Effect of recombinant human brain natriuretic combined with nicorandil in the treatment of coronary heart disease complicated with acute left heart failure
ZHANG Fang-fang
LI Lei
QIAN Wei
GAO Xiu-yin
Abstract：Objective To explore the effect of recombinant human brain natriuretic peptide(rh-BNP)for injection combined with nicorandil in the treatment of coronary heart disease complicated with acute left heart failure(ALHF).Methods From August 2020 to October 2023,120 patients with coronary heart disease and ALHF admitted to the Affiliated Hospital of Xuzhou Medical University were selected and assigned to the study group and the control group using the random number table method,with 60 cases in each group.The control group was given the conventional treatment and nicorandil treatment.On this basis,the study group was treated with rh-BNP.Clinical efficacy and changes in ventricular remodeling parameters were compared between the two groups.Serum levels of serum soluble growth stimulation expressed gene 2 protein(sST2),N-terminal pro-brain natriuretic peptide(NT-proBNP)and endocrine hormones in both groups were measured before treatment and on day 3 after treatment.Adverse reactions that occurred during treatment and adverse cardiovascular events that occurred within 6 months after treatment were recorded.Results The effective rates in the study group and control group were 93.33%and 80.00%,and the former was significantly higher(P<0.05).After treatment,heart rate(HR)and systolic blood pressure(SBP)of the study group were lower than those of the control group.The left ventricular ejection fraction(LVEF)of the study group was higher than that of the control group.The left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular posterior wall thickness(LVPWT),left ventricular posterior wall end-systolic thickness(PWS)and left ventricular posterior wall end-diastolic thickness(PWD)of the study group were lower than those of the control group[(53.94±5.63)mm vs.(56.22±5.75)mm、(49.36±5.24)mm vs.(53.42±5.47)mm、(7.68±0.79)mm vs.(8.94±0.93)mm、(9.13±0.95)mm vs.(10.22±1.14)mm、(10.46±1.35)mm vs.(11.04±1.27)mm,all P<0.05].After treatment,the serum levels of sST2 and NT-proBNP in the study group were lower than those in the control group[(27.38±2.89)ng/ml vs.(37.45±3.86)ng/ml、(351.26±36.77)ng/L vs.(455.72±46.38)ng/L,all P<0.05].After treatment,the levels of endothelin-1(ET-1)and angiotensin Ⅱ(Ang Ⅱ)in the study group were lower than those in the control group[(37.69±3.84)ng/L vs.(45.11±4.62)ng/L、(56.87±5.83)ng/L vs.(72.66±7.35)ng/L],and the level of nitric oxide(NO)was higher than that in the control group[(75.62±7.69)μmol/L vs.(67.85±7.14)μmol/L,P<0.05).The risk of adverse reactions during treatment was comparable between the two groups(11.67%vs.8.33%,P>0.05).The incidence rates of adverse events within six months after treatment was lower in the study group(6.67%vs.20.00%,P<0.05).Conclusion rh-BNP combined with nicorandil is effective in the treatment of coronary heart disease with ALHF.It can effectively inhibit ventricular remodeling,lower serum sST2 and NT-proBNP levels,and regulate endocrine hormone levels.
Keywords：Recombinant human brain natriuretic peptideNicorandilCoronary heart diseaseAcute left heart failureVentricular remodelingSoluble growth stimulation expressed gene 2 proteinN terminal pro-brain natriuretic peptide
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 253-259 )