Comparison of effects on left ventricular filling pressure of intravenous nesiritide and high-dose nitroglycerin in patients with decompensated heart failure.
The results of this study showed an advantage of nesiritide compared with high-dose nitroglycerin in the treatment of patients with decompensated heart failure. Nesiritide resulted in an early decrease in pulmonary capillary wedge pressure (< or =15 minutes), which was sustained throughout the study period (24 hours) without the need for up-titration. In contrast, the onset of the nitroglycerin-mediated hemodynamic effect was delayed, and despite aggressive up-titration, the decrease in pulmonary capillary wedge pressure was gradually attenuated because of the early development of tolerance.
Elkayam
Uri
U
Heart Failure Program, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. elkayam@usc.edu
Akhter
Mohammed W
MW
Singh
Harpreet
H
Khan
Salman
S
Usman
Ahsan
A
D006328:Cardiac Catheterization; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000008:administration & dosage / Q000627:therapeutic use*; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D011669:Pulmonary Wedge Pressure / Q000187:drug effects*; D013997:Time Factors; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects*
D045283:Natriuretic Agents; D014665:Vasodilator Agents; D020097:Natriuretic Peptide, Brain; D005996:Nitroglycerin