title: Comparison of nitrite compounds and carperitide for initial treatment of acute decompensated heart failure.
abstract: Human atrial natriuretic peptides and nitrite compounds (NC) are infused for the initial management of acute heart failure (HF). However, there have been few studies comparing their hemodynamic effects.Fifty-two patients in acute decompensated HF (ADHF) who received carperitide (0.07 ± 0.05 µg/kg/minute, n = 23, group C) or NC (0.39 ± 0.24 µg/kg/minute, n = 29, group N) during the initial 24 hours in the intensive care unit between 1997 and 2007 were studied. We measured and compared hemodynamic parameters by pulmonary artery catheter monitoring before and after drug administration. Heart rate (HR), diastolic pulmonary artery pressure (DPAP), and central venous pressure (CVP) after the 24-hour administration were lower (HR: 92 ± 18 versus 79 ± 13 bpm, DPAP: 17 ± 6 versus 11 ± 5 mmHg, CVP: 6 ± 4 versus 3 ± 3 mmHg, P < 0.05, respectively) and the reduction of DPAP and systemic vascular resistance index were higher in group N than in group C. However, there was no significant difference regarding other indicators of preload and afterload. Although the serum B-type natriuretic peptide (BNP) level at discharge was lower in group N than group C (382 ± 434 versus 207 ± 201 pg/mL, P < 0.05), there was no significant difference in either the in-hospital reduction of BNP, the duration of hospitalization, or total cardiac events during 1-year follow-up.Although NC tended to improve the hemodynamics of ADHF more than carperitide, both drugs had a similar prognostic impact in patients with ADHF.
authors.affiliation: Department of Cardio-Angiology, Kitasato University School of Medicine, Kanagawa, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Mizutani
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inomata
authors.forename: Ichiro
authors.initials: I
authors.lastname: Watanabe
authors.forename: Emi
authors.initials: E
authors.lastname: Maekawa
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Hisahito
authors.initials: H
authors.lastname: Shinagawa
authors.forename: Toshimi
authors.initials: T
authors.lastname: Koitabashi
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Izumi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: C472955:NPPA protein, human; D009320:Atrial Natriuretic Factor; D005996:Nitroglycerin; D007548:Isosorbide Dinitrate