Effect Study of the Recombinant Human Brain Natriuretic Peptide in Patients with Heart Failure Combined with Hypotension

Objective: This paper aims to investigate the effect of applying recombinant human brain natriuretic peptide in patients with heart failure combined with hypotension. Recombinant human brain natriuretic peptide is a synthetic polypeptide drug that is primarily used to treat acute heart failure. Its mechanism of action closely mimics that of human endogenous brain natriuretic peptide. By binding to receptors on cardiomyocytes, it exerts its pharmacological effects. Methods: For the study, 76 heart failure patients with hypotension were selected from our hospital between May 2022 and June 2023. These patients were divided into two groups: a control group and an observation group, each comprising 38 patients. The control group received dopamine treatment, while the observation group was treated with recombinant brain natriuretic peptide. The objective was to compare the effects of the treatments in both groups by analyzing cardiac function indices and levels of vasoactive substances to identify any significant differences in outcomes. Results: The overall response rate of the patients in the observation group and the control group was 94.74% and 73.68%, significantly higher as compared with the observation group (P 0.05). After the following treatment, BNP, ANNP and urine output in the observation group were significantly different compared with the control group, of the statistical significance (P Conclusion: For the treatment of heart failure patients with hypotension, the clinical application of recombinant human brain natriuretic peptide is the most ideal, and significantly improves the cardiac function of patients, which is worth popularizing.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Lyophilized recombinant human brain natriuretic peptide for chronic heart failure:Effects on cardiac function and inflammation

BACKGROUND Chronic heart failure(CHF)is a serious and prevalent condition characterized by impaired cardiac function and inflammation.Standard therapy for CHF has limitations,prompting the exploration of alternative treatments.Recombinant human brain natriuretic peptide(BNP)has emerged as a potential therapy,with evidence suggesting that it can improve cardiac function and reduce inflammation in patients with CHF.However,further research is required to determine the efficacy and safety of lyophilized recombinant human BNP in CHF patients and its impact on microinflammatory status.This study aimed to investigate the effects of lyophilized recombinant human BNP therapy on CHF patients’cardiac function and microinflammatory status.AIM To investigate the effects of freeze-dried recombinant human BNP therapy on cardiac function and microinflammatory status in patients with CHF.METHODS In total,102 CHF patients admitted to our hospital from January 2021 to January 2022 were randomly assigned to control and observation groups(n=51 patients/group).The control patients were treated with standard HF therapy for 3 d,whereas the observational patients were injected with the recombinant human BNP for 3 d.Clinical efficacy,inflammatory factor levels,myocardial damage,cardiac function before and after the treatment,and adverse reactions during treatment were compared between the two groups.RESULTS The overall clinical efficacy was higher in the observation group than in the control group.Compared with baseline,serum hypersensitive C-reactive protein,N-terminal proBNP,and troponin I level,and physical,emotional,social,and economic scores were lower in both groups after treatment,with greater reductions in levels and scores noted in the observation group than in the control group.The overall incidence of adverse reactions in the observation group was not significantly different compared with that in the control group(P>0.05).CONCLUSION Freeze-dried recombinant human BNP therapy can improve heart function and enhance microinflammatory status,thereby improving overall quality of life without any obvious side effects.This therapy is safe and reliable.

Lyophilized recombinant human brain natriuretic peptide: A promising therapy in patients with chronic heart failure

Lyophilized recombinant brain natriuretic peptide(BNP)is an exogenous peptide synthesized by artificial recombination technology,with a similar structure and similar physiological effects with the endogenous natriuretic peptide secreted by the human body.It’s main mechanism of action is to increase cyclic guanosine monophosphate by binding with its corresponding receptor in the body,regulating,thus,the imbalance of the vascular system and cardiac hemodynamics,improving the heart’s pumping capacity,and inhibiting sympathetic excitability and myocardial remodeling.Moreover,it can promote mitochondrial metabolism and enhance the use of adenosine triphosphate in cardiomyocytes.In the present study,102 chronic heart failure(HF)patients were randomly assigned to a control and an observation group consisting of 51 patients each.Patients of the control group were treated with standard HF therapy for 3 d including oral metoprolol tartrate tablets,spironolactone,and olmesartanate while patients of the observation group were administered the recombinant human BNP injection for the same time-period,plus the standard HF therapy.The recombinant human BNP group(observation group)demonstrated better physical,emotional,social,and economic scores,as well as cardiac and inflammatory biomarkers such as serum hypersensitive C-reactive protein,N-terminal pro BNP and troponin I levels,compared to the control group.Moreover,cardiac function was also improved,as left ventricular ejection fraction and stroke volume were significantly higher in the observation group than in the control group.Interestingly,adverse reactions were not different between the 2 groups.However,these results are not generalizable and the need of large multicenter randomized controlled trials examining the safety and efficacy of recombinant human BNP in HF patients is of major importance.

The Lebanese Society of Cardiology Consensus Statement on the Use of Natriuretic Peptides for the Management of Heart Failure

Plasma concentration of Natriuretic Peptide (NP) is a valuable diagnostic tool for heart failure (HF). It can help rule out or confirm a diagnosis of HF based on symptoms, but its use is not clearly defined. NPs should be used in conjunction with physical examination and other diagnostic tests. However, it is important to note that several conditions besides the diagnosis of HF may cause NPs levels to be elevated. Additionally, there are situations when NP concentrations may be below diagnostic thresholds in [1]. This consensus statement aims to provide a straightforward diagnostic flowchart for clinicians in both the emergency department and outpatient settings to aid in diagnosing both acute and chronic HF. The diagnosis of acute HF can be ruled out with a BNP level of 100 pg/mL or NTproBNP level of 300 pg/mL, regardless of the patient’s age. To identify HF, a 3-level cut-off point based on the patient’s age is recommended. Chronic heart failure can be ruled out with a BNP level of 35 pg/mL or NTproBNP level of 125 pg/mL, regardless of thepatient’s age [1].

Value of N-Terminal Pro B-Type Natriuretic Peptide,High-Sensitivity C-Reactive Protein,and Homocysteine Levels in Predicting Cardiovascular Events in Chronic Heart Failure Patients After Discharge

Objective:To investigate the value of N-terminal pro B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),and homocysteine(Hcy)levels in predicting cardiovascular events(CV)in patients with chronic heart failure(CHF).Methods:A total of 63 patients with CHF admitted to our hospital between June 2019 and July 2021 were selected.Their NT-proBNP,hs-CRP,and Hcy levels were detected at discharge,and a 12-month follow-up was done after their discharge to collect clinical data.The collected data were inclusive of data from 21 CHF patients with cardiovascular disease and 42 CHF patients without cardiovascular disease.The effect of NT-proBNP,hs-CRP,and Hcy levels on the occurrence of CV was analyzed.Results:The levels of NT-proBNP,hs-CRP,and Hcy in the group with cardiovascular disease were significantly higher than those in the group without cardiovascular disease(P<0.05);the levels of serum NT-proBNP,hs-CRP,and Hcy at discharge had certain value in predicting short-term CV in CHF patients(P<0.05).Conclusion:NT-proBNP,hs-CRP,and Hcy levels can be used to predict CV in CHF patients,thus having clinical application value.

The role of C-type natriuretic peptide in rat testes during spermatogenesis

C-type natriuretic peptide （CNP） is a 22-amino acid peptide and act as a local paracrine or autocrine regulator. There is growing evidence that ChIP is involved in male reproductive processes. To investigate the role of CNPduring spermatogenesis, we measured the mRNA expression of CNPand its specific membrane-bound natriuretic peptide receptor-B （NPR-B） using real-time RT-PCR in the testes of normal rats on different postnatal days. After that spermatogenesis dysfunction model induced by ornidazole was established with the aim to study the correlation of CNPwith spermatogenic dysfunction. Then, Sertoli cells from 18- to 22-day-old healthy male rats were cultured in the presence of different CNPconcentrations （1 ×10-6, 1×10-7 and1×10-8 mol l-1）, and the mRNA expression levels of androgen.binding protein, inhibin B and transferrin were examined at 0 min, 30 min, 1 h, 2 h, 4 h, 8 h, 12 h, 24 h and 48 h. During the postnatal development of rat testes, the highest mRNA expression levels of CNPand NPR-B were found at postnatal Do, and the levels then declined gradually, with a second ChIPpeak at postnatal D35. In the ornidazole-induced infertile rat testes, CIVPgene expression was lower than in the uninduced rats （P〈0.05）, while IVPR-Bgene expression was greater （P〈0.05）. In cultured Sertoli cells, supplementation with CNP stimulated the gene expression of androgen-binding pmteirginhibin B/transferrin, particularly at 12 h, and 1× 10-7 mol l-1 CNP had the highest upregulation effect. The gene expression levels of CNPIIVPR-B in rat testes at different postnatal stages and in infertile rat testes indicated that CNP may participate in the physiology and/or pathology related to spermatogenesis. Moreover, ChIP regulated endocrine function in Sertoli cells. Taken together, these results showed that CNP is closely tied to spermatogenesis.

Physiology of natriuretic peptides: The volume overload hypothesis revisited

The discovery of the natriuretic peptide system in the early 1980s aroused great interest among clinical cardiologists. The heart was not a mechanical pump alone, but also an endocrine organ that had powerful effects on blood circulation. Natriuretic peptides caused both natriuresis and diuresis, and they responded to a volume overload which caused either stretch or pressure on the heart. As a result, the findings led to the conclusion that the human body had a hormone with effects similar to those of a drug which treats high blood pressure. Later, it became evident that the volume contraction was fortified by extrarenal plasma shift. Here, a hypothesis is presented in which the role of natriuretic peptides is to regulate oxygen transport as the volume contraction leads to hemoconcentration with an increased oxygen-carrying capacity. Wall stress, either chemical or mechanical, changes the oxygen gradient of the myocardium and affects the diffusion of oxygen within a myocyte. In support of this hypothesis, hypoxia-response elements have been found in both the atrial natriuretic peptide and the brain natriuretic peptide genes.

Atrial natriuretic peptide signal pathway upregulated in stomach of streptozotocin-induced diabetic mice

AIM:To investigate atrial natriuretic peptide(ANP) secretion from gastric mucosa and the relationship between the ANP/natriuretic peptide receptor type A (NPR-A)pathway and diabetic gastroparesis. METHODS:Male imprinting control region(ICR)mice (4 wk old)were divided into two groups:control mice, and streptozotocin-induced diabetic mice.Eight weeks after injection,spontaneous gastric contraction was recorded by using physiography in control and streptozotocin-induced diabetic mice.The ANP-positive cells in gastric mucosa and among dispersed gastric epithelial cells were detected by using immunohistochemistry and flow cytometry,respectively.ANP and natriureticpeptide receptor type A(NPR-A)gene expression in gastric tissue was observed by using the reverse transcriptase polymerase chain reaction. RESULTS:The frequency of spontaneous gastric contraction was reduced from 12.9±0.8 cycles/min in the control group to 8.4±0.6 cycles/min in the diabetic mice(n=8,P<0.05).However,the amplitude of contraction was not significantly affected in the diabetic group.The depletion of interstitial cells of Cajal in the gastric muscle layer was observed in the diabetic mice.ANP-positive cells were distributed in the gastric mucosal layer and the density index of ANP-positive cells was increased from 20.9±2.2 cells/field in control mice to 51.8±2.9 cells/field in diabetic mice(n=8, P<0.05).The percentage of ANP-positive cells among the dispersed gastric epithelial cells was increased from 10.0%±0.9%in the control mice to 41.2%± 1.0%in the diabetic mice(n=3,P<0.05).ANP and NPR-A genes were both expressed in mouse stomach, and the expression was significantly increased in the diabetic mice. CONCLUSION:These results suggest that the ANP/ NPR-A signaling pathway is upregulated in streptozotocin-induced diabetic mice,and contributes to the development of diabetic gastroparesis.

Marked elevation of B-type natriuretic peptide in patients with heart failure and preserved ejection fraction

Marked elevations of B-type natriuretic peptide （BNP） are not generally seen in patients with heart failure and preserved ejection fraction （HFpEF）. The objective of this study was to examine the clinical and laboratory characteristics of a large cohort of patients with HFpEF and markedly elevated BNP. A retrospective examination of 421 inpatients at a university hospital admitted with a diagnosis of HFpEF was performed. Clinical and echocardiographic data in 4 groups of patients with levels of BNP ≤ 100 pg/mL, 100-400 pg/mL, 400-1,000 pg/mL and 〉 1,000 pg/mL were compared. Patients with HFpEF and BNP 〉 1,000 pg/mL （28% of the population） were characterized by impaired renal function and greater use of anti-hypertensive medications. A subset of these patients with BNP 〉 1,000 pg/mL had normal renal function （21%） and were significantly older, more frequently female, and tended to have lower ejection fractions. Conversely, patients with HFpEF and BNP ≤100 pg/mL were younger and had preserved renal function. BNP was inversely related to the likelihood of subsequent admission for heart failure, but not to myocardial infarction or death. In conclusion： BNP 〉 1,000 pg/mL is seen in almost 1/3 of patients hospitalized with HFpEF. This elevation of BNP often reflects impaired renal function, but can also be seen in patients with preserved renal function but relatively impaired systolic function.

Effect of atorvastatin on serum oxidative stress and N-terminal brain natriuretic peptide expression in rats

Objective:To investigate the effect of atorvastatin on serum oxidative stress and N-terminal brain natriuretic peptide expression in rats.Methods:A total of 40 healthy male SD rats were randomly divided into the sham group(Croup A,n=10,saline 5 mL/d),ischemia-reperfusion group(Group B,n=10,saline S mL/d),atorvastatin group(Group C,n=10.atorvastatin 20 mg/kg·d),atorvastatin + N-amino-arginine group(Group D,n=10,atorvastatin 20 mg/kg·d + N-amino arginine 15 mg/kg).Myocardial ischemia-reperfusion rat model was eslablished after 3 days of gavage.N-amino arginine 15 mg/kg was given by tail vein injection 15 min before ischemia.After reperfusion,enzymology indicators such us creatine kinase(CK) and lactate dehydrogenase and the oxidative stress parameters such as nitric oxide(NO),malondialdehyde(MDA) and total superoxide dismutase(TSOD),and n-terminal pro-brain natriuretic peptide(NT-proBNP)expression was detected by immunohistochemistry.Results:LDH and CK levels of group A were significantly lower than the outer three groups,and group B was the highest.There was significant difference between group B and group C(P<0.05),and no significant difference between group B and group D(P>0.05).MDA levels in group B were significantly higher than the other three groups.The lowest was group A,followed by group C,the difference among groups was significantly(P<0.05).TSOD and NO levels in group B was the lowest,the level in group A was the highest,followed by group C,the difference among groups was significant(P<0.05).NT-proBNP level in group B was significantly higher than the other three groups,the lowest was group A,followed by group C,the difference among groups was significant(P<0.05).Conclusions:Atorvastatin has a protective effect on the myocardial injury in the myocardial ischemia and reperfusion rats.It can increase NO synthesis and decrease MDA content,increase serum TSOD activity and the oxidative stress effect,meanwhile protect myocardial cells and reduce myocardial injury.

B-type natriuretic peptide in predicting the severity of community-acquired pneumonia

BACKGROUND: Although pneumonia severity index(PSI) is widely used to evaluate the severity of community-acquired pneumonia(CAP), the calculation of PSI is very complicated. The present study aimed to evaluate the role of B-type natriuretic peptide(BNP) in predicting the severity of CAP.METHODS: For 202 patients with CAP admitted to the emergency department, BNP levels, cardiac load indexes, inf lammatory indexes including C-reactive protein(CRP), white blood cell count(WBC), and PSI were detected. The correlation between the indexes and PSI was investigated. BNP levels for survivor and non-survivor groups were compared, and a receiver operating characteristic(ROC) curve analysis was performed on the BNP levels versus PSI.RESULTS: The BNP levels increased with CAP severity(r=0.782, P<0.001). The BNP levels of the high-risk group(PSI classes IV and V) were signifi cantly higher than those of the low-risk group(PSI classes I–III)(P<0.001). The BNP levels were signifi cantly higher in the non-survivor group than in the survivor group(P<0.001). In addition, there were positive correlations between BNP levels and PSI scores(r=0.782, P<0.001). The BNP level was highly accurate in predicting the severity of CAP(AUC=0.952). The optimal cut-off point of BNP level for distinguishing high-risk patients from low-risk ones was 125.0 pg/m L, with a sensitivity of 0.891 and a specifi city of 0.946. Moreover, BNP level was accurate in predicting mortality(AUC=0.823). Its optimal cut-off point for predicting death was 299.0 pg/m L, with a sensitivity of 0.675 and a specifi city of 0.816. Its negative predictive cut-off value was 0.926, and the positive predictive cut-off value was 0.426.CONCLUSION: BNP level is positively correlated with the severity of CAP, and may be used as a biomarker for evaluating the severity of CAP.

p42/p44 mitogen-activated protein kinases inhibit atrial natriuretic peptide mRNA transcription in gp130-mediated hypertrophic ventricular myocytes

Objective:To understand the role of ANP mRNA transcription regulation in gpl30-mediated cardiomyocyte hypertrophy,and the involved mitogen-aetivated protein kinase kinase(MEK)-extracellular signal-regulated kinase(ERK,also called p42/p44 MAPK)signaling pathway.Methods:isolated neonatal ventricular myocytes were treated with different concentrations of CT-1(10^(-9),10^(-8)and 10^(-7)mol/L).MTT was used to analyze the viability and RT-PCR was used to detect ANP mRNA levels in eardiomyocyte.To inhibit p42/p44 MAPK activity in hypertrophic cardiomyoeytes,the cells were pretreated with a specific MEKI inhibitor.Results:CT-1significantly induced ANP mRNA expression and the viability of canliomyocytes in a doseand time-dependent manner.Furthermore,blocking p42/p44 MAPK activity by the special MEk1 inhibitor uprcgulatcd the ANP mKNA.Conclusions:p42/p44 MAPK have an important role in suppressing ANP mRNA transcription and cell activity in gpl30-mediated hypertrophic ventricular myocytes.

Plasma N-terminal pro-brain natriuretic peptide levels in elderly patients with isolated diastolic dysfunction

To investigate plasma N-terminal pro-brain natriuretic peptide (NT-BNP) levels and to assess their clinical significance in elderly patients with isolated diastolic dysfunction. Methods Plasma NT-BNP level were measured by electrochemiluminescence immunoassay in 34 symptomatic patients (Group 1), 34 asymptomatic patients (Group 2) with isolated diastolic dysfunction, and in 16elderly healthy subjects (control group, Group 3), serving controls. Colored Doppler echocardiography was performed to evaluate the patients' cardiac structures and functions. Results The plasma NT-BNP level in Group 1 was significantly higher than those in Group 2 and Group 3 and increased with the severity of heart failure. There was no significant difference of plasma NT-BNP levels between Group 2 and Group 3 (p＞0.05). A NT-BNP value of 102.75 pg/mL showed a sensitivity of 88.2%, a specificity of 87.5%, and an accuracy of 88.1% for diagnosing diastolic dysfunction. Patients with restrictive filling pattern on echocardiography had higher NTBNP levels than those of impaired relaxation pattern (1961.2±304.9 versus 460. 1±92.7pg/mL, p＜0.001). Conclusion The elevation of plasma NT-BNP level in elderly patients with isolated diastolic dysfunction correlates with the severity of their diastolic abnormalities.The level of plasma NT-BNP has an important clinical value in the diagnosis of elderly patients with isolated diastolic dysfunction.

Differential effects of atrial and brain natriuretic peptides on human pulmonary artery:An in vitro study

BACKGROUND The prevalence of cardiovascular diseases,especially heart failure,continues to rise worldwide.In heart failure,increasing levels of circulating atrial natriuretic peptide(ANP)and brain natriuretic peptide(BNP)are associated with a worsening of heart failure and a poor prognosis.AIM To test whether a high concentration of BNP would inhibit relaxation to ANP.METHODS Pulmonary arteries were dissected from disease-free areas of lung resection,as well as pulmonary artery rings of internal diameter 2.5–3.5 mm and 2 mm long,were prepared.Pulmonary artery rings were mounted in a multiwire myograph,and a basal tension of 1.61gf was applied.After equilibration for 60 min,rings were pre-constricted with 11.21μmol/L PGF2α(EC80),and concentration response curves were constructed to vasodilators by cumulative addition to the myograph chambers.RESULTS Although both ANP and BNP were found to vasodilate the pulmonary vessels,ANP is more potent than BNP.pEC50 of ANP and BNP were 8.96±0.21 and 7.54±0.18,respectively,and the maximum efficacy(Emax)for ANP and BNP was-2.03 gf and-0.24 gf,respectively.After addition of BNP,the Emax of ANP reduced from-0.96gf to-0.675gf(P=0.28).CONCLUSION BNP could be acting as a partial agonist in small human pulmonary arteries,and inhibits relaxation to ANP.Elevated levels of circulating BNP could be responsible for the worsening of decompensated heart failure.This finding could also explain the disappointing results seen in clinical trials of ANP and BNP analogues for the treatment of heart failure.

Gastric nNOS reduction accompanied by natriuretic peptides signaling pathway upregulation in diabetic mice

AIM:To investigate the relationship between neuronal nitric oxide synthase(nNOS)expression and the natriuretic peptide signaling pathway in the gastric fundus of streptozotocin(STZ)-induced diabetic mice.METHODS:Diabetic mice were induced by injection of STZ solution.Immunofluorescence labeling of HuC/D,nNOS and natriuretic peptide receptor-A,B,C(NPRs)in the gastric fundus(GF)was used to observe nNOS expression and whether NPRs exist on enteric neurons.The expression levels of nNOS and NPRs in the diabetic GF were examined by western blotting.An isometric force transducer recorded the electric field stimulation(EFS)-induced relaxation and contraction in the diabetic GF.An intracellular recording method assessed EFSinduced inhibitory junction potentials(IJP)on the GF.GF smooth muscles acquired from normal mice were incubated with different concentrations of the NPRs agonist C-type natriuretic peptide(CNP)for 24 h,after which their nNOS expressions were detected by western blotting.RESULTS:Eight weeks after injection,43 diabetic mice were obtained from mouse models injected with STZ.Immunofluorescence indicated that the number of NOS neurons was significantly decreased and that nNOS expression was significantly downregulated in the diabetic GF.The results of physiological and electrophysiological assays showed that the EFS-induced relaxation that mainly caused by NO was significantly reduced,while the contraction was enhanced in the diabetic GF.EFSinduced IJP showed that L-NAME sensitive IJP in the diabetic GF was significantly reduced compared with control mice.However,both NPR-A and NPR-B were detected on enteric neurons,and their expression levels were upregulated in the diabetic GF.The nNOS expression level was downregulated dose-dependently in GF smooth muscle tissues exposed to CNP.CONCLUSION:These findings suggested that upregulation of the NPs signaling pathway may be involved in GF neuropathy caused by diabetes by decreasing nNOS expression.

Plasma brain natriuretic peptide, platelet parameters, and cardiopulmonary function in chronic obstructive pulmonary disease

BACKGROUND Chronic obstructive pulmonary disease(COPD)is a chronic respiratory disease with worldwide occurrence and high disability and mortality rate.It occurs mostly in the elderly population with pulmonary heart disease,type II respiratory failure,and other serious complications.AIM To investigate the correlation of plasma brain natriuretic peptide(BNP)and platelet parameters with cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease.METHODS From June 2016 to June 2019,52 patients with COPD-pulmonary heart disease(pulmonary heart disease group),30 patients with COPD(COPD group),and 30 healthy individuals(control group)in our hospital were enrolled in the study.The pulmonary heart disease group was further divided into subgroups according to cardiac function classification and pulmonary artery pressure.Plasma BNP and platelet parameters were estimated and compared among each group and subgroup.The correlation of plasma BNP and platelet parameters with cardiac function classification and pulmonary artery pressure was then analyzed.RESULTS In the pulmonary heart disease group,the COPD group,and the control group,the levels of plasma BNP,platelet distribution width(PDW),and mean platelet volume(MPV)showed a decreasing trend(P<0.05),while an increasing trend was found in platelet count(PLT)and plateletcrit(PCT)levels among the three groups(P<0.05).In the pulmonary hypertension mild,moderate,and severe subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was observed in PLT levels(P<0.05);however,PCT levels showed no significant difference among the three subgroups(P>0.05).In the cardiac function grade I,II,III,and IV subgroups,the levels of plasma BNP,PDW,and MPV showed an increasing trend(P<0.05),while a decreasing trend was noted in PLT and PCT levels among the four subgroups(P<0.05).Correlation analysis showed that the levels of plasma BNP,PDW,and MPV in patients with pulmonary heart disease were positively correlated with their pulmonary artery pressure(P<0.05),while PLT was negatively correlated with their pulmonary artery pressure(P<0.05).Moreover,plasma BNP,PDW,and MPV levels were positively correlated with cardiac function grade(P<0.05)of these patients,while PLT and PCT levels were negatively correlated with their cardiac function grade(P<0.05).CONCLUSION Plasma BNP and PLT parameters are significantly correlated with the cardiac function and pulmonary hypertension in patients with COPD and pulmonary heart disease,indicating that these parameters have high clinical relevance in reflecting the health condition of these patients and for guiding their treatment.

Protective effect of recombinant human brain natriuretic peptide against contrast-induced nephropathy in elderly acute myocardial infarction patients:A randomized controlled trial

BACKGROUND Increasing reports have demonstrated that recombinant human brain natriuretic peptide(rhBNP)can improve acute myocardial infarction(AMI)and heart failure.However,whether it can improve renal function and decrease the risk of contrastinduced nephropathy(CIN)in elderly AMI patients is still unclear.AIM To explore the effect of rhBNP on CIN in elderly AMI patients after percutaneous coronary intervention(PCI).METHODS One hundred and thirty-one elderly AMI patients underwent PCI from January 2017 to July 2021.Patients were either given 1 mL of 0.9%normal saline/(kg/h)for 72 h after PCI(control group,n=66)and or intravenous rhBNP[1.5 mg/kg followed by 0.0075 mg/(kg/min)]for 72 h(rhBNP treatment group,n=65).Serum creatinine and cystatin C levels,creatinine clearance rate,and eGFR were measured at 24 h,48 h,and 72 h after PCI.Research nurses collected data on hand-written forms,and then stored them in password-protected electronic databases.RESULTS The creatinine clearance rate and eGFR were increased,while the creatinine and cystatin C levels were decreased significantly in the rhBNP treatment group compared to the control group at 48 h and 72 h.The incidence of CIN(P=0.028)and acute heart failure(P=0.017)also significantly decreased in the rhBNP group.No significant difference was noted between the two groups in cardiac death and recurrent AMI.CONCLUSION Early application of rhBNP could protect renal function and decrease the incidence of CIN after primary PCI and acute heart failure.

Comparative study of galectin-3 and B-type natriuretic peptide as biomarkers for the diagnosis of heart failure

BackgroundHeart 失败(HF ) 是有复杂 pathophysiological 原因的普通疾病。HF 的诊断通常依靠病历和症状的全面分析，并且源于 echocardiography 和生物化学的测试。Galectin-3，在 HF 的相对新的 biomarker，被 US 食物药品管理局为 HF 在风险的层化作为一个标记在 2010 同意。我们与保存喷射部分(pEF ) 在病人为 HF 诊断作为 biomarker 估计了 galectin-3 并且把它的性能与 B 类型 natriuretic 的作比较肽(BNP ).MethodsThirty -- 有 HF (HFpEF 组) 的五个 pEF 病人和没有 HF (控制组) 的 43 个 pEF 病人被注册。在 HFpEF 和控制题目的 galectin-3 和 BNP 的血浆层次是坚定的。象为 HF 诊断的标记的 galectin-3 和 BNP 的敏感，特性，预兆的价值，和精确性被计算， galectin-3 和 BNP 的 compared.ResultsLevels 是 23.09 &#x000b1；6.97 ng/mL 和 270.46 &#x000b1；在 HFpEF 组的 330.41 pg/mL，和 16.74 &#x000b1；2.75 ng/mL 和 59.94 &#x000b1；在控制组的 29.93 pg/mL 分别地。在在二个组之间的 galectin-3 和 BNP 的层次的差别是重要的(P &#x0003c；0.01 ) 。作为为在学习题目的 HF 诊断的 biomarker，分别地， galectin-3 在 17.8 ng/mL 的截止价值显示出 94.3% 和 65.1% 的敏感和特性。分别地， BNP 在 100 pg/mL 的截止价值显示出 77.1% 和 90.7% 的敏感和特性。Galectin-3 是一显著地更敏感(P &#x0003c；0.05 ) 但是不太特定(P &#x0003c；0.01 ) biomarker 与 BNP 相比。在在 galectin-3 和 BNP 标记之间的积极预兆的价值，否定预兆的价值，和精确性的差别不是重要的(P &#x0003e；0.05 ) 。在操作典型曲线(95% 信心间隔) 的接收装置下面的区域是 0.891 (0.808-0.974 ) 并且(0.809-0.984 ) 分别地， 0.896 没有二之间的重要差别为 galectin-3 和 BNP 珍视(P &#x0003e；0.05 ) galectin-3 的 .ConclusionsThe 水平显著地与 HF 在病人被提高。Galectin-3 和 BNP 是为在有 pEF 的病人的 HF 的诊断的有用 biomarkers。

Increased N-terminal pro-brain natriuretic peptide level predicts atrial fibrillation after surgery for esophageal carcinoma

AIM: To evaluate the value of plasma N-terminal pro- brain natriuretic peptide (NT-proBNP) level for predicting postoperative atrial fibrillation (AF) in patients undergoing surgery for esophageal carcinoma. METHODS: NT-proBNP levels were measured in 142 patients 24 h before and 1 h after surgery for esophageal carcinoma. All patients having a preoperative cardiac diagnosis by electrocardiogram (ECG), remained under continuous monitoring for at least 48 h after surgery, and then underwent clinical cardiac evaluation until discharge. RESULTS: Postoperative AF occurred in 11 patients (7.7%). AF patients were significantly older (69.6 ± 12.2 years vs 63.4 ± 13.3 years, P = 0.031) than non-AF patients. There were no significant differences in history of diabetes mellitus, sex distribution, surgical approach, anastomosis site, intraoperative hypotension and postoperative fever. The preoperative plasma NT-proBNP level was significantly higher in patients who developed postoperative AF (121.3 ± 18.3 pg/mL vs 396.1 ± 42.6 pg/mL, P = 0.016). After adjustment for age, gender, chronic obstructive pulmonary disease (COPD), history of cardiac diseases, hypertension, postoperative hypoxia and thoracic-gastric dilation, NT-proBNP levels were found to be associated with the highest risk factor for postoperative AF (odds ratio = 4.711, 95% CI = 1.212 to 7.644, P = 0.008).CONCLUSION: An elevated perioperative plasma BNP level is a strong and independent predictor of postoperative AF in patients undergoing surgery for esophageal carcinoma. This finding has important implications for identifying patients at higher risk of postoperative AF who should be considered for preventive antiarrhythmic therapy.