title: Human recombinant-B-type natriuretic peptide protect ventricular function and structure in ST-elevation myocardial infarction.
abstract: BACKGROUND
  ST-elevation myocardial infarction (STEMI) is the most serious clinical type of coronary artery disease (CAD), which will lead to a loss of contractile function asa result of adverse left ventricular (LV) remodeling. Post-myocardial infarction remodeling is detrimental to the left ventricular function, which is strongly related to clinical outcome,including heart failure and cardiac death. And our study was designed to assess the efficacy of 72-hour IV infusion of rh-BNP therapy in STEMI patients with or without successful primary PCI, in preventing adverse LV remodeling and preserving LV function.
  
  
  METHODS
  100 patients diagnosed as STEMI combined with acute heart failure (Killip classification ≥ 2) were recorded. And they were divided into "rh-BNP treatment group" (n=50) and "control group" (n=50). In addition to conventional heart failure therapy, patients in the rh-BNP group received rh-BNP infusion for 72 hours. All patients were followed up at 3 month after discharge. Their medical history was taken, as well as the presence or absence of relevant symptoms. 6-minute walking test, as well as echocardiographic indexes were recorded to evaluate the improvement of cardiac function.
  
  
  RESULTS
  The data analysis about demographic comparison, including those related complicated diseases among groups showed no significant difference. After the follow-up, the indicators were all better than baseline among four subgroups (all P<0.001). Results showed that rh-BNP was able to significantly reduce the NT-pro BNP levels (P<0.001), decrease LVESD (P<0.01), and increase LVEF (P<0.05). The difference of 6WMT between two groups was significant (P<0.001). According to the classification of 6WMT, the multivariate Cox regression showed that the usage of rh-BNP was an independent predictor for 6WMT (OR 0.478, 95% CI, 0.290-0.787), while it may not for MACE (OR 1.762, 95% CI, 0.793-3.913).
  
  
  CONCLUSIONS
  Although the use of rh-BNP was not an independent risk factor in prediction of MACE in our study, the current data still showed that rh-BNP is a useful prognosis factor of 6WMT in the STEMI patients. The protection of ventricular function and structure in STEMI patients is affirmative.
authors.affiliation: Department of Integrated Traditional and Western Medicine, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Gong
authors.affiliation: Department of Oncology, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Zhengbin
authors.initials: Z
authors.lastname: Mou
authors.affiliation: Department of Integrated Traditional and Western Medicine, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Li
authors.initials: L
authors.lastname: Shao
authors.affiliation: Department of Integrated Traditional and Western Medicine, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zou
authors.affiliation: Department of Integrated Traditional and Western Medicine, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Youyi
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Integrated Traditional and Western Medicine, Yuhuangding Hospital Yantai, Shandong, China.
authors.forename: Shaoli
authors.initials: S
authors.lastname: Sun
mesh_terms: D000368:Aged; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D010446:Peptide Fragments / Q000627:therapeutic use*; D011994:Recombinant Proteins; D016276:Ventricular Function / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects; D020257:Ventricular Remodeling / Q000187:drug effects
chemical_list: D010446:Peptide Fragments; D011994:Recombinant Proteins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Human recombinant BNP; ST-elevation myocardial infarction; acute heart failure; left ventricular function