Efficacy of recombinant human brain natriuretic peptide in refractory heart failure

Objective To study the effect and safety of recombinant human brain natriuretic peptide (rhBNP)on hemodynamics in patients with refractory heart failure(RHF).Methods A total of 16 patients with RHF were enrolled in the study.We defined RHF as the symptoms and signs had not been improved with conventional intensive treatment.The patients started to receive the infusion of rhBNP with 1.5 μg/kg bolus intravenous injection followed by 0.007 5 μ4/(kg · min)for 24 hours.During 24 hours,the hemodynamic parameters,systolic blood pressure,heart rate and electrolyte were monitored.After rhBNP infused,echocardiography was used to measure the cardiac index(CI),left ventricular end diastolic diameter(LEVDD)and ejection fraction(EF)in the third day.Results After rhBNP infused,pulmonary capillary wedge pressure (PCWP),mean pulmonary artery pressure(MPAP)were significantly reduced at 15 minutes(PCWP[22.7 ±4.0]mm Hg vs[25.3 ±3.9]mm Hg;MPAP[31.9 ±3.6]mm Hg vs[34.6 ±7.8]mm Hg,P ＜0.05),the systolic blood pressure decreased remarkably at one hour([105.2 ± 11.5]mm Hg vs[119.0 ± 17.2]mm Hg,P ＜ 0.01),and the effect disappeared gradually,heart rate decreased remarkably([109.0 + 10.8]beat/min vs [82.2 ± 8.6]beat/min).blood K +,Na + and renal function remained unchanged(P ＞ 0.05).CI([3.7 ± 0.6]L/m2 vs[1.8 ±0.4]L/m2),LEVDD([63.6 ±5.7]mm vs[67.3 ±6.2]mm)and EF([43.1 ±8.3]％ vs [31.2 ± 6.4]％)were significantly improved(P ＜ 0.01).There was no symptomatic hypotension or other adverse events.Conclusion Injection of rhBNP is safe,feasible,and effective in patients with refractory heat failure for improving hemodynamics. Key words: Recombinant human brain natriuretic peptide; Heart failure; Hemodynamics