To compare the therapeutic efficacy of recombinant human brain natriuretic peptide (rhBNP) with dobutamine on acute decompensated heart failure patients with different blood BNP levels

Patients with acute decompensated heart failure (ADHF) whose left ventricular ejection fraction(LVEF) was <40%, were assigned to a high BNP group (BNP ≤ 3000 pg/mL) or an extra-high BNP group (BNP > 3000 pg/mL) , depending on their admission plasma BNP levels. Each group was then subdivided into rhBNP or dobutamine subgroups according to intravenous administration with either rhBNP or dobutamine for 24-72h. The effects of rhBNP and dobutamine on patients in the high and extra-high BNP groups were compared.

Inclusion Criteria:

• patients were classified as NYHA class III-IV
• ejection fraction <40%

Exclusion Criteria:

• intravenous administration with rhBNP or dobutamine in the 2 weeks before study entry
• acute myocardial infarction
• significant valvular stenosis
• serious ventricular arrhythmia (frequent ventricular premature beat of >5 bpm, nonsustained and sustained ventricular tachycardia)
• blood pressure <95/60 mmHg or >140/90 mmHg
• shock
• hypovolemia
• hepatic or renal impairment
• pregnant and lactating women.

Patients with acute decompensated heart failure who required hospitalization