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重组人脑利钠肽联合血管活性药物对老年心力衰竭合并低血压患者注射治疗的疗效比较研究

The comparative study of the efficacy of recombinant human brain natriuretic peptide combined with vasoactive medications for elderly patients with heart failure and hypotension receiving injections.

作者信息

Meng Rui, Li Xiangnan, Liu Huimin, Yi Zhong, Han Yalei, Xie Qing, Xiu Helu, Yao Fei, Guo Na, Yu Yan

机构信息

Department of Geriatrics, Aerospace Center Hospital, No. 15 Yuquan Road, Beijing, 100049, China.

Department of Cardiology, Aerospace Center Hospital, No. 15 Yuquan Road, Beijing, 100049, China.

出版信息

BMC Cardiovasc Disord. 2025 Mar 15;25(1):185. doi: 10.1186/s12872-025-04609-8.

Abstract

BACKGROUND

Heart failure (HF) in elderly patients with concurrent hypotension presents a therapeutic challenge due to limited standard HF therapies' applicability. Recombinant human brain natriuretic peptide (rhBNP) and vasoactive medications have shown potential in HF management, but their combined efficacy in elderly patients with HF and hypotension remains understudied.

METHODS

This retrospective cohort study included elderly HF patients with hypotension who received rhBNP alone (Group A, n = 68), rhBNP with dobutamine (Group B, n = 74), or rhBNP with dopamine (Group C, n = 71). Biomarker responses, cardiac function, adverse events, and cost implications were compared among the groups using statistical analysis.

RESULTS

The combination therapy groups (B and C) showed significantly lower NT-proBNP levels compared to the rhBNP-alone group (P < 0.001). Troponin I levels were also lower in the combination therapy groups compared to the rhBNP-alone group (P < 0.05). Left ventricular ejection fraction (LVEF) was significantly higher in the combination therapy groups compared to the rhBNP-alone group (P < 0.05). No significant differences were found in adverse events or cost implications among the groups.

CONCLUSION

Combining rhBNP with vasoactive medications in elderly patients with HF and hypotension led to notable reductions in biomarkers and improvements in LVEF without significant differences in adverse events or cost implications. These findings support the potential utility of combined rhBNP and vasoactive medications therapy in optimizing HF management in this patient population, warranting further investigation through prospective studies.

TRIAL REGISTRATION

Not applicable.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

老年并发低血压的心力衰竭(HF)患者由于标准HF治疗方法适用性有限,带来了治疗挑战。重组人脑利钠肽(rhBNP)和血管活性药物在HF管理中已显示出潜力,但它们在老年HF合并低血压患者中的联合疗效仍研究不足。

方法

这项回顾性队列研究纳入了老年HF合并低血压患者,这些患者单独接受rhBNP治疗(A组,n = 68)、rhBNP联合多巴酚丁胺治疗(B组,n = 74)或rhBNP联合多巴胺治疗(C组,n = 71)。使用统计分析比较了各组之间的生物标志物反应、心功能、不良事件和成本影响。

结果

与单独使用rhBNP的组相比,联合治疗组(B组和C组)的NT-proBNP水平显著降低(P < 0.001)。与单独使用rhBNP的组相比,联合治疗组的肌钙蛋白I水平也较低(P < 0.05)。与单独使用rhBNP的组相比,联合治疗组的左心室射血分数(LVEF)显著更高(P < 0.05)。各组之间在不良事件或成本影响方面未发现显著差异。

结论

在老年HF合并低血压患者中,将rhBNP与血管活性药物联合使用可显著降低生物标志物水平并改善LVEF,且在不良事件或成本影响方面无显著差异。这些发现支持了rhBNP与血管活性药物联合治疗在优化该患者群体HF管理中的潜在效用,值得通过前瞻性研究进一步调查。

试验注册

不适用。

临床试验编号

不适用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c9d/11909945/7b688990e1aa/12872_2025_4609_Fig1_HTML.jpg

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