[Natriuretic Peptides in the Therapy of Acute Decompensated Heart Failure]

Dtsch Med Wochenschr. 2011 Aug;136(34-35):1738-43. doi: 10.1055/s-0031-1286068. Epub 2011 Aug 29.
[Article in German]

Abstract

Heart failure is the most frequent cause of hospitalization in elderly population. Unlike the therapy of congestive heart failure, there was only a modest progress in the medical treatment for acutely decompensated heart failure over the past several decades. Moreover, current treatment is associated with many limitations in clinical practice. The family of natriuretic peptides consists of several structurally similar polypeptides (ANP, BNP, CNP, urodilatin, DNP). ANP and BNP are the most characterized substances and represent an important compensatory mechanisms in heart failure because of their vasodilatory, natriuretic and antiproliferative effects. Nesiritide is a recombinant human BNP which has been shown to be effective in treating heart failure in several clinical trials. However, a recent meta-analysis revealed a nesiritide-associated increased 30-day-mortality rate. The results of initial small-sized trials suggest beneficial hemodynamic effects of urodilatin in decompensated heart failure. Despite of being approved for the treatment of decompensated heart failure in some countries, the clinical relevance of nesiritide is currently unclear. Urodilatin might represent a potential alternative.

Publication types

  • Comparative Study
  • English Abstract
  • Review

MeSH terms

  • Acute Disease
  • Atrial Natriuretic Factor / adverse effects
  • Atrial Natriuretic Factor / blood*
  • Atrial Natriuretic Factor / therapeutic use
  • Diuretics / adverse effects
  • Diuretics / therapeutic use*
  • Drug Approval
  • Heart Failure / drug therapy*
  • Heart Failure / mortality
  • Heart Failure / physiopathology*
  • Hemodynamics / drug effects
  • Humans
  • Natriuretic Peptide, Brain / adverse effects
  • Natriuretic Peptide, Brain / blood*
  • Natriuretic Peptide, Brain / therapeutic use*
  • Natriuretic Peptide, C-Type / blood
  • Peptide Fragments / adverse effects
  • Peptide Fragments / therapeutic use
  • Randomized Controlled Trials as Topic
  • Recombinant Proteins / adverse effects
  • Recombinant Proteins / therapeutic use
  • Survival Rate

Substances

  • Diuretics
  • Peptide Fragments
  • Recombinant Proteins
  • Natriuretic Peptide, Brain
  • Natriuretic Peptide, C-Type
  • Ularitide
  • Atrial Natriuretic Factor