Abstract:

Objective To investigate the curative effect of meglumine cyclic adenylate(MCA) combined with recombinant human brain natriuretic peptide(rhBNP) in treatment of coronary artery disease patients with heart failure,and the changes of hemodynamics and the  BNP concentration. Methods Fifty-four patients with coronary atherosclerotic heart disease whose heart function was Ⅲ-Ⅳ grade were divided into three groups(n=18):groupⅠ,conventional therapy;group Ⅱ:conventional therapy plus MCA;group Ⅲ,conventional therapy plus MCA combined with rhBNP. Results ① Clinical curative effect:the total effective rates of group Ⅱ(77.8%) and group Ⅲ(88.9%) were higher than that of group Ⅰ(61.1%), but the total effectively rate of group Ⅲ was obviously higher than that of groupⅠ(P<0.05). ② The changes of hemodynamics:after treatment,the stroke volume (SV),cardiac output (CO),cardiac index (CI) and left ventricle ejection fraction (LVEF) were increased in groupⅠ,Ⅱ,Ⅲ;they were significanthy increased in groupⅡ and group Ⅲ(P<0.01);compared with group Ⅱ,they were significanthy increased in group Ⅲ(P<0.05,P<0.01). The ratios of the peak flow rate of bicuspid blood current diastolic phase to atrial systole period (E/A)  in group Ⅱand group Ⅲ were increased(P<0.01);compared with group Ⅱ,the E/A in group Ⅲ was significanthy increased (P<0.05). ③ The changes of BNP concentration:after treatment,the BNP concentrations  were decreased in three groups,especially in group Ⅱ(P<0.01) and group Ⅲ(P<0.001);compared with groupⅡ,it was significant decreased in group Ⅲ(P<0.01). Conclusion MCAcombined with rhBNP has utility,safety and synergistic effect in treatment of  coronary artery disease patients with heart failure. 

Key words: meglumine cyclic adenylate;recombinant human brain natriuretic peptide;brain natriuretic peptide;heart failure;hemodynamics