Human Brain Natriuretic Peptide Research Articles

The Protective Effect of rhBNP on Postresuscitation Myocardial Dysfunction in a Rat Cardiac Arrest Model.

Purpose We investigated the protective effects and the underlying mechanisms through which recombinant human brain natriuretic peptide (rhBNP) acts on postresuscitation myocardial dysfunction (PRMD) in the cardiac arrest (CA) model. Methods Ventricular fibrillation was induced and untreated for 6 min. And the time of cardiopulmonary resuscitation was 8 min, after which defibrillation was attempted in this rat model. 24 Sprague Dawley rats (450–550g) were randomized into cardiopulmonary resuscitation (CPR) + rhBNP and CPR + placebo groups after restoration of spontaneous circulation (ROSC). rhBNP was infused at PR 30 min (loading dose: 1.5 µg/kg, 3 min; maintenance dose: 0.01 µg/kg, 3 min; maintenance dose: 0.01 α (TNF-α (TNF-α (TNF-κB (NF-κB (NF-Results The administration of rhBNP attenuated the severity of PRMD and myocardial tissue injuries, with improvement of MAP (mean arterial blood pressure), ETCO2 (end-tidal CO2), serum level of NT-proBNP, EF, CO, and MPI values. The serum levels and protein expression levels in myocardial tissue of IL-6 and TNF-α (TNF-κB (NF-Conclusion Our research demonstrated that the administration of rhBNP attenuated the severity of PRMD and myocardial tissue injuries and increased the 24 h survival rate in this CA model. rhBNP administration also reduced the serum and myocardial tissue levels of IL-6 and TNF-α after ROSC, likely due to the suppression of the TLR4/NF-κB signaling pathway and the regulation of inflammatory mediator secretion.α (TNF-κB (NF-

Therapeutic effects of recombinant human brain natriuretic peptide on sepsis-associated encephalopathy in mice

There is little information in the sepsis treatment guidelines on the prevention and treatment of cognitive dysfunction after sepsis. This study aimed to explore whether Recombinant human brain natriuretic peptide (rhBNP) has protective effects against sepsis-associated encephalopathy (SAE) in a mouse model. The results showed that 50 μg/kg of rhBNP significantly improved the 14-day survival of cecal ligation and puncture (CLP)-induced septic mice and mitigated cognitive dysfunction and anxiety. Fourteen days after CLP surgery, septic mice showed increased BBB permeability and neuronal apoptosis. rhBNP treatment significantly reduced pathological changes in the brain of CLP mice. Meanwhile, rhBNP therapy also reduced the level of inflammatory cytokines in the hippocampus, possibly via inhibiting the TLR4-NF-κB pathway. These results indicate that rhBNP may be a promising drug for the treatment of SAE.

Brain natriuretic peptide in patients with acute ischemic stroke: Role of statins

Background: Acute ischemic stroke (AIS) is associated with disturbances in brain natriuretic peptide (BNP) serum levels. Therefore, the objective of this study is to illustrate the potential effects of atorvastatin and rosuvastatin on BNP in patients with AIS. Methods: A total of 88 patients with AIS with or without statins therapy compared with 22 healthy controls were recruited. The patients with AIS were divided into: Group A: Patients with AIS on statins therapy (atorvastatin or rosuvastatin), (n = 44) and Group B: Patients with AIS not were on statins therapy (n = 22). Body mass index, blood pressure profile, lipid profile, and serum levels of human BNP were measured. As well, stroke risk score (SRS) was assessed in all involved patients and healthy volunteers. Results: BNP serum level was higher in patients with AIS compared with healthy controls (P = 0.0006). It was higher in patients with AIS not were on statins therapy (29.96 ± 17.21 μg/dL) as compared with patients with AIS on statins therapy (21.66 ± 14.22 μg/dL), P

Roles of small-dose recombinant human brain natriuretic peptide without bolus in Chinese older patients with septic cardiac dysfunction.

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. As one of the most common organs is affected by sepsis, cardiac dysfunction increases adverse prognosis. This study was designed to analyze the roles of small-dose recombinant human brain natriuretic peptide without bolus in Chinese older patients with septic cardiac dysfunction. This study recruited 250 Chinese older patients with sepsis cardiac dysfunction in intensive care unit. Participants were randomly allocated into the control group (n = 125) and recombinant human brain natriuretic peptide group (n = 125). The control group received early goal-directed therapy, and the recombinant human brain natriuretic peptide group received recombinant human brain natriuretic peptide therapy in addition to early goal-directed therapy. There was no significant difference in medical histories, infection types, failing organs, mortality within 28days [37 (29.6%) vs. 34 (27.2%)], intensive care unit stay [27 (21.6) vs. 22 (17.6)] and hospital stay [41 (32.8%) vs. 37 (29.6%)] between the control and recombinant human brain natriuretic peptide groups (P > 0.05 for all). Lengths of intensive care unit [16 (13-22) days] and hospital stay [25 (22-30) days] in the recombinant human brain natriuretic peptide group were significantly shorter than in the control group [21 (14-23) days; 27 (23-30) days; P < 0.05 for all]. There was no significant difference in mean daily Sequential Organ Failure Assessment score between the two groups (P > 0.05 for all). Cardiovascular and respiratory scores (P < 0.05 for all) but not other organ scores (P > 0.05 for all) were significantly lower in the recombinant human brain natriuretic peptide group than in the control group. Small-dose recombinant human brain natriuretic peptide was unable to lower the mortality and improve the liver, renal, and coagulation functions, but able to shorten the length of hospital stay and improve the cardiovascular and respiratory functions in Chinese older patients with septic cardiac dysfunction.

Integration of multiple computer modeling software programs for characterization of a brain natriuretic peptide sandwich DNA aptamer complex

Several molecular modeling programs including Pep-Fold 3, Vienna RNA, RNA Composer, Avogadro, PatchDock, RasMol, and VMD were used to define the three-dimensional and basic binding characteristics of an extant sandwich DNA aptamer assay complex for human brain natriuretic peptide (BNP). In particular, the theoretical question of demonstrating likely binding of 72 base capture and reporter aptamers to at least two separate "epitopes" or binding sites on the small 32-amino acid BNP target was addressed, and the data support the existence of separate aptamer binding sites on BNP. The binding model was based on first docking BNP to the capture aptamer based on shape complementarity with PatchDock, followed by docking the capture aptamer-BNP complex with the reporter aptamer in PatchDock. Although, shape complementarity clearly dominated this binding model and aptamers are known to be somewhat flexible, the model demonstrates hydrogen bond stabilization within each of the two different aptamers and between the aptamers and the BNP target, thus suggesting a strong binding and high affinity sandwich assay that matches the author's former published assay results (Bruno et al., Microchem. J. 2014;115:32-38) with subpicogram per milliliter sensitivity and good specificity. Other aspects such as capture and reporter aptamer interactions in the absence of BNP are illustrated and suggest means for potentially improving the existing assay by truncating the capture and reporter aptamers where they overlap to further decrease background signal levels.

Effect of recombinant human brain natriuretic peptide on the cardiac function and serum N terminal pro-B-type natriuretic peptide level in elderly patients with heart failure

Objective To analyze the effect of recombinant human brain natriuretic peptide (rhBNP) on the cardiac function and serum N terminal pro-B-type natriuretic peptide (NT-proBNP) level in elderly patients with heart failure. Methods From January 2015 to December 2017, 150 elderly patients (aged 80 years) with heart failure in the 117th Hospital of the Chinese People′s Liberation Army were selected in the research.According to the digital random list method, the patients were divided into two groups, with 75 cases in each group.The control group was given nitroglycerin treatment, and the observation group was given rhBNP treatment.The levels of serum NT-proBNP, left ventricular ejection fraction (LVEF), clinical efficacy and complications were compared between the two groups. Results After treatment, the levels of serum NT-proBNP in the two groups were significantly lower than before treatment, and the level of NT-proBNP in the observation group [(2 964.42±607.25)pg/mL] was significantly lower than that in the control group [(4 213.57±524.07)pg/mL] (t=13.49, P 0.05). Conclusion rhBNP in the treatment of elderly patients with heart failure can effectively improve the symptoms of dyspnea and systemic symptoms, reduce serum NT-proBNP levels, improve heart function, and will not cause serious complications, with good safety, so it is worthy of clinical promotion and application. Key words: Heart failure; Natriuretic peptide, brain; Heart function tests; Aged; Comparative effectiveness research

Effect of recombinant human brain natriuretic peptide on myocardial enzymes and cardiac function after percutaneous coronary intervention in patients with acute myocardial infarction

Purpose: To study the effect of recombinant human brain natriuretic peptide rhBNP on myocardial enzymes and cardiac function following percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) subjects.Methods: Patients with AMI (124 cases) subjected to PCI for 2 years were used as subjects in this investigation. Two groups of patients were used (62 patients per group). One group received rhBNP while the other group served as control. The patients consisted of 76 males and 48 females (mean age, 63.54 ± 12.31 years). The two groups of patients received 75 mg/kg body weight of clopidogrel orally and aspirin (300 mg/kg) 2 h before PCI. The peaks of creatine kinase (CK), creatine kinase MB (CKMB), and the levels of troponin I (cTnI) were assayed at pre-determined intervals with an automated biochemical analyzer, and changes in the enzyme levels were recorded. Echocardiography (ECG) parameters were also measured.Results: Lower peaks of CK, CK-MB and levels of cTnI were seen in rhBNP-treated patients, when compared with controls (p &lt; 0.05). Total effectiveness was markedly higher in rhBNP-treated group than in control group (p &lt; 0.05). Moreover, myocardial infarct size was significantly lower in rhBNP treatment group than in control group (p &lt; 0.05).Conclusion: Treatment with rhBNP before PCI in patients with AMI increases coronary blood flow, ameliorates perfusion injury, inhibits left ventricular remodeling, reduces myocardial cell necrosis, and improves cardiac function and prognosis.Keywords: Recombinant human brain natriuretic peptide (rhBNP), Acute myocardial infarction, percutaneous coronary intervention, Myocardial enzymes, Cardiac function

Recombinant human brain natriuretic peptide regulates PI3K/AKT/mTOR pathway through lncRNA EGOT to attenuate hypoxia-induced injury in H9c2 cardiomyocytes

This study aimed to investigate whether recombinant human brain natriuretic peptide (rhBNP) regulated hypoxia-induced injury in H9c2 cardiomyocytes through lncRNA EGOT. H9c2 cardiomyocytes were cultured under normoxia and hypoxia (21% and 3% O2) conditions, and whether hypoxia induced injury by assessing cell viability, apoptosis and autophagy. H9c2 cells were then treated with different doses of exogenous rhBNP (200, 600 and 900 nmol/L, respectively) and the effects of rhBNP on hypoxia-induced injury in H9c2 cells as well as the expression of EGOT were studied. In addition, the regulatory relationships between rhBNP and EGOT as well as between rhBNP and PI3K/AKT/mTOR pathway in hypoxia-treated H9c2 cells were investigated. Hypoxia significantly induced injury in H9c2 cells (inhibited cell viability and promoted cell apoptosis and autophagy) and decreased the expression of EGOT. However, administration of rhBNP alleviated hypoxia-induced injury in H9c2 cells and elevated expression of EGOT. Suppression of EGOT significantly reversed the effects of rhBNP on hypoxia-induced injury in H9c2 cells. Further studies showed that the effects of EGOT on cell viability and apoptosis were by positively regulating the expression of Cyclin D1. Moreover, rhBNP alleviated hypoxia-induced cell injury by activating PI3K/AKT/mTOR pathway in H9c2 cells. Our results reveal that rhBNP may play a protective role in attenuating hypoxia-induced injury in H9c2 cardiomyocytes via regulating lncRNA EGOT/Cyclin D1/PI3K/AKT/mTOR pathway axis. The findings will provide a new strategy for the treatment of heart failure induced by hypoxia.

Brain Natriuretic Peptide-Regulated Expression of Inflammatory Cytokines in Lipopolysaccharide (LPS)-Activated Macrophages via NF-κB and Mitogen Activated Protein Kinase (MAPK) Pathways.

BackgroundThis study aimed to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on IL-6, TNF-α, and IL-10 secretion in LPS-activated RAW 264.7 cells and human peripheral blood mononuclear cells (PBMCs) in vitro and to explore the related signaling pathways of the regulation mechanisms of BNP in systemic inflammatory response syndrome (SIRS).Material/MethodsMTT assay was used to evaluate the effects of rhBNP on cell viabilities. Lipopolysaccharide (LPS) was used to induce inflammation response. The whole study was divided into 8 groups: Control, low, middle, and high concentrations of rhBNP, LPS, LPS with low, middle, and high concentrations of rhBNP. Levels of IL-6, TNF-α, and IL-10 were evaluated using the Cytometric Bead Array Kit and RT-PCR assay. Western blotting was used to test the effects of rhBNP on inflammation-related NF-κB and MAPK pathways.ResultsExcept for the concentrations ≥1.6 ng/mL, all concentrations of rhBNP showed little effect on cell viabilities of RAW264.7 cells and PBMCs after 24 h and 48 h, suggesting a weak cytotoxicity to cells. Expression of IL-6 and TNF-α significantly increased and expression of IL-10 significantly decreased at protein and mRNA levels after LPS treatment, and these effects were strongly inhibited in a dose-dependent manner by pretreatment of rhBNP. Similarly, the LPS-induced increase of NF-κB and MAPK pathway phosphorylation levels were also significantly inhibited by rhBNP.ConclusionsrhBNP can regulate expression of IL-6, TNF-α, and IL-10 in LPS-activated RAW 264.7 cells and PBMCs through inhibiting NF-κB and MAPK pathways. These results may reveal potential causes of the increase of BNP in SIRS and may provide an experimental basis for treatment of SIRS.

A rapid reporter assay for recombinant human brain natriuretic peptide (rhBNP) by GloSensor technology

Accurate determination of biological activity is essential in quality control of recombinant human brain natriuretic peptide (rhBNP). In previous study, we successfully developed a genetically modified cell line 293GCAC3-based ELISA assay for rhBNP. But ELISA procedure is still tedious, so this study was aimed to develop a rapid and simple bioassay for rhBNP using GloSensor technology, which provides a platform of flexible luciferase-based biosensors for real-time detection of signaling events in live cells, including cGMP production. A reporter cell line 293GCAGlo-G1 was constructed by transfecting pGloSensor™ 40 F plasmid into 293GCAC3. The reporter assay based on 293GCAGlo-G1 showed high precision with intra-assay CV being 8.3% and inter-assay CV being 14.1%; high accuracy with 80%, 100% and 120% recovery rate being 99.2%, 102.4% and 99.0% respectively; and great linearity with R2 of linear fitting equation being 0.99. Besides, no significant difference was found in test results of reporter assay and 293GCAC3-based ELISA assay (paired t test, p = 0.630). All these results suggested that the reporter assay was a viable assay for biological determination of rhBNP.

Safety and efficacy of the perioperative administration of recombinant human brain natriuretic peptide (rhBNP): a systematic review and meta-analysis.

ObjectiveRetrospective studies and a meta-analysis were performed to evaluate the safety and effectiveness of the perioperative administration of recombinant human brain natriuretic peptide (rhBNP) during cardiac surgery under extracorporeal circulation.MethodsComputerized literature searches were performed in Medline, Embase, The Cochrane Library, CNKI, CBM, and WANFANG to find randomized controlled trials (RCTs) related to the perioperative administration of rhBNP during cardiac surgery starting from the database inception until December 2016. Two researchers independently performed study screening, information extraction, and quality evaluation according to the inclusion/exclusion criteria, and a meta-analysis was performed using RevMan 5.2 software.ResultsA total of 12 studies were analyzed, including 12 RCTs and 727 patients. The meta-analysis results indicated that the perioperative administration of rhBNP could reduce the occurrence rate of postoperative complications, length of intensive care unit (ICU) stay, length of hospital stay, and serum creatinine (Scr) levels, and increase the 24-hour urine volume; however, it did not affect the postoperative mortality rate.ConclusionThe perioperative administration of rhBNP during cardiac surgery was safe and effective, and could improve the prognosis of the patients.

Protective effects of recombinant human brain natriuretic peptide in perioperative period during open heart surgery.

The aim of the present study was to evaluate the protective effects and safety aspects of recombinant human brain natriuretic peptide (rhBNP) on cardiac functions of patients undergoing open-heart surgery during perioperative period. In total, 150 patients undergoing open heart surgery in the Second Hospital of Shandong Universty from August 2015 to July 2016 were randomly divided into control group and observation group each with 75 cases. Patients in control group were treated by routine rehabilitation while patients in the observation group were treated by both the routine rehabilitation and rhBNP. All the observations were made before operation, after operation and 7 days after operation. The changes of N-terminal pro-brain natriuretic peptide (NT-proBNP) of patients, the left ventricular ejection fraction (LVEF), cardiac function [Cardiac output (CO), pulmonary capillary wedge pressure (PAWP) and central venous pressure (CVP)] of patients were measured. Further, respirator support time, ICU stay time, incidence of complications and vital signs (BP, HR, SaO2) of patients in the two groups were also compared. NT-proBNP levels of all patients improved after operation but it decreased in both groups after 7 days of operation. The decrease of NT-proBNP levels in observation group was significantly higher than that of control group. Whereas, LVEF, CO, PAWP and CVP of patients in both the groups increased after operation but effects were significantly higher in the observation group after 7 days of medication. Respirator support time and ICU stay time of patients in observation group were significantly shorter than those in control group, and the incidence of postoperative complications of patients in the observation group were significantly lower than the control group. Moreover, BP, HR and SaO2 of patients in observation group were significantly elevated in comparison to control group (P<0.05). Recombinant human brain natriuretic peptide (rhBNP) could significantly improve the cardiac functions of patients after open heart surgery, and is safe as well as reliable.

New Innovations in Treatment and Monitoring of Heart Failure With Guidelines on the Use of Sacubitril/Valsartan and Ivabradine

Background: Heart failure is a clinical syndrome that carries a significant burden of morbidity and is associated with poor long-term prognosis. Treatment of heart failure is constantly evolving, with large amounts of research going into the development of new medications, in the hopes of improving symptom management as well as reducing morbidity and mortality. Area of Uncertainty: One of the major areas of uncertainty regarding recent advances in heart failure management is the applicability of data from existing trials to the geriatric population. The majority of current research focuses on patients in a younger age group with a median age around 60, and there is a lack of randomized control trials assessing efficacy in the geriatric population specifically. Therapeutic Advances: Three new medications are examined in this review: sacubitril/valsartan, ivabradine, and nesiritide. Sacubitril/valsartan is a combination of neprilysin inhibitor and angiotensin receptor blocker that acts to increase natriuretic peptides and block the effect of angiotensin, leading to diuresis and vasodilation. The resultant reduction in systemic blood pressure and intravascular volume leads to decreased cardiac stress. This drug has Class 1B recommendation for the treatment of heart failure with reduced ejection fraction, with superior improvement in cardiovascular mortality and hospitalization rate compared with enalapril. Ivabradine is an If channel inhibitor that allows for selective reduction in heart rate without hindering cardiac contractility. This drug has Class IIa-B recommendation for heart failure with reduced ejection fraction with evidence of reduction in hospital admission rate. Nesiritide is a recombinant human brain natriuretic peptide that causes arterial and venous dilation and suppression of the renin–angiotensin–aldosterone system. Clinical trials have shown that this medication has some positive effect with patients in acute heart failure exacerbation; however, no benefit in long-term management has been shown. Conclusion: As the population of the United States continues to age, the number of patients with heart failure will continue to rise. Understanding the wide range of treatment options available to elderly patients is increasingly important for clinicians. Determining whether any of the new therapeutic options is appropriate for a patient will be a collaborative effort between a clinician and patient and will depend heavily on the patient's comorbidities, functional status, and goals of care.

Effects of rhBNP on Elderly Emergency Patients with Acute Heart Failure

Objective: To study the effect of re-combinant human brain natriuretic peptide (rhBNP) in older emergency patients with acute heart failure. Patients and Methods: A total of 130 patients were randomly divided into two groups as: rhBNP treatment group and sodium nitroprusside (SNP) treatment group, half by half. The rhBNP was taken once every three days for treatment. But dose was doubled at first time used. In the whole progress, it measured the concentration of rhBNP. Echocardiography examination and 6-minute walk testing (6MWT) were used to evaluate the improvement of heart function after rhBNP treatment, compared with SNP. Results: It taken vital symptoms assessment according to the clinical manifestations, once every four hours in the whole 48 hours emergency treatment procedure. Compared before and after treatment, there were significant improvement about LVEF (left ventricular ejection fraction), 6MWT and proBNP level changes in rhBNP group. Furthermore, it revealed that there were also significant differences in LVEF, 6MWT and proBNP level changes between rhBNP and SNP group. Conclusion: Recombinant human brain natriuretic peptide (rhBNP) could be used to treat old patients with acute heart failure in emergency with meaningful clinical value.

Mechanism study of glucose transport by recombinant human brain natriuretic peptide pretreating myocardial cells in rats with hypoxia/reoxygenation

Objective To investigate the mechanism of glucose transport by recombinant human brain natriuretic peptide(rh-BNP) pretreating myocardial cells in rats with hypoxia/reoxygenation. Methods Left ventricular cardiomyocytes were obtained from SD rats aged 6~8 weeks and were cultured in vitro.They were divided randomly into 5 groups including the control group, hypoxia group, hypoxia/reoxygenation group, rh-BNP pretreating hypoxia group and rh-BNP pretreating hypoxia/reoxygenation group.MTT assay was used to detect the changes of cells viability.The levels of lactate dehydrogenase(LDH), glutathione, superoxide dismutase(SOD) and BNP were measured by ELISA.The expression of iNOS, eNOS, GLUT1 and GLUT4 were detected by RT-PCR. Results The rh-BNP intervention significantly increased the viability of hypoxia and hypoxia/reoxygenation treated cardiomyocytes(P<0.05), reduced the levels of LDH, glutathione, SOD and BNP induced by hypoxia and hypoxia/reoxygenation(P<0.05), and increased the mRNA expression of iNOS, eNOS, GLUT1 and GLUT4 in cardiomyocytes(P<0.05). Conclusion The rh-BNP alleviates hypoxia/reoxygenation-induced cardiomyocytes injury by affecting oxidative stress and the expression of GLUT1 and GLUT4. Key words: Recombinant human brain natriuretic peptide; Hypoxia/Reoxygenation; Glucose transporter; Oxidative stress

Efficacy and safety of intravenous recombinant human brain natriuretic peptide in patients with severe heart failure: a prospective multicenter clinical study

To explore the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). A prospective multicenter study was conducted. Patients whose age > 18 years old, and with the New York Heart Association (NYHA) cardiac function grade over III-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. 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): 4 378.58±4 082.29 vs. 6 403.41±5 759.48, 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: 2 676.54±1 006.83, 2 678.74±975.97 vs. 2 150.36±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. 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.

Effects of recombinant human brain natriuretic peptide on the prognosis of patients with acute anterior myocardial infarction undergoing primary percutaneous coronary intervention: a prospective, multi-center, randomized clinical trial.

This study aims to investigate the effects of recombinant human brain natriuretic peptide (rhBNP) on serum enzyme data, cardiac function parameters and cardiovascular events in patients with acute anterior myocardial infarction (MI). A total of 421 patients with acute anterior or extensive anterior MI were collected from 20 hospitals. These patients were randomly divided into two groups: rhBNP and control groups. Both groups of patients received primary percutaneous coronary intervention (PCI) within the effective time window. In the rhBNP group, rhBNP administration (0.01 µg/kg/min, 48-72 successive hours) was performed as early as possible after hospital admission. Prior to and one or seven days after PCI, serum concentrations of cardiac troponin (cTnT), creatine kinase-MB (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured. At seven days and 6 months after PCI, left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd) and stroke volume (SV) were measured using 2D Doppler echocardiography. MACEs that occurred during hospitalization and within 6 months after PCI were recorded. At postoperative days one and seven, serum concentrations of cTnT were significantly lower in the rhBNP group than in the control group. At postoperative day one, serum concentrations of CK-MB were significantly lower in the rhBNP group than in the control group. At postoperative day seven, serum concentrations of NT-proBNP were significantly lower in the rhBNP group than in the control group, and LVEF was significantly greater in the rhBNP group than in the control group. At postoperative 6 months, LVEDd was significantly lower in the rhBNP group compared with the control group. In addition, SV and LVEF were significantly greater in the rhBNP group than in the control group. By postoperative month 6, the incidence of composite cardiovascular events (16.0% vs. 26.0%, P=0.012), cardiac death (7.0% vs.13.5%, P=0.030), and particularly cardiac death + re-hospitalization for congestive heart failure (13.1% vs. 25.5%, P=0.001) were significantly lower in the rhBNP group than in the control group. Early intravenous rhBNP administration after PCI significantly lowered the serum concentrations of cTnT and NT-proBNP, increased LVEDd, SV and LVEF, and reduced MACEs, including cardiac death, in patients with acute anterior MI undergoing PCI.

Effects of Low-Dose Recombinant Human Brain Natriuretic Peptide on Anterior Myocardial Infarction Complicated by Cardiogenic Shock.

Introduction The mortality due to cardiogenic shock complicating acute myocardial infarction (AMI) is high even in patients with early revascularization. Infusion of low dose recombinant human brain natriuretic peptide (rhBNP) at the time of AMI is well tolerated and could improve cardiac function.Objective The objective of this study was to evaluate the hemodynamic effects of rhBNP in AMI patients revascularized by emergency percutaneous coronary intervention (PCI) who developed cardiogenic shock.Methods A total of 48 patients with acute ST segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock and whose hemodynamic status was improved following emergency PCI were enrolled. Patients were randomly assigned to rhBNP (n=25) and control (n=23) groups. In addition to standard therapy, study group individuals received rhBNP by continuous infusion at 0.005 µg kg−1 min−1 for 72 hours.Results Baseline characteristics, medications, and peak of cardiac troponin I (cTnI) were similar between both groups. rhBNP treatment resulted in consistently improved pulmonary capillary wedge pressure (PCWP) compared to the control group. Respectively, 7 and 9 patients died in experimental and control groups. No drug-related serious adverse events occurred in either group.Conclusion When added to standard care in stable patients with cardiogenic shock complicating anterior STEMI, low dose rhBNP improves PCWP and is well tolerated.

Effectiveness and safety of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction in elderly in combination with cardiac failure.

Objective:To investigate the effects and safety of recombinant human brain natriuretic peptide (rhBNP) in the treatment of elderly acute myocardial infarction induced cardiac failure.Methods:One hundred and forty-six patients who were diagnosed as elderly acute myocardial infarction induced cardiac failure in the hospital from July 2014 to July 2015 were selected. They were divided into a test group and a control group, 73 each. Patients in both groups were given conventional treatment such as stabilization of atherosclerotic plaques, anti-platelet and remodeling and reversion of myocardium. The curative effects and the incidence of adverse reactions of the two groups were observed.Results:The overall efficacy of the test group and the control group was 87.7% and 65.8% respectively, and the difference had statistical significance (P<0.05). The heart rate, urine volume, n-terminal pro-brain natriuretic peptide level and left ventricular ejection fraction (LVEF) of both groups significantly improved after treatment, and the improvement of the test group was superior to that of the control group (P<0.05). The serum creatinine of the test group remarkably reduced after treatment (P<0.05). The incidence of hypotension and arrhythmia of the test group was lower than that of the control group during hospitalization period (P<0.05).Conclusion:rhBNP can effectively relieve the clinical symptoms, cardiac function indexes and hemodynamic indexes of patients with elderly acute myocardial infarction induced cardiac failure, with a high safety. It can be extensively applied in the treatment of acute myocardial infarction in combination with cardiac failure.

Therapeutic effects of recombinant human brain natriuretic peptide on cardiac function in patients with septic shock

Objective To observe the change of cardiac function and tissue perfusion in septic shock patients treated with recombinant human brain natriuretic peptide (rhBNP) in a single center prospective randomized controlled study, and the therapeutic effects of it were analyzed . Methods A total of 100 patients with septic shock admitted in the ICU ward of Guangdong General Hospital were prospectively studied from January 2014 to February 2016. In reference to 6 h early goal-directed therapy (EGDT), 49 patients of experimental group treated with rhBNP and 51 patients of control group without rhBNP treatment were randomly generated by means of random number table. The main parameters of outcome were defined in cardiac index (CI) and amino terminal pro-BNP precursor (NT-proBNP) level in venous blood in patients 72 hours after presence or absence of the treatment of rhBNP, and the secondary parameters of outcome were confined to the patient's heart rate (HR), mean arterial pressure (MAP), transcutaneous oxygen saturation (SPO2), lactic acid (LAC) in patients 72 hours after presence or absence of the treatment of rhBNP. At the same time, the changes in the levels of NT-proBNP, Lac and HR, CI, MAP, SPO2 at 0 h, 24 h, 48 h, and 72 hours after treatment with rhBNP in the experimental group and control group without rhBNP treatment were recorded in order to detect the therapeutic effects of rhBNP. Results There were no significant differences in demographics between the two groups. Compared with control group, the length of ICU stay time was shorter[ (12.93±7.45) vs.( 20.67±6.96) , P<0.01] and the mortality rate was lower in the experimental group (30.6%, (15/49) vs.54.9%, (28/51), P=0.014). After treatment for 72 h, the level of Pro-BNP in experimental group was significantly lower than that in control group (14 965.7 ± 5 984.5)pg/mL vs.(17 392.5 ± 3 830.5)pg/mL, P=0.030); the CI in experimental group were significantly improved compared to control group [(4.0 ± 0.2)vs.(3.7 ± 0.6), P=0.002]. the Lac were significantly decreased in experimental group compared to control group [(2.4 ± 0.6)mmol/L vs.(3.7 ± 0.6)mmol / L, P=0.001]. The HR in experimental group were significantly decreased after treatment for 24 h compared to HR before the treatment with rhBNP (the HR in patients before treatment of rhBNP was (113.3 ± 7.2)beats/min, the HR in patients with the treatment of rhBNP for 24 h was (97.5 ± 14.7)beats/min; but there was no significant further change in HR during 24 h-72 h; there were no significant changes in MAP and SPO2 in patients before and after the treatment of rhBNP. Conclusions The rhBNP can significantly reduce Pro-BNP and lactate levels and improve cardiac index in septic shock patients treated with rhBNP for 24 h, suggesting that rhBNP can improve cardiac function and tissue perfusion in septic shock patients. Key words: Lyophilized recombinant human brain natriuretic peptide; Septic shock; Cardiac function; NT-proBNP; Heart rate; Mean arterial pressure; Transcutaneous oxygen saturation; Lactic acid