Influence Of Recombinant Human Brain Natriuretic Peptide Upon Cardiac Function And Inflammatory Factors In Patients With Decompensated Heart Failure

Objective: To investigate the influence of recombinant human brain natriuretic peptide upon the cardiac function and inflammatory factors in patients with decompensated heart failure(DHF).Methods: The concentration of serum tumor necrosis factor-α(TNF-α) and high sensitivity C reactive protein (hsCRP) were measured in 40 DHF patients and 20 control healthy subjects. A randomized and controlled study was performed. 40 DHF patients were randomely devided into two groups and treated with nitroprusside and recombinant human brain natriuretic peptide (rhBNP) respectively. Pulmonary capillary wedge pressure (PCWP) and left ventricular ejection fration (LVEF ) were obtained by noninvasive assessment before and after 1 hour, 24 hour intravenous agents respectively. After treatment for 7 days, the levels of TNF-αand hsCRP were repeatly measured.Results:1) Compared with control subjects, TNF-αand hsCRP concentrations were significantly elevated in patients with decompensated heart failure (all P<0.01).2) PCWP was decreased and LVEF was improved markedly after 1 hour and 24 hours of treatment than those before treatment (all P<0.01). Compared with the nitroprusside group, the changes of those in rhBNP group were more significant (all P<0.05) .3) After 7 days of therapy, the levels of serum TNF-αand hsCRP decreased obviously in the two groups (all P<0.01). However, there was no significant difference between the two groups (all P>0.05).Conclusions:1) The patients with DHF have elevated levels of hsCRP and TNF-α, which suggests the presence of an active inflammatory reaction.2) Compared with those intravenous nitroprusside, patients intravenous rhBNP significantly decreased PCWP and improved LVEF. The results demonstrate rhBNP can probably improve hemodynamics more effectively in patients with DHF than nitroprusside.3) After treatment with rhBNP and nitroprusside , the levels of serum TNF-αand hsCRP decreased significantly in the two groups. However, there was no significant difference between the two groups. Those changes indicate that the inflammatory reaction is inhibited along with the improve the cardiac function in patients with DHF. However, It needs further studies whether rhBNP could perform a directly effect on inflammation in patients with heart failure.