.88),3-month mortality (RR=0.89,95%CI:0.63-1.27,P =0.53)and 6-month mortality (RR = 0.97, 95% CI: 0.87 - 1.08,P = 0.59 )in rhBNP group had no statistical differences;no statistical difference was found in the incidence of side effects (RR=1.01,95%CI:0.71-1.43,P =0.97).The incidence of hypotension in rhBNP group was significantly higher than that in control group (RR= 1.42,95%CI:0.99 -2.03,P =0.06).Conclusion:Compared with dobutamine,vasodilator drugs and placebo,rhBNP doesn’t change the mortality and incidence of adverse reactions of the patients with ADHF,but increases the risk of hypotension.Clinical application of rhBNP should be reasonable and its effectiveness should be exerted sufficiently,meanwhile,as much as possible to avoid hypotension,etc.
ABSTRACT
Objective To compare the effects of levosimendan (Levo) and recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF). Methods Seventy-five patients were included into this randomized positive-controlled and parallel-group study to receive either Levo (Levo group), rhBNP (rhBNP group) or dobutamine therapy (control group). Heart rate, respiratory rate, 24-hour urine volume,improvement in six-minute walk-test after 72-h treatment were compared between three groups. The blood level of BNP and values of left ventricular end dia?stolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) after one-week treatment were compared between three groups. Results After 72-h treatment, heart rate and respiratory rate were significantly decreased, and 24-hour urine volume, six-minute walk-test were significantly increased in three groups (P0.05), but the LVEDD was improved barely (P>0.05). The improvements were more significant in Levo group and rhBNP group compared to those of control group (P<0.05). There were no significant differenc?es in improvements between Levo group and rhBNP group. The common adverse reactions were hypotension and ventricular premature beats. There were no significant differences in adverse event rates between three groups (P<0.05). Conclusion As compared with dobutamine, Levo and rhBNP have optimized efficacy, fewer side effects and good safety in the treatment of ADHF. They are worth of clinical application.
ABSTRACT
Objective To investigate the effects of recombinant human brain natriuretic peptide and sodium nitroprusside in the treatment of acute decompensated heart failure.Methods 82 patients with acute decompensated heart failure were randomly divided into observation group and control group,41 cases in each group.The control group was given sodium nitroprusside intravenous infusion therapy on the basis of routine treatment.The observation group was given recombinant human brain natriuretic peptide infusion treatment on the basis of control group treatment.The clinical efficacy was compared between the two groups.Results The total effective rate of the observation group was 95.12％,which was significantly higher than 75.61％ of the control group (x2 =5.33,P ＜ 0.05).After treatment,the left ventricular diastolic end diameter in the observation group [(67.38 ± 6.82) mm] was significantly lower than before treatment and control group after treatment (t =4.12,3.23,all P ＜ 0.05).After treatment,the left ventricular shot ejection fraction in the observation group [(48.91 ± 7.42)％] was significantly higher than before treatment and control group after treatment (t =3.92,3.77,all P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 9.76％,which of the control group was 7.32％.,the difference was not statistically significant (P ＞ 0.05).Conclusion Recombinant human brain natriuretic peptide combined with sodium nitroprusside could significantly improve the clinical curative effect of acute decompensated heart failure,improve heart function of patients,and inhibit myocardial remodeling.It had good security.
ABSTRACT
Objective To explore the interventional effect of recombinant human brain natri-uretic peptide(rhBNP)on the patients with sepsis induced myocardial dysfunction by comparing N-terminal pro-B-type natriuretic peptide(Nt-proBNP),troponin and left ventricular ejection fraction (LVEF).Methods Forty septic patients were admitted into department of critical care medicine from February 2013 to May 201 5.They were randomly divided into control group and rhBNP group,with 20 patients in each group.Both groups received early goal directed therapy(EGDT),and rhBNP group re-ceived additional therapy of rhBNP 1.5 μg/kg bolus,and then 0.075 μg·kg-1 ·min-1 for 48 h.Con-trol group received saline in the same way.Vasoactive agents were used to maintain blood pressure. Concentration of plasma Nt-proBNP and troponin were determined at baseline,on days 1,3,and 7 day by point of care (POCT ).LVEF was also detected by transthoracic echocardiography. Results Concentrations of plasma Nt-proBNP and troponin in rhBNP group were lower than control group on days 1 and 3 (P <0.05).On day 3,levels of Nt-proBNP and troponin in both groups were higher than the days 1 and 7 (P <0.01).LVEF in the rhBNP group was higer than control group on days 3 and 7 (P <0.05 or P <0.01);On day 3,LVEF in both groups was significantly lower than the pre-therapy and day 7 (P < 0.05 or P < 0.01 ).Conclusion rhBNP can improve sepsis induced myocardial dysfunction by decreasing the Nt-proBNP and troponin levels with increased left ventricular ejection fraction.
ABSTRACT
Objective To observe the efficacy and prognosis of recombinant human brain natriuretic peptide ( rhBNP) and conventional treatment in acute myocardial infarction patients undergoing percutaneous coronary intervention therapy complicated by acute of left heart failure. Methods Retrospective analysis of 229 cases of hospitalized patients with acute myocardial infarction undergoing percutaneous coronary intervention therapy in 24 hours after admission, complicating with acute left ventricular failure in Shenyang Military General Hospital from June 2012 to January 2014 were enrolled and devided into: the conventional heart failure therapy group (the control group, n=122) and the rhBNP plus conventional treatment group ( the treatment group, n =107 ) , according to the patient's economic conditions and wishes. Observed improvement in heart failure symptoms before and after treatment during hospitalization and follow-up and also the 30 days and 12 months mortality. Results After 72 hrs of treatment of heart failure, both groups had decrease in heart rates, systolic blood pressure and NT-proBNP levels as compared to pre-treatment levels ( all P ﹤ 0. 05 ) . The NT-proBNP levels and heart rate of the treatment group decreased more significantly compared to the control group (both P﹤0. 05). Compared with the control group, rhBNP which to be used 72 hrs, can improve the cardiac function of AMI patients with the ratio of KillipⅡ-Ⅲ(72. 9%vs. 54. 9%, P=0. 005). There was no significant differences between two groups in in-hospital mortality and early follow-up period ( 30 days ) ( P ﹥0. 05 ) . After 12 months of follow-up, the mortality of the treatment group was lower than the control group ( 6. 5% vs. 13. 9%, P = 0. 068 ) . Through logistic regression analysis, the value of NT-proBNP and whether patients were treated with rhBNP on the basis of the routine drug were independent influencing factors for mortality of 12 months. Conclusions Additional to standard conventional therapy for acute left heart failure in patients with acute myocardial infarction undergoing PCI, rhBNP can lower the 12 months mortality and improve prognosis.
ABSTRACT
Objective To study the clinical effect and prognosis of lyophilized recombinant human brain natriuretic peptide at different times for acute left heart failure.Methods A total of 58 consecutive patients diagnosed as acute left heart failure from February 2013 to February 2014 were randomly divided into early group (30 patients) and late group (28 patients).The patients in early group received lyophilized recombinant human brain natriuretic peptide and other common treatment immediately after arriving at hospital,and the patients in late group received lyophilized recombinant human brain natriuretic peptide until symptoms were hard to control.Results After treatment,the NYHA class and the levels of brain natriuretic peptide (BNP) and left ventricular ejection fraction (LVEF) in early group and late group were significant differences:(1.4 ± 0.5) grade vs.(2.6 ± 0.7) grade,(934.2 ± 52.4) ng/L vs.(1 632.5 ± 147.6) ng/L,(49.6 ± 5.4)％ vs.(31.2 ± 6.7)％,P ＜ 0.01 or ＜ 0.05.The average stay and expenses in early group were significandy less than those in control group:(11.2 ± 3.4) d vs.(19.7 ± 4.2) d,(15.8 ± 4.6) thousand Yuan vs.(27.4 ± 6.3) thousand Yuan,P ＜ 0.05.The total effective rate and survival rate in early group were significantly higher than those in late group:66.7％(20/30) vs.39.3％(11/28),P ＜ 0.05.Conclusion Earlier application of lyophilized recombinant human brain natriuretic can significantly improve the symptoms in acute left heart failure patients.
ABSTRACT
Objective: To explore the effect of intravenous recombinant human brain natriuretic peptide (rhBNP) on regional myocardium deformability in patients with anterior acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI). Methods: A total of 35 patients with anterior AMI who received primary PCI within 12 hours of symptom onset in our hospital from 2013-06 to 2013-12 were enrolled in this study and randomized into 2 groups: rhBNP group, the patients received intravenous rhBNP,n=18, Control group, the patients received standard intravenous nitrates,n=17, and the intravenous pumping administration maintained for 72 hours in both groups. The echocardiography was conducted at immediately, 7 days and 1 month after PCI respectively to compare the relative parameters. The occurrence of major adverse cardiac events (MACE) were followed-up for 6 months in all patients. Results: The baseline condition was similar between the two groups,P>0.05 , the parameters of echocardiography as LVEF and WMSI at immediately and 7 days after PCI were similar between the two groups,P>0.05. Compared with Control group, rhBNP group had the increased LVEF and decreased WMSI at 1 month after PCI ,P0.05; SRs, SEe and Sra were increased at 1 month after PCI, allP0.05. Conclusion: Intravenous administration of rhBNP could improve the regional myocardium deformability and the systolic/diastolic function in patients with anterior AMI after primary PCI.
ABSTRACT
The physiological mechanisms involved in isoproterenol (ISO)-induced chronic heart failure (CHF) are not fully understood. In this study, we investigated local changes in cardiac aldosterone and its synthase in rats with ISO-induced CHF, and evaluated the effects of treatment with recombinant human brain natriuretic peptide (rhBNP). Sprague-Dawley rats were divided into 4 different groups. Fifty rats received subcutaneous ISO injections to induce CHF and the control group (n=10) received equal volumes of saline. After establishing the rat model, 9 CHF rats received no further treatment, rats in the low-dose group (n=8) received 22.5 μg/kg rhBNP and those in the high-dose group (n=8) received 45 μg/kg rhBNP daily for 1 month. Cardiac function was assessed by echocardiographic and hemodynamic analysis. Collagen volume fraction (CVF) was determined. Plasma and myocardial aldosterone concentrations were determined using radioimmunoassay. Myocardial aldosterone synthase (CYP11B2) was detected by quantitative real-time PCR. Cardiac function was significantly lower in the CHF group than in the control group (P<0.01), whereas CVF, plasma and myocardial aldosterone, and CYP11B2 transcription were significantly higher than in the control group (P<0.05). Low and high doses of rhBNP significantly improved hemodynamics (P<0.01) and cardiac function (P<0.05) and reduced CVF, plasma and myocardial aldosterone, and CYP11B2 transcription (P<0.05). There were no significant differences between the rhBNP dose groups (P>0.05). Elevated cardiac aldosterone and upregulation of aldosterone synthase expression were detected in rats with ISO-induced CHF. Administration of rhBNP improved hemodynamics and ventricular remodeling and reduced myocardial fibrosis, possibly by downregulating CYP11B2 transcription and reducing myocardial aldosterone synthesis.
Subject(s)
Animals , Humans , Male , Aldosterone/blood , /metabolism , Heart Failure/drug therapy , Myocardium/metabolism , Natriuretic Agents/therapeutic use , Natriuretic Peptide, Brain/therapeutic use , Aldosterone/genetics , Cardiotonic Agents , Chronic Disease , Collagen/analysis , Disease Models, Animal , Echocardiography , Fibrosis/etiology , Heart Failure/chemically induced , Heart Failure/metabolism , Hemodynamics/drug effects , Isoproterenol , Long-Term Care , Myocardium/pathology , Natriuretic Agents/administration & dosage , Natriuretic Peptide, Brain/administration & dosage , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Recombinant Proteins/therapeutic use , Transcription, Genetic/drug effects , Ventricular Remodeling/drug effectsABSTRACT
Objective To observe the influence of recombinant human brain natriuretic peptide(rhBNP)on serum HMGB1 levels in canines'acute renal injury induced by endotoxin and explore its protective role of rhBNP in protecting canines'kidney against acute renal injury.Methods A total of 20 healthy dogs were randomly divided into four groups:blank group,sepsis shock group,low-dose intervention group and high dose intervention group, and there were 5 rats in each group.After establishing the model of canines'sepsis shock induced by endotoxin,15 canines (besides blank group)were randomly divided into 3 groups.As follows,5 μg/kg rhBNP was given to the low-dose intervention group,10μg/kg rhBNP was given to the high-dose intervention group.But nothing was given to control group.Systemic vascular resistance index(SVRI)at 0 h,2 h,4 h,8 h,12 h were observed by PICCO instrument.High mobility group box 1 protein (HMGB-1)and creatinine(CR)in blood samples at each time point were detected.After 12 hours,kidney samples were taken for histological examination.Results The results revealed that some renal tubulars epithelial cell were swelled,some epithelial cells were atrophy and interstitial cells swelled in control group under the light microscope.Kidney pathology score was 2-3.But these changes were improved in low-and high-dose intervention groups,and there were no significant difference in the latter two groups,kidney of both groups pathology score were 1-2.Compared with control group at the same point,CR of blood serum were significantly decreased in low-dose intervention group at 8 h,12 h(P<0.01), and high-dose intervention group significantly decreased at 4 h,8 h,12 h(P<0.01).Compared with low-dose intervention group at the same point,CR of blood serum in high-dose intervention group were significantly decreased at 4 h,8 h,12 h (P<0.05).Compared with control group at the same point, systemic vascular resistance index(SVRI)were significantly decreased in low-dose intervention group at 2 h (P<0.01 ),but significantly decreased in high-dose intervention group at 2 h and 4 h (P<0.01).Compared with low-dose intervention group at the same point,SVRI in high-dose intervention group were significantly decreased at 4 h (P<0.05 ).Compared with control group at the same point,the expressions of high mobility group box 1 protein (HMGB-1)in blood serum in low- and high-dose intervention groups were significantly decreased(P<0.01);Compared with low-dose intervention group at the same point,the expressions of HMGB-1 in blood serum in high-dose intervention group were significantly decreased (P<0.05).Conclusion rhBNP can effectively reduce canine kidney tissue injury mediated by endotoxin and improve kidney function,reduce SVRI,and its therapeutic effect of rhBNP was in a dose-response relationship.rhBNP can effectively reduce HMGB-1 levels in blood serum of sepsis shock canines,which may be associated with the decrease of late inflammatory factor HMGB1.