Protective effects of recombinant human brain natriuretic peptide on the myocardial injury induced by acute carbon monoxide poisoning

The expression of MALAT1, plasma brain natriuretic peptide, and Tei index in sepsis-induced myocardial injury

PURPOSE

We sought to investigate the expression of MALAT1, plasma brain natriuretic peptide, and Tei index in sepsis-induced myocardial injury.

METHODS

The current retrospective analysis focused on 146 sepsis patients admitted to our hospital from February 2021 to March 2023. Based on the presence or absence of myocardial injury, the patients were divided into two groups: the sepsis group (n = 80) and the sepsis-induced myocardial injury group (n = 66). Based on the 28-day mortality status of the patients, they were also divided into a survival group of 143 cases and a death group of 3 cases. The study compared the levels of MALAT1, plasma brain natriuretic peptide, and Tei index between the sepsis group and sepsis-induced myocardial injury group, as well as the comparison of two sets of ultrasound indicators. Univariate logistic regression analysis was performed to identify the influencing factors of sepsis-induced myocardial injury, followed by multivariate logistic regression analysis to identify the influencing factors of such condition. MALAT1, plasma brain natriuretic peptide and cardiac Tei index between the survival and death groups were compared and Pearson correlation analysis was conduct to assess their correlations.

RESULTS

In terms of general information, there were no significant differences in gender, age, BMI, mean arterial pressure, systolic pressure, diastolic pressure, respiratory rate, oxygenation index, basic diseases and infection site between the two groups (P > 0.05). However, significant differences were observed in heart rate, SOFA score, and APACHE II score between the two groups (P < 0.05). The levels of MALAT1, plasma brain natriuretic peptide, and Tei index in the sepsis-induced myocardial injury group were significantly higher than those in the sepsis group (P < 0.05). Furthermore, the sepsis-induced myocardial injury group exhibited lower left ventricular end-diastolic diameter and left ventricular end-systolic diameter compared to the sepsis group, along with higher levels of E, E/e', and e', showing significant differences (P < 0.05). The independent variables considered in the analysis included general data, ultrasound indicators with significant differences, as well as MALAT1, plasma brain natriuretic peptide, and Tei index. The dependent variable was sepsis-induced myocardial injury, and univariate logistic regression analysis identified E, E/e', e', MALAT1, plasma brain natriuretic peptide, and Tei index as influencing factors of sepsis-induced myocardial injury. Subsequently, a multivariate logistic regression analysis was conducted with the independent variables set as E, E/e', e', MALAT1, plasma brain natriuretic peptide, and Tei index, and the dependent variable as sepsis-induced myocardial injury. The results indicated that MALAT1, plasma brain natriuretic peptide, and Tei index were influencing factors of sepsis-induced myocardial injury. The levels of MALAT1, plasma brain natriuretic peptide and cardiac Tei index in the death group were significantly higher than those in the survival group (P < 0.05). The Pearson correlation analysis showed that MALAT1, plasma brain natriuretic peptide and cardiac Tei index were correlated with the prognosis of patients with sepsis-induced myocardial injury (P < 0.05).

CONCLUSION

We demonstrated high expression levels of MALAT1, plasma brain natriuretic peptide, and Tei index in patients with sepsis-induced myocardial injury. Ultrasound indicators can effectively contribute to the diagnosis of sepsis-induced myocardial injury. Moreover, MALAT1, plasma brain natriuretic peptide, and Tei index have been identified as influencing factors of sepsis-induced myocardial injury.

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.

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 contrast-induced 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 handwritten 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.

A narrative review on sacubitril/valsartan and ventricular arrhythmias

Sacubitril/valsartan, the first angiotensin receptor neprilysin inhibitor approved by the Food and Drug Administration for marketing, has been shown to reduce the risk of cardiovascular death or heart failure hospitalization and improve symptoms in patients with chronic heart failure with a reduced ejection fraction. However, some researchers have also found that sacubitril/valsartan has an antiarrhythmic effect. The mechanism by which sacubitril/valsartan reduces the mortality associated with malignant ventricular arrhythmias is not precise. Many studies have concluded that ventricular arrhythmia is associated with a reduction in myocardial fibrosis. This article reviews the current understanding of the effects of sacubitril/valsartan on the reduction of ventricular arrhythmia and explains its possible mechanisms. The results of this study suggest that sacubitril/valsartan reduces the occurrence of appropriate implantable cardioverter-defibrillator shocks. Meanwhile, sacubitril/valsartan may reduce the occurrence of ventricular arrhythmias by affecting 3 pathways of B-type natriuretic peptide, Angiotensin II, and Bradykinin. The conclusion of this study is that sacubitril/valsartan reduces the number of implantable cardioverter-defibrillator shocks and ventricular arrhythmias in heart failure with reduced ejection fraction patients.

Effect of Recombinant Human Brain Natriuretic Peptide on Acute Carbon Monoxide Poisoning Complicated with Heart Failure with Reduced Ejection Fraction

This paper aims to observe the effect of recombinant human brain natriuretic peptide (rhBNP) on treatment of acute carbon monoxide poisoning (ACMP) complicated with heart failure with reduced ejection fraction (HFREF).A total of 103 patients with ACMP complicated with HFREF admitted to our department from October 2016 to March 2020 were observed. Patients were divided into control group (50 cases) and experimental group (53 cases). The control group was given diuretic, vasodilator, and digitalis treatment, and the experimental group was supplemented with rhBNP treatment based on the control group. Patients' general information was collected. The levels of myocardial injury-associated indicators of patients were detected at and after admission.No significant differences were observed in the general data of patients compared with control group. The acute physiology and chronic health enquiry II score of patients was positively correlated with left ventricular ejection fraction (LVEF). At admission, the levels of myocardial injury indicators, N-terminal B-type brain natriuretic peptide, and cardiac ultrasound indexes had no significant difference between the control group and experimental group. However, after admission, the LVEF and stroke output levels were elevated, while the other indicators were all decreased compared with the control group.The rhBNP exerts a protective effect on ACMP-induced cardiomyocyte injury to improve cardiac function, shorten the length of hospital stay, and reduce the incidence and mortality of delayed encephalopathy after carbon monoxide poisoning.