Document Detail

Clinical and hemodynamic effects of nesiritide (B-type natriuretic peptide) in patients with decompensated heart failure receiving beta blockers.
MedLine Citation:
PMID:  15860969     Owner:  NLM     Status:  MEDLINE    
The use of beta blockers in congestive heart failure presents a therapeutic challenge for patients with acute episodes of decompensation. Such patients may be less responsive to positive inotropic agents, whereas the beneficial effects of nesiritide, which are not dependent on the beta-adrenergic receptor signal-transduction pathway, may be preserved. This analysis of the Vasodilation in the Management of Acute CHF trial evaluated the safety and efficacy of nesiritide in decompensated congestive heart failure patients receiving beta blockers. The Vasodilation in the Management of Acute CHF trial was a multicenter, randomized, controlled evaluation of nesiritide in 489 hospitalized patients with decompensated congestive heart failure. One hundred twenty-three patients were on chronic beta-blocker therapy at enrollment (31 randomized to placebo, 50 to nesiritide, and 42 to nitroglycerin). Primary end points included pulmonary capillary wedge pressure and dyspnea evaluation at 3 hours. Patients receiving nesiritide, but not IV nitroglycerin, had significantly reduced pulmonary capillary wedge pressure vs. placebo at 3 hours regardless of beta-blocker use. The use of beta blockers did not alter the beneficial effects of nesiritide on systemic blood pressure, heart rate, or dyspnea evaluation. In nesiritide-treated subjects, safety profiles were similar regardless of beta-blocker use. Thus, the clinical and hemodynamic benefits and safety of nesiritide are preserved in decompensated congestive heart failure patients receiving chronic beta blockade.
William T Abraham; Mei L Cheng; Geraldine Smoluk;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Congestive heart failure (Greenwich, Conn.)     Volume:  11     ISSN:  1527-5299     ISO Abbreviation:  Congest Heart Fail     Publication Date:    2005 Mar-Apr
Date Detail:
Created Date:  2005-04-29     Completed Date:  2005-08-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9714174     Medline TA:  Congest Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  IM    
Division of Cardiovascular Medicine, The Ohio State University, Columbus, OH 43210-1252, USA.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use*
Double-Blind Method
Heart Failure / drug therapy*,  physiopathology
Hemodynamics / drug effects
Injections, Intravenous
Middle Aged
Natriuretic Agents / therapeutic use*
Natriuretic Peptide, Brain / therapeutic use*
Nitroglycerin / administration & dosage,  therapeutic use
Pulmonary Wedge Pressure / drug effects
Time Factors
Vasodilation / drug effects
Vasodilator Agents / administration & dosage,  therapeutic use
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Natriuretic Agents; 0/Vasodilator Agents; 114471-18-0/Natriuretic Peptide, Brain; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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