Nesiritide for pulmonary arterial hypertension with decompensated cor pulmonale.
Pulmonary arterial hypertension complicated by decompensated cor pulmonale is a challenging clinical problem with few effective therapeutic options. B-type natriuretic peptide is a pluripotent hormone that promotes diuresis and natriuresis, vasodilates systemic and pulmonary vessels, and reduces circulating levels of endothelin and aldosterone. It may represent a possible therapeutic strategy for decompensated cor pulmonale in the same manner that it is used to treat decompensated left heart failure. The authors report their experience with B-type natriuretic peptide as adjunctive therapy for pulmonary arterial hypertension complicated by decompensated cor pulmonale. A detailed case report is presented followed by the evaluation of a series of 11 cases occurring in eight patients from December 2002 through April 2004.
Kingman
Martha S
MS
Pulmonary Hypertension Group, Pulmonary Hypertension Clinic, Cardiovascular Institute, St. Paul University Hospital, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Thompson
Brenda S
BS
Newkirk
Trixie
T
Torres
Fernando
F
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D015400:Clinical Nursing Research; D018450:Disease Progression; D016903:Drug Monitoring; D004417:Dyspnea / Q000209:etiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D045283:Natriuretic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000494:pharmacology / Q000627:therapeutic use*; D011660:Pulmonary Heart Disease / Q000209:etiology*; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D012720:Severity of Illness Index; D016896:Treatment Outcome
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain