Serum NF-κB P65 Level In Heart Failure Patients And The Effect Of RhBNP Treatment

Background and Objective:We designed this experiment to test the serum NF-κB p65 level in heart failure patients and to approach the relationship between NF-κB and pathogenesis of heart failure,evaluate the clinical therapeutic effect of rhBNP on heart failure patients by observing changes of several indexes and NF-κB p65 after drug-use.Methods:Forty patients with HF were recuited for the study,who came from the in-patient of cardiology department,Second Affiliated Hospital, Xiangya Medical College since Aug,2008 to Jan,2009.They were selected according to the selecting and exclusion standards of the fourth stage multicentre clinical investigation of Xinhuosu,and were ordered by time.They were given rhBNP 1000μg by vessel pumping,and were tested blood routine,hepatic and renal function,electrolytes,NT-pro BNP and hs-CRP before and 24hours later after discontinuation.Record vital signs,urine volume of 24 hours,score the degree of dyspnea at the same time.Meanwhile,collect venous blood samples pre drug-use and 24hours later after discontinuation,separate serum and store them in -20℃refrigerator,waiting for testing the nuclear factor kappa B P65 peptide(NF-κB P65) in serum by ELISA at the end of experiment.Results:1.After treatment of rhBNP,the patients' SBP and DBP decreased, HR and respiratory rate slowed down,urine volume increased obviously, and there's no change in body temperature;The patients' liver and renal function had improved to some degree,among which the changes of AST,BUN and UA have statistics significance(P＜0.05).However,the patients' blood routine and electrolyte had no significant changes except Cl~- decreased;Lg-NT-pro BNP has reduced significantly(3.7572±0.5476 V.S 3.5740±0.5488,P=0.006);Lg-hs-CRP has reduced observably (1.1533±0.5275 V.S 1.0199±0.5126,P=0.002);Lg-NF-κB has reduced as well(0.4522±0.7061 V.S 0.3422±0.6127,P=0.237) but had no statistics significance. 2.Lg-NF-κB p65 has nothing to do with blood pressure,heart rate, respiratory frequency and urine volume in 24 hours(P＞0.05) by Pearson correlation analysis;It also has nothing to do with liver function and creatinine,urine acid level,but do has positive correlation with blood urea nitrogen(r=0.440,P=0.005)level;It has no correlation with Lg-NT-pro BNP,Lg-hs-CRP and NYHA cardiac functional grading as well.3.Lg-NT-pro BNP has no correlation with Lg-NF-κB P65,but has positive correlation with Lg-hs-CRP(r=0.353,P=0.025) by Pearson correlation analysis;NT-pro BNP(χ~2 value is 17.035,P=0.000)and hs-CRP (χ~2 value is 10.628,P=0.005)have positive correlation with NYHA cardiac functional grading by Kruskal-Wallis test.Conclusion:1.After the intervention of rhBNP,the patients' NF-κB level in serum decreased and has statistical significance;hs-CRP level had also decreased,but the mechanism that why they decreased is still unknown.2.Serum NT-pro BNP and hs-CRP level in heart failure patients have positive correlation,and they both have correlation with NYHA cardiac functional grading.3.After the intervention of rhBNP,Plenty of indexes in the patients like BP,HR,R,urine volume,NT-pro BNP,et al.had improved significantly,which confirmed that rhBNP does have the abilities of dilate blood vessel,diuresis,inhibit the renin-angiotensin-aldosterone system(RAAS) and so on,it can be considered as first place drug used in HF therapy.4.rhBNP has considerable safety in clinical use.However,its safety on clinical use still need to be evaluated by prospective double-blind randomized controlled trials using case fatality ratio as end-point event.