B-type natriuretic peptide for the treatment of congestive heart failure.
Since their discovery 20 years ago, the natriuretic peptides have emerged as an important endocrine response to excessive increases in intravascular volume. In a cGMP-dependent fashion, the natriuretic peptides induce a balanced vasodilation, decreasing preload and afterload in states of cardiac impairment and stimulating the excretion of salt and water by the kidneys. Recombinant B-type natriuretic peptide (nesiritide), identical to the principle natriuretic peptide produced by human cardiac ventricles, has just been approved for the treatment of acute decompensated congestive heart failure. Nesiritide has been shown in controlled trials in congestive heart failure to decrease pulmonary capillary wedge pressure, improve cardiac output, stimulate natriuresis and diuresis, and rapidly induce symptomatic relief. As a naturally occurring stress hormone of the heart, with particular rectifying effects on the pulmonary, cardiac and renal vasculatures, B-type natriuretic peptide may prove useful in a variety of cardiovascular disease states.
Schreiner
George F
GF
Scios Inc., 820 West Maude Avenue, Sunnyvale, California 94085, USA. schreiner@sciosinc.com
Protter
Andrew A
AA
D000595:Amino Acid Sequence; D000818:Animals; D009320:Atrial Natriuretic Factor / Q000502:physiology / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008969:Molecular Sequence Data; D020097:Natriuretic Peptide, Brain; D011994:Recombinant Proteins / Q000627:therapeutic use
D002316:Cardiotonic Agents; D011994:Recombinant Proteins; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor