Nesiritide improves hemodynamics in children with dilated cardiomyopathy: a pilot study.
BACKGROUND
This study aimed to obtain hemodynamic measurements of nesiritide in children with dilated cardiomyopathy.


METHODS
A prospective, randomized, double-blinded, placebo-controlled pilot study was conducted in the pediatric intensive care unit at the University of California, Los Angeles. All subjects younger than 21 years admitted to the pediatric intensive care unit with a diagnosis of dilated cardiomyopathy and submitted to cardiac catheterization were randomized to receive either nesiritide or placebo. Right heart catheterization with Swan-Ganz catheter placement was performed. Nesiritide was infused over 24 h. Hemodynamic data were obtained before, during, and after the 24-h nesiritide infusion. The measures obtained included pulmonary capillary wedge pressure (PCWP), central venous pressure, mean pulmonary arterial pressure (MPAP), systolic arterial blood pressure (SBP), cardiac index, and systemic vascular resistance.


RESULTS
The study included 20 children: 9 randomized to nesiritide and 11 to placebo. At 24 h, the mean decreases in PCWP, MPAP, and SBP were significantly greater for nesiritide than for placebo: PCWP (-5.3 vs. 1.2 mmHg; p = 0.02), MPAP (-8.0 vs. 0.4 mmHg; p = 0.006), SBP (-7.9 vs. 2.6 mmHg; p = 0.04).


CONCLUSIONS
Nesiritide significantly decreases PCWP, MPAP, and SBP in children with dilated cardiomyopathy.
Behera
Sarina K
SK
Department of Pediatrics, University of California, Los Angeles, CA, USA. sarinabehera@yahoo.com
Zuccaro
Jennifer C
JC
Wetzel
Glenn T
GT
Alejos
Juan C
JC
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002140:California; D002311:Cardiomyopathy, Dilated / Q000188:drug therapy*; D002407:Catheterization, Swan-Ganz; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006305:Health Status Indicators; D006352:Heart Ventricles; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015141:Los Angeles; D008297:Male; D045283:Natriuretic Agents / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000627:therapeutic use*; D011446:Prospective Studies; D013599:Systole / Q000187:drug effects; D016896:Treatment Outcome; D055815:Young Adult
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain