| Objective: After the acute myocardial infarction often is accompanied by the serious myocardium remodeling, Also the evidence indicated the remodeling of left ventricular correlated with each kind of serious complication, Therefore the inhibition remodeling has become a cornerstone in therapeutic regimen of acute myocardial infarction. As a endogenous protection hormone, It was proved that Brain natriuretic peptide (BNP) to have the function which inhibited remodeling from basic research and animal experiment. The purpose of this research is to investigate and analyze the effect of intravenous rhBNP on left ventricular remodeling and short time prognosis in patients with acute anterior myocardial infarction , through the observation of related index (change of plasma BNP concentration and echocardiogram examination).Methods: The study population consisted of 24 consecutive first acute anterior myocardial infarction patients undergoing primary PCI in time(<6h),from December 2005 to June 2006. Patients were randomly divided into intravenous rhBNP group and control group .Patients received the same regimen after successful PCI, included anticoagulation, antiplatelet, ACEI or ARB,β-blockers. Under standard treatment, rhBNP was given as a 1.5μg/kg intravenous bolus followed by an infusion of 0.0075μg/kg/min continued 30h in rhBNP group。Examining and recording 7th d, 3th month blood plasma BNP concentration, as well as the related echocar diogram indices (LVEF, LVEDVI, LVESVI) in hospital period and 6th month, and calculate△LVEDVI=LVEDVI2 -LVEDVI1 (LVEDVI2 means 6th month LVEDVI, LVEDVI1 means hospital period LVEDVI ), likewise calculated△LVEF,△LVEDSVI as evaluated index of myocardial remodeling. The major adverse cardiac events (MACE) were recorded following up 6 month.Results: Twenty-four patients were enrolled in this study (21 Male)。the mean age was 60.9±5.8 years. There were no statistic differences between the two group baseline characteristic. The plasma BNP level in different time, rhBNP group is lower than control group obviously ( 7thBNP :115.58±74.36pg/ml vs. 233.41±140.89 pg/ml;3thBNP:67.00±47.64 pg/ml vs.113.12±90.65 pg/ml;P<0.05) as well as the related echocardiogram indices, rhBNP group is better than control group(hospital period: LVEF : 48.83%±2.98% vs. 44.50%±4.60%, LVEDVI:77.47±11.96 vs.88.78±12.80 ml/m2, LVESVI:49.34±8.12 vs.56.65±7.62 ml/m2;6th month: LVEF: 53.50%±3.34% vs.48.9±4.77%, LVEDVI: 70.58±11.24 ml/m2 vs.85.62±13.62 ml/m~2, LVESVI : 43.26±7.26vs.52.76±8.12 ml/m2;P<0.05).△LVEF,△LVEDVI,△LVESVI as evaluated remodeling indices, rhBNP group outweighs control (△LVEF :5.67±1.15% vs.4.42±0.99%;△LVEDVI:-6.95±4.07 vs.-2.32±6.25 ml/m~2 ;△LVESVI: -6.28±3.47vs.-3.76±4.86 ml/m~2;P<0.05). In addition, the cumulative incidence of MACE, rhBNP group were less than control group( post -infarction angina:1 vs. 2; NYHA≥Ⅲheart failure: 0 vs. 4, P<0.05).Conclusions:Administration of intravenous rhBNP in patient with acute anterior myocardial infarction, may inhibit the process of left ventricular remodeling, improve cardiac performance and reduce the MACE following up 6 months.
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