Effect Of Brain Natriuretic Peptide On Inflammatory Factors And Myocardial Function Recovery Of Heart Failure Patients With Acute Myocardial Infarction Underwent Percutaneous Coronary Intervention

Background:The morbidity of coronary heart disease(CHD) is rising in our country.Acute myocardial infarction(AMI) is the main reason causing patients with CHD death.Early,sufficient and sustained patency of the infarct-related coronary artery(IRA) has become the main goal in the care of patients with ST-segment elevation myocardial infarction(STEMI).After thrombolytic therapy or PCI in STEMI,there are some patients retaining an impaired microvascular perfusion despite restoration of normal flow in the epicardial infarct-related artery,which may be owing to microcirculation damage.Brain natriuretic peptide could improve the hemodynamic index of acute heart failure patients,degrade pulmonary capillary wedge pressure (PCWP),dilate coronary artery,increase blood supply of myocardium, ameliorate the activation of neuroendocrine and decrease the release of inflammatory factors.Objective:Observe the effect of brain natriuretic peptide(BNP) on inflammatory factors,myocardial function and prognosis of patients with acute myocardial infarction underwent emergence percutaneous coronary intervention(PCI). Methods:Ninty-two patients randomized to BNP group and control group.Patients of BNP group were given BNP for 3 d and the control group were given nitroglycerin for 3 d.1.Observe the peak of creatine kinase(CK),CK-MB,corrected TIMI frame count(CTFC),wall motion index(WMSI),resolution of ST segment and NT-proBNP.2.The level of angiotensionâ…¡(Angâ…¡)and aldosterone(Ald) before PCI and 6 after PCI were measure and the effect of BNP on Angâ…¡and Ald were analysed.3.The levels of soluble intercellular adhesion molecule-1(sICAM-1), soluble vascular adhesion molecule-1(sVCAM-1) and interleukin-6(IL-6) of the two groups were measured.4.The risk for major adverse cardiac events(MACE,including death, recurrent MI,recurrent angina,heart failure) at 12 weeks was analyzed.Results:1.There were no significant differences between the two groups with regard to age,sex,mean blood pressure,heart rate,incidence of coronary risk factors.2.There were no difference between the two groups with respect to many angiographic variables:location of culprit lesion,collateral circulation, reference diameter,minimal luminal diameter.3.The levels of sICAM-1,sVCAM-1and IL-6 before PCI of the two groups had no difference.24 h and 72 h after PCI,the sICAM-1,sVCAM-1 and IL-6 levels of BNP group were lower than the control group.4.The peak of CK and CK-MB of BNP group were lower than the control group.5.There was no difference between the two groups in Angâ…¡and Ald before PCI.6h after PCI,the levels of Angâ…¡and Ald of the BNP group were lower than that of before operation. 6.There were no difference of the two groups in CTFC and the percentage of complete ST-segment-elevation resolution,while the WMSI after PCI of BNP group was lower than the control group.7.12w after PCI,the risk for MACE was lower than the control group.Conclusions:The results suggested:1.BNP could decrease the levels of inflammatory factors and endocrine hormone.2.BNP could improve cardial function and lessen the damage of myocardial cells.3.BNP could diminish the risk of MACE and ameliorate the prognosis of patients.