The effect of brain natriuretic peptide on serum angiotensin-converting enzyme 2 levels in acute heart failure patients with reduced ejection fraction
10.11958/20161435
- VernacularTitle:重组人脑型钠尿肽对急性射血分数降低心衰患者血清ACE2水平的影响
- Author:
Jie YAN
;
Hong ZHAO
;
Yanjun LIU
;
Pengyu SU
- Keywords:
heart failure;
ejection fraction;
renin-angiotensin system;
angiotensin-converting enzyme 2;
brain natriuretic peptide
- From:
Tianjin Medical Journal
2017;45(4):372-376
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of brain natriuretic peptide (BNP) on serum angiotensin-converting enzyme (ACE) 2 levels in acute heart failure patients with reduced ejection fraction (HFrEF). Methods A total of 106 patients with acute HFrEF were selected, and were divided randomly into control group and trial group. The control group was under routine treatment, while the trial group was under routine treatment combined with lyophiluzed recombinant human BNP for 24-hour. Cardiac functional parameters were measured by echocardiography both at the enrollment and the end of 7-day treatment. Serum levels of ACE2 and N-terminal pro-BNP (NT-proBNP) were determined using commercially available ELISA kits at the enrollment, the end of 24-hour treatment, and the end of 7-day treatment,respectively. Results A total of 103 patients with acute HFrEF were enrolled (control group=51, trial group=52). There were no significant differences in the use of drugs (e.g., aspirin) and serum biochemical indices (e.g. cardiac troponin I, creatinine) before treatment between these two groups. Compared to systolic blood pressure (SBP) at admission, SBP on the second day after treatment were significantly decreased in two groups (P<0.05). Compared to left ventricular ejection fraction (LVEF) at admission, LVEF values were significantly elevated on the seventh day after treatment in two groups ( P<0.05). There were no significant differences in SBP, diastolic blood pressure (DBP), and LVEF at admission between these two groups (P>0.05);there were also no significant differences in DBP on the second day after treatment, and LVEF on the seventh day after treatment (P>0.05), while SBP was significantly higher on the second day after treatment in control group than that of trial group (P < 0.05). Serum levels of NT-proBNP were decreased with the prolongation of time in two groups. Serum levels of ACE2 were decreased with the prolongation of time in control group, while were increased initially following decreased (which were still higher on the seventh day after treatment than that at admission) with the prolongation of time in trial group. Serum levels of NT-proBNP were higher after 2 days treatment or 7 days of treatment in control group than those of trial group, while serum levels of ACE2 were decreased after 2 days of treatment or 7 days of treatment in control group than those of trial group (P<0.05). Conclusion Patients with acute HFrEF may benefit from BNP by increasing serum ACE2 levels.