The Clinical Study Of The Plasma BNP Level In Patient With Chronic Heart Failure And Drug Therapy

Objective:Brain natriuretic peptide(BNP) was mainly from the ventricular myocardial cells by the secretion of a peptide hormone nerve.In patients with heart failure,increases of both cardiac load and cardiac capacity induce the distraction of myocardial cells,and result in an increase of BNP secretion.Therefore BNP can be used as a marker of severity of congestive heart failure. This study was to investigate the change of blood plasma BNP concentration in patients with chronic heart failure,and to observe the effects of captopril and valsartan on blood plasma BNP in patients with severe heart failure.Method:According to New York Heart Association(NYHA) classification,79 patients with heart failure were divided into different heart function groups:classⅡgroup(n=21),classⅢgroup(n=18),classⅣgroup(n=40),and compared plasma BNP in three groups to that in control group(n=84).2.All patients with heart failure were divided into group A[left ventricular end-diastolic diameter(LVEDd)≤50mm]and group B(LVEDd＞50mm),and compared BNP in group A to group B.3.All patients were divided into group C[left ventricular ejection fraction (LVEF)＜50%]and group D(LVEF＞50%),and compared BNP in group C to group D.4.The patients with classⅣheart function were randomly divided into treatment group 1(n=22) and treatment group 2(n=18).Although all groups were given same routine treatment,patients in treatment group 1 were added Captopril and patients in treatment group 2 were given Valsartan. After 8 weeks treatment,the changes of BNP density in treatment group 1 and treatment group 2 were investigated.Results:1.Plasma BNP was significantly different among all groups(P＜0.05).2.Compared to the left ventricular end-diastolic diameter＞50 mm group,BNP is significant higher in the left ventricular end-diastolic diameter≤50mm group(P=0.003).3.BNP was significant difference between the left ventricular ejection fraction＜50%group and≥50%group(P=0.001).4.After 8 weeks treatment,BNP significantly decreased in both treatment group 1 and treatment group 2 (P＜0.0001),but There was no difference between treatment group 1 and treatment group 2(P =0.767)。Conclusion:BNP concentration was significantly increase in patients with chronic heart failure, especial in patients with worse heart function,decreased left ventricular ejection fraction,and greater left ventricular diameter.Both valsartan and captopril can improve heart function and lower blood plasma BNP levels.Thus,the concentration of blood plasma BNP can be use to diagnosis heart failure and judge severity,and to be used to estimate the effects of treatment on heart failure and to indicate the prognosis.