| Objectives: The aim of this study was to evaluate the effects ofintravenous rhBNP（recombinant human brain natriuretic peptide）on regionalmyocardium deformability in patients with anterior acute myocardialinfarction after primary percutaneous coronary intervention(pPCI).Methods: From January2012to December2013,a total of35patientswith first-time anterior acute myocardial infarction who underwent pPCIwithin12hour of symptom onset were enrolled in this study. The patientswere randomized into rhBNP group(group A,n=18) and control group(groupB,n=17). Under standard treatment,patients in rhBNP group received a1.5ug/kg/min intravenous bolus injection followed by0.0075μg/kg/min-0.020μg/kg/min infusion for72hours. Patients in control group may be giventhe right amount of nitrates and diuretics. Myocardial enzymes were observedafter pPCI, and the peak of cTnI were compared. SRs(peak systolic strain rate),SRe(peak early diastolic strain rate), SRa(peak late diastolic strain rate) ininfarcted segments and LVEF(left ventricular ejecton fraction) were observedand recorded by echocardiography at immediately post-PCI,7thday and1stmonth. The major adverse cardiac events(MACE) were followed up for6months.Results: No significant difference in baseline clinical characteristics wasfound between two groups, including age, gender,previous history, bloodpressure, heart rate, time to revascularization, and basic medication,etc(P＞0.05). The value of LVEF in rhBNP group was significantly higher than that incontrol group at1stmonth(51.83±5.19vs.47.97±5.78, P＜0.05), while therewere no significant difference between the two groups at immediatelypost-PCI and7thday(45.47±4.59vs.44.91±5.31,46.71±5.29vs.45.37± 4.87,all P＞0.05). The value of LVEF increased significantly in rhBNP groupand control group respectively from7thday to1stmonth(46.71±5.29vs.51.83±5.19,45.37±4.87vs.47.97±5.78,all P＞0.05), but no sigenificantdifference were observed at immediately post-PCI and7thday(45.47±4.59vs.46.71±5.29,44.91±5.31vs.45.37±4.87,all P＜0.05). The value of SRs inrhBNP group was significantly higher than that in control group at7thday(0.91±0.23vs.0.81±0.22,P＜0.05) and1stmonth(0.95±0.24vs.0.84±0.22,P＜0.05), while there were no significant difference between the twogroups at immediately post-PCI(0.48±0.15vs.0.47±0.14,P＞0.05). SRsincreased significantly in rhBNP group and control group in the first week(0.48±0.15vs.0.91±0.23,0.47±0.14vs.0.81±0.22,all P＜0.05) and therewas significant increase from7thday to1stmonth(0.91±0.23vs.0.95±0.24,0.81±0.22vs.0.84±0.22,P＜0.05). The value of SRe in rhBNP groupwas significantly higher than that in control group at1stmonth (1.28±0.35vs.1.09±0.34,P＜0.05), while there were no significant difference between thetwo groups at immediately post-PCI(0.93±0.32vs.0.92±0.32,P＞0.05) and7thday(0.94±0.32vs.0.93±0.33,P＞0.05). SRe increased significantly inrhBNP group and control group from7thday to1stmonth(0.94±0.32vs.1.28±0.35,0.93±0.33vs.1.09±0.34,P＜0.05),but no significant differencewere observed at immediately post-PCI and7thday (0.93±0.32vs.0.94±0.32,0.92±0.32vs.0.93±0.33,P＞0.05). The value of SRa in rhBNP groupwas significantly higher than that in control group at1stmonth(1.30±0.34vs.1.08±0.33，P＜0.05), while there were no significant difference between thetwo groups at immediately post-PCI(0.95±0.31vs.0.93±0.30,P＞0.05) and7thday(0.96±0.31vs.0.94±0.31,P＞0.05). SRa increased significantly in rhBNPgroup and control group from7thday to1stmonth(0.96±0.31vs.1.30±0.34,0.94±0.33vs.1.08±0.33,P＜0.05), but no sigenificant differencewere observed at immediately post-PCI and7thday(0.95±0.31vs.0.96±0.31,0.93±0.30vs.0.94±0.33,P＞0.05). The peak level of cTnI was significantlylower in rhBNP group than that in control group(50.09±16.88vs.63.24±18.60,P=0.036). The incidence of MACE was not reduced significantly(P＞0.05).Conclusions: Intravenous administration of rhBNP can improve theregional myocardium deformability, reduce the infracted size, protect ischemicmyocardium and inhibit the process of left ventricular remodeling... |
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