BNP in decompensated heart failure: diagnostic, prognostic and therapeutic potential.
B-type or brain natriuretic peptide (BNP) is a balanced vasodilator with no inotropic nor chronotropic properties. Plasma levels can be used in diagnosis and prognosis of patients with heart failure, hypertension, myocardial infarction, right ventricular dysfunction and cor pulmonale. Intravenous therapy with BNP (nesiritide) in nearly 1000 patients demonstrated significant dose-dependent reductions in pulmonary capillary wedge pressure and systemic vascular resistance, as well as increased cardiac index. Compared to dobutamine, it is not pro-arrhythmic and has no effect on heart rate. Compared to standard therapy, it improves dyspnea by 3 h of therapy and leads to fewer headaches and arrhythmias than the commonly used intravenous agents nitroglycerin and dobutamine, respectively. Current research suggests an important role for use of nesiritide in the treatment of decompensated heart failure.
Burger
M R
MR
Beth Israel Deaconess Medical Center, Noninvasive Cardiology Laboratory, Boston, MA 02215, USA.
Burger
A J
AJ
D015415:Biomarkers / Q000097:blood; D004417:Dyspnea / Q000188:drug therapy; D006333:Heart Failure / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000378:metabolism* / Q000502:physiology / Q000627:therapeutic use*; D011379:Prognosis; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D014655:Vascular Resistance / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*
D015415:Biomarkers; D011994:Recombinant Proteins; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain