Predictive values of baseline plasma B-type natriuretic peptide levels for short-term clinical efficacy of recombinant human brain natriuretic peptide in heart failure patients

Abstract

Objective To evaluate the predictive values of baseline plasma B-type natriuretic peptide(BNP)levels for short-term clinical efficacy of recombinant human brain natriuretic peptide(rhBNP)in patients with heart failure. Methods A total of 46 heart failure patients including 24 males and 22 females were selected between December 2012 and December 2013.For these patients rhBNP was used subsequent to appropriate conventional therapies for heart failure.24 hours fluid input and output were recorded before and the first, second, third 24 hours after drug used.The difference value of 24-hour output day 1, day 2, day 3 after rhBNP and 24-hour output before rhBNP was defined as primary endpoint.The degree of improvement in overall clinical condition was also recorded after drug used.Baseline plasma concentrations of BNP were measured before rhBNP administration.According to the plasma BNP quartile to compare diuretic effect and degree of improvement in overall clinical status.Bivariate correlation was used to analyze the relationship between baseline BNP levels and the diuretic effect. Results The baseline BNP concentrations ranged from 380 pg/ml to 5 000 pg/ml, with a median of 1 225 pg/ml.According to the plasma BNP quartile, diuretic effect of the first 24 hours after drug administration showed a significant difference among four groups(F=3.132, P=0.035). There was a significant negative correlation between baseline BNP levels and the diuretic effect of the first 24 hours(r=-0.412, P<0.01). A negative correlation trend was found between baseline BNP value and the diuretic effect of the second 24 hours(r=-0.059, P=0.69). The diuretic effect of the third 24 hours and baseline plasma BNP values were negatively correlated(r=-0.292, P=0.049). The degree of improvement in overall clinical status was statistically significant among the BNP groups(χ2=18.815, P=0.03). Conclusions The heart failure patients with higher BNP levels have a poor short-term clinical efficacy after rhBNP administration than the patients with lower BNP levels.The short-term diuretic effect of rhBNP is negatively correlated with baseline plasma BNP levels.Baseline BNP levels can be used to predict the short-term clinical efficacy of rhBNP in heart failure patients. Key words: Natriuretic peptide, brain; Heart failure; Treatment outcome