The Impact of Early rhBNP on Myocardial Work in Patients With Anterior ST-segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention
试验速览
- 阶段
- 4 期
- 入组人数
- 200
- 主要终点
- Global myocardial work efficiency by echocardiography
研究概览
简要总结
The study intends to evaluate the efficacy of early rhBNP on myocardial work in patients with anterior ST-segment elevation myocardial infarction after percutaneous coronary intervention
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 75 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Anterior myocardial infarct (anterior myocardial infarct is defined as persistent chest pain for 30 mins at least, with ST-segment elevation of at least 0.2 mV in two or more contiguous precordial leads) within 12 hours after onsets of symptom;
- •No contraindication for rhBNP;
- •Left anterior descending (LAD) as culprit vessel, with TIMI 0-1 grade.
排除标准
- •1.Cardiogenic shock (systolic BP <90mmHg after fluid infusion or systolic BP<100mmHg after vasoactive drugs);
- •History of myocardial infarct;
- •3.Severe arrhythmia: with III degree A-V block ,atrial fibrillation,ventricular fibrillation,ventricular tachycardia;
- •Any history of severe renal or hepatic dysfunction (hepatic failure, cirrhosis, portal hypertension or active hepatitis); neutropenia or thrombocytopenia; known acute pancreatitis;
- •Pregnant or lactating;
- •life expectancy≤12 months;
- •Inability to follow the protocol and comply with follow-up requirements or any other reason the investigator feels would place the patient at increased risk;
研究组 & 干预措施
rhBNP
rhBNP intra-coronary injection 1.5 ug/kg loading dose, with intravenous injection 0.0075-0.01 ug/kg/min persistent for 72 hour.
干预措施: rhBNP (Drug)
Control
Saline intra-coronary injection 0.15ml/kg loading dose, with same intravenous injection speed for 72 hour after randomization.
干预措施: Control (Drug)
结局指标
主要结局
Global myocardial work efficiency by echocardiography
时间窗: 30 days after PCI
Echocardial myocardial work (MW) may identify early abnormalities in left ventricular(LV) function and may establish a more sensitive index for early stage LV dysfunction.Global MW was quantified by calculating the rate of regional shortening by differentiation of the strain tracing and multiplying by instantaneous LV pressure. This instantaneous measure of power was this integrated over time to measure MW as a function of time during systole (time interval from mitral valve closure through to mitral valve opening). During LV ejection, segments were analyzed for wasted work (WW) and/or constructive work (CW), with global values determined as the averages of all segmental values and displayed on the LV pressure-strain loop diagram. Global myocardial work efficiency (GWE; %), constructive MW divided by the sum of CW and WW, expressed as a percentage.
次要结局
- Clinical Outcomes(30 days after PCI)
- Global myocardial constructive work by echocardiography(Day 1, 7, 30 after PCI)
- Global myocardial waste work by echocardiography(Day 1, 7, 30 after PCI)
- Global myocardial work index by echocardiography(Day 1, 7, 30 after PCI)