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<b>Objective::Evaluate the effects of Danhong injection for perioperative percutaneous coronary intervention (PCI) on cardiac function and thrombolysis in myocardial infarction (TIMI) in patients with acute myocardial infarction (AMI). <b>Method::Computer retrieving CNKI, Wanfang database, VIP database, PubMed, CBM, Web of Science, The Cochrane Library, gathering Danhong injection in percutaneous coronary intervention perioperative application in the treatment of acute myocardial infarction clinic trials. The Cochrane risk evaluation is adopted to improve the quality of literature evaluation, with Revman 5.3 software for Meta-analysis. <b>Result::Participants included in 12 clinic trials contains a total of 1 131 patients, including 569 patients in Danhong treatment and 562 patients in control group. The results showed that compared with conventional treatment, Danhong injection treated patients had LVEF increased obviously [mean difference (MD)=6.62, 95% confidence interval (CI) (4.91, 8.34), <italic>P</italic><0.000 01], the number of TIMI class 3 patients significantly increased[relative risk (RR)=0.22, 95%CI(0.12, 0.41), <italic>P</italic><0.000 01], and BNP levels significantly decreased [MD=151.86, 95%CI (-247.00, -56.72), <italic>P</italic>=0.002]. <b>Conclusion::Danhong injection can improve the function of acute myocardial infarction after percutaneous coronary intervention.
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Transfusion-associated circulatory overload (TACO) is recently becoming more important than transfusion-related acute lung injury (TRALI) in terms of the number of patients with definite diagnosis as well as its prognosis. In order to diagnose TACO, it is helpful to recognize early the symptoms suspicious of transfusion reaction through electronic medical record system and computer network, and this will be of help for obtaining samples for brain natriuretic peptide (BNP) measurement before and after the onset of transfusion reaction. We report a case in which a transfusion reaction was diagnosed as TACO. A 62-year-old woman was admitted to the emergency room due to bleeding tendency. Two fresh frozen plasma units and one unit of leukocyte-reduced red blood cells were transfused. Blood pressure increased during transfusion, and the chest X-ray showed findings suggestive of newly developed pulmonary edema. N-terminal prohormone of BNP (NT-proBNP) test was carried out using the specimens in refrigerated storage. Compared with the NT-proBNP level measured 12 hours before the transfusion, that measured 6 hours after the transfusion was markedly increased (>48 fold of pre-transfusion level). As a result, this case was diagnosed with TACO.
Subject(s)
Female , Humans , Middle Aged , Acute Lung Injury , Blood Pressure , Diagnosis , Electronic Health Records , Emergency Service, Hospital , Erythrocytes , Hemorrhage , Natriuretic Peptide, Brain , Plasma , Prognosis , Pulmonary Edema , Thorax , Transfusion ReactionABSTRACT
Objective: To investigate the role of common clinical indicators in volume assessments of peritoneal dialysis (PD) patients. Methods: Eligible PD patients in Renji Hospital, Shanghai Jiao Tong University School of Medicine from Nov. 2016 to Nov. 2017 were enrolled. Demographic data of patients were collected and clinical parameters were measured. Hydration status index overhydration (OH) was measured by bioimpedance spectroscopy, and the association between clinical indicators and OH was analyzed. Results: A total of 200 PD patients aged 56.3±13.8 years with median PD duration of 46.6 months were enrolled in the study. Among them, 117 (58.5%) patients were males and 42 (21.0%) patients were diabetic. 141 (70.5%) patients in the present study were overhydrated (OH>1.1 L). Compared to those with normal hydration, the overhydrated patients had higher blood pressure, more obvious edema and higher brain natriuretic peptide (BNP) level (P<0.05). In the overhydrated patients, 51 (36.2%) patients had normal blood pressure, 67 (47.5%) patients had no edema and 46 (32.6%) patients had BNP less than 100 pg/mL. In the normal hydrated patients, 20 (33.9%) patients had high blood pressure, 8 (13.6%) patients had edema and 1 (1.7%) patient had BNP higher than 400 pg/mL. Systolic pressure and BNP level were both correlated with OH positively (systolic pressure r=0.361, P=0.001; BNP r=0.615, P=0.000). The patients who had more obvious edema also had higher OH (P=0.000). Conclusion: Blood pressure, edema and BNP are closely associated with the hydration status, but only one of these clinical indicators can not accurately reflect the hydration status in all PD patients. Combination of different indicators may be useful in evaluation of hydration status in PD patients.
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BACKGROUND: Recently, quantitative point-of-care testing (POCT) for cardiac markers using colloidal gold particles was developed in Korea. We evaluated the analytical performance of the HUBI-QUANPRO (Humasis, Korea) assay in comparison with two other assays. METHODS: We evaluated the analytical precision and linearity of HUBI-QUANPRO creatine kinase (CK)-MB, cardiac troponin I (cTnI), and B-type natriuretic peptides (BNP). HUBI-QUANPRO assay was compared with ADVIA Centaur (Siemens, Germany) and Triage (Biosite Diagnostics, USA) assays by using 100 blood samples. In addition, we evaluated the interference of hemoglobin on the HUBI-QUANPRO assay. RESULTS: The coefficients of variation of HUBI-QUANPRO CK-MB, cTnI, and BNP were 7.5-9.7%, 12.0-17.4%, and 14.7-15.7%, respectively. The linearity ranges of HUBI-QUANPRO CK-MB, cTnI, and BNP were 4.7-27.8 ng/mL, 0.76-6.51 ng/mL, and 76.2-762.2 ng/mL, respectively. The comparison study showed no significant difference among them. When 0.5% hemolysis occurred, remarkable hemoglobin interference was found in the three markers resulting in underestimation of the concentrations. CONCLUSIONS: HUBI-QUANPRO CK-MB and BNP showed good analytical performances compared with the other two assays. Hemoglobin interference was noted in the HUBI-QUANPRO assay, especially more in BNP. Although the linearity range of cTnI was narrow, its agreement rate with ADVIA Centaur was good, thus the HUBI-QUANPRO assay could be useful as a quantitative POCT for cardiac markers in the emergency department.
Subject(s)
Creatine Kinase , Emergencies , Gold Colloid , Hemoglobins , Hemolysis , Korea , Natriuretic Peptides , Triage , Troponin IABSTRACT
@#Objective To explore the variance of plasma brain natriuretic peptide (BNP) concentrations in the aged patients after noncardiac surgery and its significance. Methods 101 patients undergoing elective noncardiac surgery were divided into two groups based on the BNP concentrations before surgery: group A: BNP≤100 ng/L，n=61; group B: BNP>100 ng/L，n=40. The BNP concentrations before and after noncardiac surgery and the incidence of cardiac events in both groups were compared. Results There was no significant difference （P>0.05） of BNP concentrations before and after noncardiac surgery in group A, which were (58.2±28.7) ng/L and (53.7±25.9) ng/L respectively, but was significant difference （P<0.05） in group B, which were (147.3±72.1) ng/L and (341.5±92.4) ng/L respectively. There was significant difference （P<0.05） between group A, in which no patient happened cardiac event, and group B, in which 14 patients happened. Conclusion The plasma BNP concentration would be increased significantly in the aged patients with a BNP concentration>100 ng/L before surgery, which may cause more cardiac events.
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Objective To explore the relationship between the extent of coronary artery lesions and plasma brain natriurefic peptide(BNP)levels in the patients with coronary artery disease(CAD)except for congestive heart failure(CHF).Method Seventy CAD patients without CHF evidenced by dinical manifestation and coronary arte- riography(CAG)from Cardiology Depamnent of the First Affiliated Hospital of Zhejiang University School of Medicine,China,were enrolled in the study.These patients were diagnozed under coronary arteriography(CAG) during March to May of 2007.They were divided into 3 groups:stable angina goup(24 patients),unstable angina group(25 patients),myocardial infarction group(21 patients).Twenty patients without coronary history and with normal CAG served as controls.Plasma BNP concentrations were measured with ELASA before CAG.The coronary lesion vessels and scores were estimated after CAG.The relationship between BNP levels and the coronary lesion vessels,as well as scores in CAD was analyzed.The data were expressed as(x±s)and was analyzed by using 2 independent samples test and spearman correlation with SPSS 13.0.A P value less than 0.01 indicated statistical significance.Results The plasma BNP concentrations in the patients,especially in the patients with myocardial infarction,were significantly higher than those in the controls.Spearman analysis showed that there was a positive correlation between the BNP levels and coronary lesion vessels(r1=0.309,P=0.01),also between BNP and coronary lesion score(r2=0.279,P=0.01).Conclusions In the patients without congestive heart failure,the more serious the coronary artery lesions,the higher the plasma BNP concentrations were.The degree of myocardial ischemia caused by coronary artery lesions was correlated with the plasma BNP level.Plasma BNP concentration could be valuable for the extent of coronary artery lesions in the patients of coronary artery disease.
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0.05).②The mean of SV, the mean of CO and the mean of CI in acute SAH group were lower than those in healthy persons group respectively (33.46?11.33 vs 52.67?12.46,P
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Objective to observe plasma Brain Natriuretic Peptide level by use of low dose Betaloc for congestive heart failure.Methods We chose 31 heart failure patients with Ⅲ～Ⅳ New York Heart Association (NYHA)functional classification,and used low dose Betaloc on the basis of traditional treatment,then observed the changement of plasma Brain Natriuretic Peptide level during treatment. Results After treatment,patients' heart rate, blood pressure ,cardio-thoracic ratio and LVDd all descended,but LVEF increased.The value of BNP declined obviously,after the use of the Betaloc.Conclusions We treated congestive heart failure with low dose Betaloc,the availability ratio was more than 80%,and the value of BNP declined obviously.It implied dynamic monitoring plasma Brain Natriuretic Peptide was helpful in understanding treatment effect and prognosis.
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Brain natriuretic peptide(BNP) is a recently discovered novel neuropeptide of 26 amino acid residues, isolated from porcine brain, that is of similar potency to atrial natriuretic factor(ANF) in natriuretic, diuretic, hypotensive and smooth muscle relaxant activities. we used a highly selective antisera against BNP raised in rabbit to observe its distribution and localization in some brain areas and some other peripheral tissues by utili zing high sensitive avidin-biotin-peroxidase complex technique. Positive brain natriuretic peptide immunoreactive (BNPir) fibers and cell bodies were observed in the lateral hypothalamic area, caudate-putamen, hippocampus, amygdala, and supraoptic and paraventricular nuclei. A lot of BNPir granules were also found in rat atria. They were of similar localization to that of ANF. Most of the specific granules were accumulated in cytoplasm at both nuclear poles of atrial myocytes. The BNP immunoreactivity is less intense than that of the ANF. Some of scanty, diffuse and fine BNPir granules could also be observed in ventricular myocytes.The coexistence of both BNP and ANF in the brain and heart indicates that BNP may function as a neuropeptide and circulating hormone, and suggests the possibility that the physiological effects such as diuretic natriuretic, hypotensive and smooth muscle relaxant activities so far thought to be mediated by ANF may be regulated through a dual mechanism involving both BNP and ANF. In addition, some BNPir positive cells were also present in the anterior and intermediate lobes of rat pituitary gland. The significance of BNP in hypophysis would be elucidated in the further studies.