PMID- 28625241
OWN - NLM
STAT- MEDLINE
DCOM- 20181018
LR  - 20181018
IS  - 2095-4352 (Print)
VI  - 29
IP  - 6
DP  - 2017 Jun
TI  - [Efficacy and safety of intravenous recombinant human brain natriuretic peptide 
      in patients with severe heart failure: a prospective multicenter clinical study].
PG  - 520-524
LID - 10.3760/cma.j.issn.2095-4352.2017.06.009 [doi]
AB  - OBJECTIVE: To explore the efficacy and safety of recombinant human brain 
      natriuretic peptide (rhBNP) in the patients with severe heart failure (HF). 
      METHODS: A prospective multicenter study was conducted. Patients whose age > 18 
      years old, and with the New York Heart Association (NYHA) cardiac function grade 
      over III-IV, acute cardiac insufficiency and the acute exacerbation of chronic 
      cardiac insufficiency admitted to intensive care unit/cardiovascular care unit 
      (ICU/CCU) of 58 Hospitals in China were enrolled. On the basis of the 
      conventional treatment, all patients would be given rhBNP (neo adjuvant) with a 
      loading dose of 1.5 mug/kg for 3-5 minutes, and followed by a maintenance dose of 
      0.010-0.015 mugxkg(-1)xmin(-1) for 3-7 days. Before the treatment and 1, 3, 7 days 
      after treatment, researchers detected indexes of cardiac and renal function, the 
      levels of N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular 
      ejection fraction (LVEF), cardiac output (CO), pulmonary capillary wedge pressure 
      (PCWP), central venous pressure (CVP), urea nitrogen (BUN), serum creatinine 
      (SCr), and urine output; the renal function index was re-evaluated at 30 days 
      after administration, and the time entering ICU again, re-admission, 
      cardiovascular events were recorded. RESULTS: 408 patients were enrolled, with 
      241 males and 167 females. Age range was 28-95 years, the average age was 
      (63.0+/-15.8) years, and 50-70 years old accounted for 46.8%. Compared with the 
      data before treatment, NT-proBNP, PCWP and CVP significantly decreased at 6 hours 
      after treatment [NT-proBNP (mugxkg(-1)xmin(-1)): 4 378.58+/-4 082.29 vs. 6 403.41+/-5 
      759.48, PCWP (mmHg, 1 mmHg = 0.133 kPa): 12.41+/-2.21 vs. 14.26+/-2.85 , CVP (mmHg): 
      10.63+/-2.62 vs. 11.45+/-3.45, all P < 0.05], and with the prolongation of injection, 
      NT-proBNP, PCWP and CVP were gradually declined; CO 1 day after treatment (mL: 
      4.89+/-0.81 vs. 4.40+/-0.92) and LVEF 3 days after treatment (0.465+/-0.100 vs. 
      0.431+/-0.107) were significantly increased (both P < 0.05), and with the 
      prolongation of injection, CO and LVEF were gradually increased. There were no 
      obvious changes in BUN and SCr during the treatment, but 30 days after treatment, 
      SCr was significantly lower than that pre-treatment (mumol/L: 110.98+/-47.40 vs. 
      132.62+/-75.60, P < 0.01). Compared with the data pre-treatment, urine output per 
      hour was significantly increased at 3 hours after treatment (mL: 129.59+/-82.16 vs. 
      89.60+/-53.49, P = 0.000); urine output every 24 hours was significantly increased 
      at day 1 and day 2 after administration (mL: 2 676.54+/-1 006.83, 2 678.74+/-975.97 
      vs. 2 150.36+/-283.76, both P < 0.01). In 7 days, the re-entry ICU rate was 2.7%, 
      and the re-hospitalization rate was 2.88% within 30 days, re-cardiac failure rate 
      was 1.43% in 30 days, and the overall fatality rate was 9.55% in 30 days. 
      CONCLUSIONS: The rhBNP can significantly improve heart function in patients with 
      HF. And, it has a certain effect on renal function. The rhBNP is effective and 
      safe for the treatment of cardiac insufficiency.
FAU - Feng, Xue
AU  - Feng X
AD  - Cardiac Rehabilitation Center, Fuwai Hospital, Chinese Academy of Medical 
      Sciences, Beijing 100037, China (Feng X, Wu Y); Department of Cardiac Surgery, 
      Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing 100037, China (Meng 
      Y, Wei YZ). Corresponding author: Wei Yizhen, Email: weiyizhen@sohu.com.
FAU - Wu, Yue
AU  - Wu Y
FAU - Meng, Ying
AU  - Meng Y
FAU - Wei, Yizhen
AU  - Wei Y
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
JT  - Zhonghua wei zhong bing ji jiu yi xue
JID - 101604552
RN  - 0 (Peptide Fragments)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - China
MH  - Female
MH  - *Heart Failure
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain
MH  - New York
MH  - Peptide Fragments
MH  - Prospective Studies
EDAT- 2017/06/20 06:00
MHDA- 2018/10/20 06:00
CRDT- 2017/06/20 06:00
PHST- 2017/06/20 06:00 [entrez]
PHST- 2017/06/20 06:00 [pubmed]
PHST- 2018/10/20 06:00 [medline]
AID - 10.3760/cma.j.issn.2095-4352.2017.06.009 [doi]
PST - ppublish
SO  - Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Jun;29(6):520-524. doi: 
      10.3760/cma.j.issn.2095-4352.2017.06.009.