Research Of RhBNP Therapy In Decompensated Heart Failure

Intravenous recombinant human brain natriuretic peptide(rhBNP) became a new way to treat heart failrue since 2004. It can make effects as a selective vessel dilator and a diuretic , correct the turbulence of hemodynamic immediately, and what more is it can inhibit neurohumor excessive activation, protect heart from heart failure. But there is only a few literatures about rhBNP, This acticle discussed the efficacy and safety of rhBNP and tried to have a research on effect of rhBNP in heart failure.Objective: To compare the efficacy and safety of intravenous infusion of recombinant human brain natriuretic peptide(rhBNP) versus Sodium Nitroprusside on treating patients with decompensated acute heart failure.Discuss rhBNP's effect on connective tissue of heart.Methods: A total of 44 patients characterized of decompensated acute heart failure were enrolled in this study. The patients were randomly allocated to rhBNP group who receive rhBNP (1.5 g/kg bolus intravenous injection followed by 0·0075 g·kg-1·min-1for 24hours,n=23) and Sodium Nitroprusside group (10 g/min for 24 hours,n=21).Blood pressure, heart rate, dyspnea grade, 24 hours fluid in-and-output and improvement in patient symptoms and signs were evaluated and adverse events were documented. MMPs was measured before and after intravenous injection.Results: Dyspnea and symptom improvements were much more significant in rhBNP group compared to Sodium Nitroprusside group(P<0.05). Fluctuation of blood pressure in rhBNP groop were much more stable than Sodium Nitroprusside groop. Urine output was much more significantly increased after rhBNP treatments than Sodium Nitrprusside(P<0.05). There is no significant difference on LVEF(left ventricle ejection fraction).(P=0.38) The rates of adverse events were resemble. There were less patient who were in hospital again after treatment for one month.There is no significant difference on death rate after treatment for one week or one month.Compared with Sodium Nitroprusside ,rhBNP can significantly decrease the level of MMP-2 ,before treatment of rhBNP patients serum MMPs showed ( pro-MMP2 3512±65 INT·mm2INT·mm2)MMP2 (3384±78 INT·mm2)After treatment ofrhBNP for one week patients serum MMPs showed pro-MMP2(2168±40 INT·mm30.1%),MMP2 (2036±58 INT·mm2), patients'level of pro-MMP2 ,MMP2 decreased 38.3% ,39.8%,P<0.05.Conclusions: rhBNP can significantly improve the hemod- ynamic, dyspnea and clinical situation. Adverse events rate of rhBNP is no more than sodium Nitroprusside at least. rhBNP can improve the prognosis of heart failure patient. We consider that the rhBNP can inhibit serum MMP2 ,as a result ,rhBNP can prevent ventricle from dilating. It's safe for patients suffered from coronary heart disease.