Interní Med. 2006; 8(4): 179-181

Therapeutic use of natriuretic peptides

prof. MUDr. Jaromír Hradec CSc., FESC

III. interní klinika VFN a 1. LF UK, Praha

Natriuretic peptides, mainly type B (BNP) have become a useful tool for diagnosis and differential diagnosis of heart failure. Its plasmatic values have an independent predictive value for patient prognosis. Its physiologic effects, mainly vasodilatory, natriuretic, diuretic, and inhibition of pathologically activated vasoconstrictive neurohumoral systems theoretically determine them to the treatment of heart failure. Recombinant human BNP nesiritide (Natrecor, Scios, USA) applied in IV infusion was evaluated in several clinical studies in patients with acute or acutely decompensated chronic heart failure. It improved symptoms in patients, especially dyspnoea, and also hemodynamic parameters (a decrease of pulmonary wedge pressure). Based on these results it was registered in USA in 2001 for hospital infusion treatment of patients with acute and acutely decompensated heart failure. However, a concern about safety was raised in subsequent analysis. A suspicion about increased risk of renal damage and deterioration of renal function and also increased mortality occurred. European Drug Regulatory Agency (EMEA) took a prudent waiting position. In Europe nesiritide has not yet been registered and EMEA is awaiting results of a planned large mortality and morbidity study.

Keywords: Key words: heart failure, natriuretic peptides, nesiritide.

Published: June 1, 2006  Show citation