Abstract
OBJECTIVES: To evaluate the efficacy of recombinant human brain natriuretic peptide (rhBNP) in patients with acute decompensated heart failure (ADHF) complicated with atrial fibrillation (AF) and poor response to conventional treatment. METHODS: The study included 172 ADHF patients with AF who had poor response to conventional therapy and received rhBNP. Primary observations including changes in blood pressure, C-reactive protein (CRP), heart rate, blood urea nitrogen, oxygen saturation, creatinine, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were monitored from admission to discharge. Secondary metrics included left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD) taken at the 3-month follow-up. AF recurrence was recorded, and logistic regression analyses were conducted. RESULTS: After treatment with rhBNP, patients' heart rate and blood pressure decreased significantly, oxygen saturation improved, levels of NT-proBNP and CRP decreased, and indicators of renal function improved. At 3 months, LVEF increased and LVESD decreased. Overall, patients in the recurrence group were older, had lower BMI, and showed higher baseline NT-proBNP, CRP, and renal function-related parameters compared with the non-recurrence group. Multivariate analysis demonstrated that low BMI, as well as elevated baseline creatinine, CRP, blood urea nitrogen, and, NT-proBNP were independent risk factors for AF recurrence. CONCLUSIONS: rhBNP significantly improves hemodynamics, reduces inflammation, and ameliorates renal function in ADHF patients with AF who respond poorly to conventional therapy. Low BMI and elevated baseline NT-proBNP, CRP, creatinine, and blood urea nitrogen are independent predictors of AF recurrence.