Effect of recombinant human brain natriuretic peptide (rhBNP) versus nitroglycerin in patients with heart failure

Abstract

Background:This study was the first to evaluate the therapeutic outcomes of recombinant human brain natriuretic peptide (rhBNP) versus nitroglycerin (NIT) in patients with heart failure (HF).Methods:The electronic databases were systematically searched to identify available studies. The pooled odds ratios (ORs) and their 95% confidence intervals (95% CIs) were analyzed to assess the mortality, readmission, hypotension, and renal dysfunction in the comparison of rhBNP and NIT therapies.Results:Final 5 randomized controlled trials (RCTs) involving 782 patients with HF were carried out in our study. The pooled OR of mortality, readmission, and hypotension showed that no significant difference was found in both drugs (P > 0.05), with the absence of heterogeneity. The incidence of renal dysfunction was not significant difference in both groups (P = 0.85). The pooled OR from 2 studies of Asian population using multivariate analysis demonstrated that the use of rhBNP was correlated with a significantly decreased risk of renal dysfunction (I2 = 0.0%, OR = 0.19, P = 0.001). Possible publication bias was not detected using Egger's test (P > 0.05).Conclusions:The results suggested that rhBNP and NIT therapies were not significant difference in mortality, readmission, and hypotension. The use of rhBNP may become a useful predictor of renal dysfunction in Asian patients with HF. Additional studies are needed for Caucasian population with HF.

BNP and NT-proBNP as Diagnostic Biomarkers for Cardiac Dysfunction in Both Clinical and Forensic Medicine

“…It can directly dilate blood vessels and effectively reduce cardiac preload and afterload. Nesiritide, approved by the FDA for the therapy of acute decompensated HF in 2001, is a successful rhBNP that has several biological functions that are similar to endogenous BNP, including facilitating natriuresis, diuresis, inhibiting RAAS, increasing output of the heart, decreasing wedge pressure in pulmonary capillaries, and improving cardiac diastolic and systolic function [80,81,82,83]. As of today, rhBNP has been widely used for the therapy of HF from various causes.…”

Protective effects of recombinant human brain natriuretic peptide in perioperative period during open heart surgery

“…The above observation could be justified in the light of the fact that the natriuretic peptide has balanced expansion arteriovenous/coronary artery diastolic function ( 14 ). A related study also showed improvements in the hemodynamic parameters after 15 min of treatment ( 15 ). The natriuretic peptide could improve the heart rate through the comprehensive effect ( 16 ).…”

Role of recombinant human brain natriuretic peptide combined with sodium nitroprusside in improving quality of life and cardiac function in patients with acute heart failure

“…In recent years, with accumulating and detailed studies on the pathological mechanism underlying heart failure, neuroendocrine factors have drawn much attention (5,6). Recombinant human brain natriuretic peptide (RHBNP), which is a B-type natriuretic peptide, secretes an endogenous polypeptide, which is usually distributed in heart tissues and can effectively improve hemodynamic function (7). In addition, as a local multifunctional drug with spatial structure and biological activity similar to those of endogenous brain natriuretic peptides, RHBNP can regulate diuresis, promote the diuresis and relaxation of bladder smooth muscles, improve heart and kidney functions after cardiopulmonary bypass and accelerate healing following myocardial injury (7,8).…”

“…Recombinant human brain natriuretic peptide (RHBNP), which is a B-type natriuretic peptide, secretes an endogenous polypeptide, which is usually distributed in heart tissues and can effectively improve hemodynamic function (7). In addition, as a local multifunctional drug with spatial structure and biological activity similar to those of endogenous brain natriuretic peptides, RHBNP can regulate diuresis, promote the diuresis and relaxation of bladder smooth muscles, improve heart and kidney functions after cardiopulmonary bypass and accelerate healing following myocardial injury (7,8). Sodium nitroprusside (SN) is considered as the drug of choice for cardiac surgery as its short half-life enables high efficiency and rapid titration during and after cardiac surgery (9).…”