Clinical Efficacy of Recombinant Human Brain Natriuretic Peptide Combined with Tolvaptan in the Treatment of Acute Left Heart Failure and its Effects on Heart Failure Markers and Ventricular Remodeling
Objective:To investigate the clinical efficacy of recombinant human brain natriuretic peptide(rhBNP)combined with tolvaptan in the treatment of acute left heart failure(ALHF)and its effects on heart failure markers and ventricular remodeling.Methods:A total of 102 patients with ALHF from January 2022 to February 2023 were selected and divided into the control group and the observation group by random number table method,with 51 patients in each group.The control group was treated with rhBNP in addition to the conventional treatment,whereas the observation group was treated with tolvaptan in addition to the treatment given in the control group,and both groups were treated for 3 days.The changes in blood gas analysis results[arterial partial arterial pressure of oxygen(PaO2),oxygen saturation(SaO2)and pH],heart failure markers[serum hypoxia-inducible factor-1ɑ(HIF-1ɑ),glucose regulatory protein 78(GRP78),microRNA-499(miR-499)],and left ventricular remodeling-related parameters[left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF)]before and after 7 days of treatment as well as clinical effect and adverse reactions were observed and compared between the two groups.Results:After 7 days of treatment,PaO2,SaO2 and pH in the observation group were higher than those in the control group(P<0.05),and the levels of serum HIF-1ɑ,GRP78 and miR-499 in the observation group were lower than those in the control group(P<0.05).LVEDD and LVESD in the observation group were both lower than those in the control group,with LVEF higher than that in the control group(P<0.05).The total response rate in the observation group(94.12%)was higher than that in the control group(78.43%,P<0.05).No statistically significant difference was observed in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:The combined rhBNP and tolvaptan is effective in improving the blood gases in patients with ALHF,reducing such heart failure markers as levels of serum HIF-1ɑ,GRP78,and miR-499,and inhibiting ventricular remodeling,and did not increase the risk of adverse reactions.
recombinant human brain natriuretic peptidetolvaptanacute left heart failureefficacyheart failure markersventricular remodeling
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