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passages: Systemic hemodynamic , neurohormonal , and renal effects of a steady-state infusion of human brain natriuretic peptide in patients with hemodynamically decompensated heart failure . BACKGROUND Human brain natriuretic peptide ( hBNP ) is a promising agent for the treatment of decompensated cardiac failure . However , the systemic hemodynamic , neurohormonal , and renal effects of hBNP have been incompletely studied in human heart failure . METHODS AND RESULTS The effects of a continuous 4-hour infusion of hBNP were determined in 16 decompensated heart failure patients in an invasive , randomized , double-blind , placebo-controlled study . Patients were evaluated during three 4-hour study periods : baseline , treatment ( placebo [ n = 4 ] versus hBNP 0.025 or 0.05 microgram/kg/min [ n = 12 ] ) , and post-treatment . Urinary volume losses were replaced hourly to separate the vasodilatory and diuretic effects of hBNP . Two patients in the hBNP group were excluded from the analysis because of adverse events . hBNP significantly ( P < .001 ) reduced right atrial pressure and pulmonary capillary wedge pressure by approximately 30 % and 40 % , respectively . hBNP also significantly lowered systemic vascular resistance from 1722 +/- 139 to 1101 +/- 83 dynes.s.cm-5 ( P < .05 ) . These unloading effects of hBNP produced a 28 % increase in cardiac index ( P < .05 ) with no change in heart rate . Compared to placebo , hBNP decreased plasma norepinephrine and aldosterone . Renal hemodynamics were unaffected by hBNP ; however , most patients were resistant to its natriuretic effect . CONCLUSIONS 1 ) The predominant hemodynamic effects of hBNP were a decrease in cardiac preload and systemic vascular resistance . 2 ) hBNP also improved cardiac output without increasing heart rate . 3 ) Plasma norepinephrine and aldosterone levels decreased during hBNP infusion . 4 ) hBNP is pharmacologically active and has potential in the therapy for decompensated heart failure .
entities: 4051
entities: Intervention_Pharmacological
entities: human brain natriuretic peptide
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entities: Intervention_Pharmacological
entities: Human brain natriuretic peptide ( hBNP )
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Control
entities: placebo-controlled
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entities: Intervention_Control
entities: placebo
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP .
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
entities: 4062
entities: Intervention_Pharmacological
entities: hBNP
entities: 4063
entities: Intervention_Control
entities: placebo
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP ;
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Intervention_Pharmacological
entities: hBNP
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entities: Outcome_Physical
entities: Systemic hemodynamic , neurohormonal
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entities: Outcome_Physical
entities: renal effects
entities: 4072
entities: Outcome_Physical
entities: systemic hemodynamic
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entities: Outcome_Physical
entities: neurohormonal
entities: 4074
entities: Outcome_Physical
entities: renal effects
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entities: Outcome_Adverse-effects
entities: adverse events .
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entities: Outcome_Physical
entities: right atrial pressure and pulmonary capillary wedge pressure
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entities: Outcome_Physical
entities: systemic vascular resistance
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entities: Outcome_Physical
entities: cardiac index
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entities: Outcome_Physical
entities: heart rate .
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entities: Outcome_Physical
entities: plasma norepinephrine and aldosterone . Renal hemodynamics
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entities: Outcome_Physical
entities: natriuretic effect .
entities: 4082
entities: Outcome_Physical
entities: hemodynamic effects
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entities: Outcome_Physical
entities: cardiac preload and systemic vascular resistance .
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entities: Outcome_Physical
entities: cardiac output
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entities: Outcome_Physical
entities: heart rate .
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entities: Outcome_Physical
entities: Plasma norepinephrine and aldosterone levels
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entities: Participant_Condition
entities: patients with hemodynamically decompensated heart failure .
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entities: Participant_Sample-size
entities: 16
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entities: Participant_Condition
entities: decompensated heart failure patients