Effects of intravenous injection with recombinant human brain natriuretic peptide on ventricular remodeling in patients with acute coronary syndrome

Objective To observe the effects of intravenous injection with recombinant human brain natriuretic peptide(rhBNP)on neuroendocrine and heart function in patients with acute coronary syndrome(ACS),and to estimate the effect of intravenous rhBNP on ventricular remodeling in patients with ACS.Methods The 70 patients with ACS were randomly divided into two groups,rhBNP group(n=35)and control group(n=35).The patients in control group were treated by routine therapy(nitroglycerin),however,the patients in rhBNP group were treated by rhBNP.The levels of plasma B-type natriuretic peptide(BNP),renin,angiotensinII and aldosterone were detected before and after treatment.The changes of left ventricular morphology and function were detected by two-dimensional,M-mode and Doppler ultrasound examination.Results which was significantly decreased after 48 hours,5 days,7days in both groups(P0.05).The levels of plasma BNP in rhBNP group were significantly lower than those in control group(P0.05).The levels of plasma BNP were increased after 5 days and showed the second peak,but the peak-amplitude in rhBNP group was significantly lower than that of control group(P0.05).The levels of plasma renin,angiotensinII and aldosterone in rhBNP group were significantly reduced by 26.8%,19.6%,17.3% respectively at 36 hours after treatment(P0.05).The ejection fraction was significantly increased in rhBNP group,as compared with that in control group(P0.05).The LVEDd was increased in both groups at 14days,which in rhBNP group was significantly lower than that in control group(P0.05).Conclusion The intravenous injection with recombinant human brain natriuretic peptide can reduce the levels of renin,angiotensinⅡ,aldosterone and BNP,enhance cardiac ejection fraction,inhibit the increment LVEDd at some extent.The exogenous BNP can inhibit the ventricular remodeling in patients with AC.