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Objective: To investigate the effects of acetaminophen on the hemodynamics, left ventricular function and plasma level of brain natriuretic peptide (BNP) in the premature young rats, and to clarify its mechanism in the treatment of patent ductus arteriosus (PDA) in the premature infants. Methods: The pregnant rats were injected intraperitoneally with lipopolysaccharide (LPS) to prepare the premature young rat models. The premature young rats were divided into model control group (n=18) and administration group (n= 19); another 10 young rats with normal gestratonal age were selected and used as blank control group. The young rats in blank control group didn' t receive any treatment, the young rats in model control group were not given any drug, and the premature young rats in administration group were continunously administrated with acetaminophen for 3 d. Color Doppler ultrasonography was used to detect the hemodynamic parameters of the young rats in various groups, including left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd), fractional shortening (FS), left ventricular end-systolic volume (ESV), and left ventricular end-diastolic volume (EDV). The plasma BNP levels of young rats were detected. Results: The body weights of the young rats in administration group and model control group were lower than that in blank control group ( P0.05). Compared with blank control group, the plasma BNP level of the young rats in model control group was significantly increased (P= 0.004); compared with model control group, the plasma BNP level of the young rats in administration group was significantly decreased (P= 0.009). Conclusion: Acetaminophen can protect the left ventricular function of the young rats by improving the hemodynamic indicators and reducing the plasma BNP level.
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Objective To explore the clinical effect of non-invasive positive pressure ventilation(NPPV)for treatment of acute left heart failure after mitral valve replacement. Methods Sixty patients with acute left heart failure after mitral valve replacement in Xinxiang Central Hospital from April 2009 to August 2017 were selected. The patients were divided into control group and NPPV group,with 30 patients in each group. The patients in the control group were treated with double oxygen ab-sorption (mask and nasal catheter),strong heart,diuresis and dilated blood vessels. Based on the treatment of control group, the patients in NPPV group were treated with NPPV therapy. The plasma N-terminal pro-B-type natriuretic peptide(NT-proB-NP)level of patients in the two groups was monitored by rapid determination of immunofluorescence before treatment and 6,24 hours after treatment. The respiratory frequency,blood oxygen saturation,heart rate and oxygen partial pressure monitoring of patients in the two groups was monitored before treatment and 2,6 and 24 hours after treatment. Results The total effective rate of patients in the control group and NPPV group was 92. 4％(26 / 28)and 96. 6％(28 / 29)respectively;there was no sig-nificant difference in the total effective rate between the two groups(χ2 = 1. 25,P > 0. 05). There was no significant difference in the plasma NT-proBNP level between the two groups before treatment (P > 0. 05);the level of NT-proBNP at 6,24 h after treatment was significantly lower than that before treatment in the two groups (P < 0. 05);the level of NT-proBNP of patients in the NPPV group was significantly lower than that in the control group at 6,24 h after treatment (P < 0. 05). There was no significant difference in the respiratory frequency,blood oxygen saturation,heart rate and oxygen partial pressure between the two groups before treatment(P > 0. 05). Compared with before treatment,the respiratory frequency and heart rate of patients were decreased and the blood oxygen saturation,oxygen partial pressure were increased at 2,6,24 h after treatment in the two groups (P < 0. 05). There was no significant difference in the oxygen partial pressure between the two groups at 2 h after treat-ment(P > 0. 05);the oxygen partial pressure of patients in the NPPV group was significantly higher than that in the control group at 6,24 h after treatment(P < 0. 05);there was no significant difference in the respiratory frequency,blood oxygen satu-ration and heart rate between the two groups at each time piont after treatment(P > 0. 05). Conclusion NPPV is an effective treatment for acute left heart failure after mitral valve replacement.
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Objective To investigate the value of brain natriuretic peptide and heart failure ultrasound in the diagnosis of early chronic heart failure.Methods One hundred and forty-six patients with chronic heart failure and seventy-five healthy people with normal heart function were involved.According to NYHA classification,patients with chronic heart failure were divided into grade Ⅰ,Ⅱ,Ⅲ and Ⅳ,including grade Ⅰ twenty six,grade Ⅱ forty three,grade Ⅲ forty eight and grade Ⅳ twenty nine patients.Results There was no significant difference in the general information between patients with chronic heart failure and healthy people with normal heart function (P ＞ 0.05),including age,sex,ALT,AST,fasting blood glucose,total cholesterol,triglyceride,serum creatinine and CRP.The BNP of the two groups were compared,and we found the BNP of grade Ⅱ (181.19 ±48.06),Ⅲ (279.26 ±49.45) and Ⅳ (882.34 ± 388.71) patients was significantly higher than healthy people (54.12 ± 25.87),and with the severity of heart failure,BNP increased gradually.There was statistically significant the difference (P ＜ 0.05).but there was no significant difference between the patients of grade Ⅰ (77.14 ± 24.32) and healthy people (P ＞ 0.05).Compared with healthy people(0.78 ± 0.42),HFEI was significantly higher in patients with chronic heart failure.The HFEI of grade Ⅰ (1.58 ± 0.89),Ⅱ (2.64 ± 1.07),Ⅲ (4.47 ± 1.39) and Ⅳ (6.33 ± 1.61) were compared,we found HFEI increased gradually with the severity of heart failure,and the difference was statistically significant (P ＜ 0.05).From the analysis between BNP and HFEI,we found that BNP was significantly positively correlated with HFEI in patients with chronic heart failure (r =0.935,P =0.000).From ROC curve analysis,the area under the ROC curve of early chronic heart failure was 0.970,showing that plasma BNP combined with HFEI could be accurately diagnosed early chronic heart failure.Conclusion We find plasma brain natriuretic peptide and heart failure echocardiography index can be used in early diagnosis of chronic heart failure.
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Objective To explore the influence of trimetazidine on left cardiac systolic function and plasma brain natriuretic peptide(BNP)in alcoholic cardiomyopathy.Methods 60 cases of alcoholic cardiomyopathy in our hospital from December 2014 to December 2015 were chosen to research,and they were divided into observation group and control group by random number table,30 patients in each group.The control group was treated with bisoprolol combined with strengthening heart,diuretic and other treatment,the observation group was treated with trimetazidine on the basis of routine treatment.Left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter (LVEDD),each sub output(CO)after 6 months'treatment were compared.Results LVEF of the observation group was from pre -treatment (34.8 ±5.4)% up to (47.4 ±5.5)%,LVEDD value (49.1 ±6.5)min and CO values (5.6 ±0.7)L/min were significantly better than the control group[(53.4 ±7.5)min,(4.9 ±0.7)L/min],the differences were statistically significant(t =2.373,3.873,all P <0.05).BNP level of the observation group after treatment was significantly lower than control group[(455.8 ±133.2)fmoL/mL vs (542.7 ±128.3)fmoL/mL,t =2.574,P <0.05)].The total effective rate of the observation group (96.67%)was higher than that of the control group (80%),and the difference between the two groups was significant (χ2 =13.09,P <0.05 ).Conclusion Alcoholic cardiomyopathy should pay attention to the daily scientific daily routine,take measure to quit smoking and alcohol.Trimetazidine could effectively improve the left ventricular systolic function,decrease the level of BNP,thus is worthy of clinical application.
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Objective To explore the value of plasma brain natriuretic peptide test in the diagnosis and treatment of elderly heart failure patients with normal ejection fraction,and to provide reference for clinical diagnosis and treatment of the disease.Methods 104 patients with heart failure were selected,at the same time,30 elderly patients with normal heart function in our hospital were selected as the control group.The plasma brain natriuretic peptide and cardiac color Doppler ultrasound were examined.The plasma brain natriuretic peptide and left ventricular ejection fraction,left ventricular posterior wall thickness,left ventricular mass index,left ventricular diastolic diameter and ventricular septal thickness were compared between two groups ; at the same time,peptide and left ventricular plasma brain natriuretic ejection fraction were compared in heart failure patients with different levels of NYHA.Results The plasma level of brain natriuretic peptide,left ventricular posterior wall thickness,left ventricular mass index in the heart failure group were (401.37 ± 368.63) ng/L,(13.42 ± 1.33) mm,(130.62 ± 9.18) g/m2,which were significantly higher than those of the control group (all P ＜ 0.05).The left ventricular ejection fraction of the heart failure group was (51.36 ±4.41) ％,which was significantly lower than the control group(P ＜0.05).The left ventricular ejection fraction of patients with different NYHA grading in the heart failure group was significantly lower than that of the control group(all P ＜0.05),plasma brain natriuretic peptide levels in patients with different NYHA grading were significantly higher than those in the control group,and with the elevated levels of NYHA classification,the plasma brain natriuretic peptide level increased significantly(P ＜ 0.05).Conclusion The level of plasma brain natriuretic peptide in elderly heart failure patients with normal ejection fraction was significantly increased,and with the increase of NYHA grade,plasma brain natriuretic peptide level rised,it is important to assess diagnosis and severity of this disease.
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Objective To investigate the effect of salvianolate on chronic heart failure in patients with cardiac function and plasma brain natriuretic peptide effect.Methods Sixty-eight cases with chronic heart failure patients were randomly divided into treatment group and control group (34 cases for each group).Patients in control group were given the conventional treatment,in treatment groups were given conventional treatment plan plus salvianolic acid at dose of 0.2 g added 5％ glucose injection 250 ml (or 0.9％ sodium chloride injection 250 ml),1 times a day for 12 weeks.The cardiac function was recorded and brain natriuretic peptide level was measured before and after treatment.Results After 12 weeks of treatment,the total efficiency in treatment group was 91.2％ (31/34)) higher than that in control group(70.6％ (24/34)),and the difference was statistically significant (x2 =9.399,P ＜ 0.01).Before treatment,the left ventricular ejection fraction (LVEF),stroke volume(SV),cardiac output(CO) in treatment group were (38 ±6)％,(44.64 ± 11.03) ml,(4.81 ± 1.03) L/min respectively,differed from that after treatment ((51 ± 8) ％,(63.21 ± 11.94) ml,(5.67 ± 1.17) L/min),and there were significant differences between before and after treatment (t =-7.580,-8.975,-3.233 respectively; P ＜ 0.01).The levels of systolic blood pressure,diastolic blood pressure,heart rate,left ventricular end-diastolic internal diameter (Dd),the left ventricular diastolic wall thickness (PWT),diastolic interventricular septal thickness (IVST),left ventricular mass (LVMW),brain natriuretic peptide in treatment group before treatment were (131 ± 11) mmHg,(85 ± 7) mmHg,(116 ± 9) times/min,(55.1 ± 7.9) mm,(11.8 ± 2.4) mm,(11.4 ± 2.3) mm,(231 ± 112) g,(572.9 ± 183.6) ng/L respectively,significant differed from those of after treatment((104 ± 7) nmHg,(76 ± 8) mmHg,(75 ± 7) times/min,(48.8 ± 3.9) mm,(9.2±1.3) mm,(8.9± 1.1) mm) (172 ±57) g,(101.8 ± 18.5) ng/L respectively),and the differences were significant (t =12.075,4.937,20.961,4.169,5.556,5.721,2.738,14.886 ; P ＜ 0.01).The levels of LVEF,SV in control group before treatment were (37 ±7)％ and (44.87 ± 10.82) ml,differed from those of after treatment((42 ± 9)％ and (56.70 ± 10.60) ml;t =-2.556,-4.554;P ＜ 0.01).The systolic blood pressure,heart rate,Dd,IVST,plasma brain natriuretic peptide in control group before treatment were (130 ±12) mmHg,(114 ± 10) times/min,(54.8 ± 8.7) rmm,(11.3 ± 2.6) mm,(574.1 ± 181.4) ng/L respectively,significantly differed from those of after treatment ((115 ± 9) mmHg,(76 ± 8) times/min,(50.6 ±8.3) mm)(9.9±1.3) mm,(215.7 ±23.2) ng/L;t=5.830,17.304,2.037,2.806,11.427;P＜0.01 or P ＜ 0.05).The levels of systolic blood pressure,diastolic blood pressure,LVEF,SV,CO,PWT,IVST,plasma brain natriuretic peptide in treatment group were better than that in control group (t =-4.601,-3.093,4.358,3.253,2.802,-3.066,-3.425,-27.985,P＜0.01).Conclusion Salvianolate is proved to be better drug on treating chronic heart failure curative with left ventricular reverse effect and less adverse reaction.
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PURPOSE: The purpose of this study is to clarify the effect of hemodynamic changes of ductal shunt on brain natriuretic peptide(BNP) secretion and to investigate the value of plasma BNP level as a predictor of spontaneous closure of ductus arteriosus(DA) in healthy preterm infants. METHODS: 24 preterm infants were enrolled. Echocardiographic examinations and blood samplings of BNP were carried out in 24 hours, 72 hours and on 5th days after birth. The magnitudes of ductal shunts were estimated using ductal color Doppler flow pattern, left atrial/aortic root ratio(LA/Ao ratio) and antegrade peak diastolic flow velocity(APDFV) in left pulmonary artery. RESULTS: DA in healthy preterm infants were closed spontaneously within 5 days of birth. Plasma BNP levels in infants with ductal shunt were higher than that of infants without shunt in 24 hours and then significantly decreased within 72 hours of birth according to the decreases of flow in ductal shunts. BNP levels of all infants with ductal shunt were significantly correlated with LA/Ao ratio and APDFV. CONCLUSION: Reduction of BNP levels may serve as an indicator of spontaneous closure of DA in healthy preterm infants. Its levels show significant correlations with the magnitudes of ductal shunt. Therefore BNP levels may be used in determining the necessity of and the optimal time to initiating medical and surgical management of preterm infants with significant PDA.