| B-type natriuretic peptide infusions in acute myocardial infarction. | |
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MedLine Citation:
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PMID: 17639095 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Natriuretic peptides have actions likely to ameliorate cardiac dysfunction. B-type natriuretic peptide (BNP) is indicated as treatment for decompensated cardiac failure. OBJECTIVE: To determine the utility of BNP in acute myocardial infarction (MI). DESIGN: Double-blind randomised placebo-controlled trial. SETTING: Tertiary hospital coronary care unit. PATIENTS: 28 patients with acute MI with delayed or failed reperfusion and moderate left ventricular dysfunction. INTERVENTIONS: Infusion of BNP or placebo for 60 hours after MI. MAIN OUTCOME MEASURES: Neurohormonal activation and renal function in response to BNP infusion, secondary end points of echocardiographic measures of left ventricular function and dimension. RESULTS: BNP infusion resulted in a significant rise in BNP (276 pg/l vs 86 pg/l, p = 0.001). NT-proBNP levels were suppressed by BNP infusion (p = 0.002). Atrial natriuretic peptide (ANP) and NT-proANP levels fell with a significant difference in the pattern between BNP infusion and placebo during the first 5 days (p<0.005). C-type natriuretic peptide (CNP) and NT-proCNP levels rose during the infusion with higher levels than placebo at all measurements during the first 3 days (p<0.01). Cyclic guanosine monophosphate (cGMP) was raised during the infusion period showing a peak of 23 pmol/l on day 2 (placebo 8.9 pmol/l, p = 0.002), with a correlation between BNP and cGMP levels (p<0.001). Glomerular filtration rate (GFR) fell with BNP infusion but was not significantly lower than with placebo (71.0 (5.6) vs 75.8 (5.4) ml/min/1.73 m2, p = 0.62). Patients receiving nesiritide exhibited favourable trends in left ventricular remodelling. CONCLUSIONS: Nesiritide, given soon after MI, induced increments in plasma cGMP and CNP and decrements in other endogenous cardiac peptides with a neutral effect on renal function and a trend towards favourable ventricular remodelling. |
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Authors:
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R J Hillock; C M Frampton; T G Yandle; R W Troughton; J G Lainchbury; A M Richards |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-07-16 |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 94 ISSN: 1468-201X ISO Abbreviation: Heart Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-04-15 Completed Date: 2008-05-02 Revised Date: 2009-07-30 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: England |
Other Details:
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Languages: eng Pagination: 617-22 Citation Subset: AIM; IM |
Affiliation:
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Christchurch Cardioendocrine Research Group, Christchurch School of Medicine and Health Sciences and Christchurch Hospital, Christchurch, New Zealand. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atrial Natriuretic Factor / blood Coronary Artery Disease / blood, drug therapy* Cyclic GMP / metabolism* Dose-Response Relationship, Drug Double-Blind Method Echocardiography, Doppler, Pulsed / methods Female Follow-Up Studies Humans Kidney / drug effects Male Middle Aged Myocardial Infarction / blood, drug therapy* Natriuretic Agents / administration & dosage* Natriuretic Peptide, Brain / administration & dosage*, blood Peptide Fragments / blood Receptors, Atrial Natriuretic Factor / administration & dosage*, blood |
| Chemical | |
Reg. No./Substance:
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0/Natriuretic Agents; 0/Peptide Fragments; 0/brain natriuretic peptide receptor; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 7665-99-8/Cyclic GMP; 85637-73-6/Atrial Natriuretic Factor; EC 4.6.1.2/Receptors, Atrial Natriuretic Factor |
| Comments/Corrections | |
Comment In:
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Heart. 2008 May;94(5):542-4
[PMID:
18411344
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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