Therapeutic efficacy of recombinant human brain natriuretic peptide in elderly chronic heart failure patients: associations with changes in PⅢNP and suPAR levels

Objective To systematically evaluate the clinical efficacy of recombinant human brain natriuretic peptide (rhBNP) added to conventional treatment in elderly patients with chronic heart failure (CHF), and to analyze its regulatory effects on fibrosis- and inflammation-related biomarkers such as procollagen type III amino-terminal propeptide (PⅢNP) and soluble urokinase-type plasminogen activator receptor (suPAR). Methods A retrospective comparative cohort study was conducted to collect clinical data of 124 elderly CHF patients treated in our hospital from February 2023 to April 2025. According to the treatment regimens received, the patients were divided into two groups: the control group ( n = 62) received conventional treatment, while the study group ( n = 62) received rhBNP in addition to conventional treatment. The clinical therapeutic effects, cardiac function indicators [left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), cardiac index (CI)], blood gas indices [arterial oxygen partial pressure (PaO2), arterial carbon dioxide partial pressure (PaCO2)], myocardial injury markers [N-terminal pro-B-type natriuretic peptide (NT-proBNP), cardiac troponin I (cTnI), lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB)], fibrosis and inflammation-related biomarkers (PⅢNP, suPAR), as well as adverse reactions and adverse prognosis, were compared between the two groups. Results (1) Clinical therapeutic effects: Post-treatment, the overall efficacy of the study group was significantly better than that of the control group (total effective rate: 93.55% vs. 82.26%, P < 0.05). (2) Cardiac function indicators: Post-treatment, LVEF and CI levels increased compared with Pre-treatment, while LVEDD and LVESD decreased in both groups, with greater changes observed in the study group ( P < 0.05). (3) Blood gas indices: Post-treatment, PaO2 increased and PaCO2 decreased in both groups compared with Pre-treatment, with greater changes observed in the study group ( P < 0.05). (4) Myocardial injury markers: Post-treatment, NT-proBNP, cTnI, LDH, and CK-MB levels decreased in both groups compared with Pre-treatment, with greater reductions in the study group ( P < 0.05). (5) Fibrosis and inflammation-related biomarkers: Post-treatment, PⅢNP and suPAR levels decreased in both groups compared with Pre-treatment, with more pronounced improvements observed in the study group ( P < 0.05). (6) Adverse reactions and adverse prognosis: There were no statistically significant differences between the two groups in the incidence of related adverse reactions or adverse prognosis ( P > 0.05). Conclusion Elderly CHF patients receiving rhBNP in addition to conventional treatment showed significantly greater improvements in cardiac function, myocardial injury markers, blood gas parameters, and fibrosis- and inflammation-related biomarkers (PⅢNP, suPAR). Meanwhile, the treatment was well tolerated, with no obvious increase in adverse reactions or adverse prognosis. However, considering the limitations of the study design, these findings mainly reflect correlation rather than causation. Further validation is required through multicenter, large-sample, prospective randomized controlled trials.