| Treatment with B-type natriuretic peptide for chronic decompensated heart failure: insights learned from the follow-up serial infusion of nesiritide (FUSION) trial. | |
| | |
MedLine Citation:
|
PMID: 15809819 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Several evidence-based treatment regimens are modestly effective in patients with moderately severe to severe heart failure, but truly effective therapies that improve symptoms, reduce hospitalizations, and extend meaningful survival do not exist for these patients. Only ventricular replacement therapy, with either heart transplantation or left ventricular assist devices, has been shown to significantly improve outcomes. Nesiritide, a recombinant B-type natriuretic peptide, is associated with significant reductions in filling pressure, with corresponding relief of symptoms, and diminished neurohormonal levels and has no inotropic effects and no evidence of proarrhythmia when given to patients with decompensated acute heart failure. Results of the Follow-Up Serial Infusion of Nesiritide (FUSION) trial suggest that a regimen incorporating nesiritide can be accomplished with a reasonable assurance of safety and tolerability; pre-study concerns regarding hypotension were not realized. A qualified look at outcomes data within FUSION I suggests that further study of this paradigm is reasonable, especially if the studied patient population includes patients with a low left ventricular ejection fraction and New York Heart Association (NYHA) class III disease with renal insufficiency, or patients with low left ventricular ejection fraction and NYHA class IV heart failure. Therefore, FUSION II, a double-blind, placebo-controlled trial, will randomly assign approximately 900 such patients to treatment with usual care plus nesiritide or usual care plus placebo and will use mortality/cardiorenal hospitalization as a composite end point. If positive data emerge from FUSION II that either confirm or strengthen the data in FUSION I, a new therapeutic option may be available for patients with chronic decompensated heart failure. |
| | |
Authors:
|
Clyde W Yancy |
Related Documents
:
|
15075049 - Are angiotensin-converting enzyme inhibitors and beta-blockers making an impact on the ... 11176759 - Treatment of congestive heart failure: guidelines for the primary care physician and th... 2891589 - Updated use of digitalis and nitrates in the elderly. 17013239 - Perioperative management of patients with impaired left ventricular function. 8681319 - Identification, diagnosis and treatment of heart failure: could we do better? 8076659 - Ace inhibition, atherosclerosis and myocardial infarction--the aire study in practice. ... 7288989 - Improved criteria for admission to cardiac care units. 18376199 - Ascending and transverse aortic arch repair: the impact of glomerular filtration rate o... 10703689 - Nitric oxide synthase ii mrna expression in cardiac tissue of patients with heart failu... |
Publication Detail:
|
Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial |
Journal Detail:
|
Title: Heart failure reviews Volume: 9 ISSN: 1382-4147 ISO Abbreviation: Heart Fail Rev Publication Date: 2004 Jul |
Date Detail:
|
Created Date: 2005-04-05 Completed Date: 2005-10-04 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9612481 Medline TA: Heart Fail Rev Country: United States |
Other Details:
|
Languages: eng Pagination: 209-16 Citation Subset: IM |
Affiliation:
|
University of Texas Southwestern Medical Center, Dallas, TX, USA. clyde.yancy@utsouthwestern.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Chronic Disease Dose-Response Relationship, Drug Drug Administration Schedule Female Follow-Up Studies Heart Failure / drug therapy* Humans Infusions, Intravenous Male Natriuretic Agents / administration & dosage* Natriuretic Peptide, Brain / administration & dosage* Severity of Illness Index Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Natriuretic Agents; 114471-18-0/Natriuretic Peptide, Brain |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Practical application of human B-type natriuretic peptide as a therapeutic intervention in the perio...
Next Document: Desmoplastic fibroma of the skull in an infant.