Human recombinant-B-type natriuretic peptide protect ventricular function and structure in ST-elevation myocardial...

Area of Science:

• Cardiology
• Pharmacology

Background:

• ST-elevation myocardial infarction (STEMI) is a severe form of coronary artery disease (CAD) leading to adverse left ventricular (LV) remodeling and impaired cardiac function.
• Post-MI remodeling negatively impacts LV function, increasing risks of heart failure and cardiac death.

Purpose of the Study:

• To evaluate the efficacy of 72-hour intravenous infusion of recombinant human brain natriuretic peptide (rh-BNP) in STEMI patients.
• To assess rh-BNP's role in preventing adverse LV remodeling and preserving LV function, with or without successful primary percutaneous coronary intervention (PCI).

Main Methods:

• A study involving 100 STEMI patients with acute heart failure (Killip class ≥ 2) was conducted.
• Patients were divided into an rh-BNP treatment group (n=50) and a control group (n=50).
• The rh-BNP group received a 72-hour infusion alongside conventional therapy; all patients were followed up for 3 months, assessing cardiac function via echocardiography and the 6-minute walking test (6WMT).

Main Results:

• rh-BNP infusion significantly reduced NT-proBNP levels, decreased LV end-systolic diameter (LVESD), and increased LV ejection fraction (LVEF).
• A significant improvement in the 6-minute walking test (6WMT) was observed in the rh-BNP group compared to the control group (P<0.001).
• Multivariate analysis identified rh-BNP usage as an independent predictor for improved 6WMT, but not for major adverse cardiac events (MACE).

Conclusions:

• rh-BNP therapy demonstrated a protective effect on ventricular function and structure in STEMI patients.
• While not an independent predictor of MACE in this study, rh-BNP is a valuable prognostic factor for 6WMT in STEMI patients.
• The findings support rh-BNP's utility in managing STEMI patients with heart failure, particularly in improving functional capacity.