(Circulation. 1996;93:2037-2042.)
© 1996 American Heart Association, Inc.
Articles |
Effects of Brain Natriuretic Peptide on Exercise Hemodynamics and Neurohormones in Isolated Diastolic Heart Failure
From the University Departments of Clinical Pharmacology (P.B.M.C., R.J.M., T.M.M.) and Cardiology (S.D.P.), Ninewells Hospital and Medical School, Dundee, United Kingdom, and the Cardiothoracic Unit, Northern General Hospital (N.M.W.), Sheffield, United Kingdom.
Correspondence to Peter B.M. Clarkson, University Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, DD1 9SY United Kingdom.
Background Experimental models suggest that brain natriuretic peptide (BNP) can modify left ventricular diastolic performance. The aim of this study was to evaluate the effects of BNP on resting and exercise hemodynamics and neurohormones in patients with isolated diastolic heart failure.
Methods and Results Six patients with isolated diastolic heart failure were studied. After baseline hemodynamic measurements were obtained with use of thermistor-tipped pulmonary artery catheters, patients were randomized to receive infusion of BNP or placebo in a single-blind, crossover study. Hemodynamic and neurohormonal parameters were measured at rest after 30 minutes of infusion and during incremental supine bicycle exercise. BNP did not significantly affect resting hemodynamics but attenuated the rise in both pulmonary capillary wedge pressure (placebo, 23±2 mm Hg; BNP, 16±2 mm Hg; P<.01) and mean pulmonary artery pressure (placebo, 34±3 mm Hg; BNP, 29±3 mm Hg; P<.05) during exercise without affecting changes in heart rate, systemic blood pressure, or stroke volume. In response to BNP, there was significant suppression of plasma aldosterone concentration (placebo, 551±107 pmol/L; BNP, 381±56 pmol/L; P<.05).
Conclusions BNP infusion causes beneficial hemodynamic and neurohormonal effects during exercise in patients with isolated diastolic heart failure.
Key Words: peptides • heart failure • hemodynamics
This article has been cited by other articles:
 |
|
 |
|
  N. O. Neverdal, C. W. Knudsen, T. Husebye, O. A. Vengen, J. Pepper, M. Lie, and T. Tonnessen The effect of aortic valve replacement on plasma B-type natriuretic peptide in patients with severe aortic stenosis -- one year follow-up Eur J Heart Fail, May 1, 2006; 8(3): 257 - 262. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Butler, C. Emerman, W. F. Peacock, V. S. Mathur, and J. B. Young The efficacy and safety of B-type natriuretic peptide (nesiritide) in patients with renal insufficiency and acutely decompensated congestive heart failure Nephrol. Dial. Transplant., February 1, 2004; 19(2): 391 - 399. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Yamaguchi, J. Yoshida, K. Yamamoto, Y. Sakata, T. Mano, N. Akehi, M. Hori, Y.-J. Lim, M. Mishima, and T. Masuyama Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy J. Am. Coll. Cardiol., January 7, 2004; 43(1): 55 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. W. Kitzman, W. C. Little, P. H. Brubaker, R. T. Anderson, W. G. Hundley, C. T. Marburger, B. Brosnihan, T. M. Morgan, and K. P. Stewart Pathophysiological Characterization of Isolated Diastolic Heart Failure in Comparison to Systolic Heart Failure JAMA, November 6, 2002; 288(17): 2144 - 2150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Militello Role of Nesiritide in Decompensated Heart Failure Journal of Pharmacy Practice, August 1, 2002; 15(4): 326 - 333. [Abstract] [PDF]
|
|
|
|
|
|
Publication Committee for the VMAC Investigators Intravenous Nesiritide vs Nitroglycerin for Treatment of Decompensated Congestive Heart Failure: A Randomized Controlled Trial JAMA, March 27, 2002; 287(12): 1531 - 1540. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Peter Brunner-La Rocca, W. Kiowski, D. Ramsay, and G. Sutsch Therapeutic benefits of increasing natriuretic peptide levels Cardiovasc Res, August 15, 2001; 51(3): 510 - 520. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Geny, R. Richard, B. Mettauer, J. Lonsdorfer, and F. Piquard Cardiac natriuretic peptides during exercise and training after heart transplantation Cardiovasc Res, August 15, 2001; 51(3): 521 - 528. [Full Text] [PDF]
|
|
|
|
 |
|
 W.J. Paulus Natriuretic peptides to probe haemodynamic overload in hypertrophic cardiomyopathy Eur. Heart J., August 1, 2001; 22(15): 1249 - 1251. [Abstract] [PDF]
|
|
|
|
 |
|
 T A McDonagh, A D Cunningham, C E Morrison, J J V McMurray, I Ford, J J Morton, and H J Dargie Left ventricular dysfunction, natriuretic peptides, and mortality in an urban population Heart, July 1, 2001; 86(1): 21 - 26. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. MacFadyen, C. M. MacLeod, P. Shiels, W. R. Smith, and T. M. MacDonald Isolated diastolic heart failure as a cause of breathlessness in the community: the Arbroath study Eur J Heart Fail, March 1, 2001; 3(2): 243 - 248. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Geny, A. Charloux, E. Lampert, J. Lonsdorfer, P. Haberey, and F. Piquard Enhanced brain natriuretic peptide response to peak exercise in heart transplant recipients J Appl Physiol, December 1, 1998; 85(6): 2270 - 2276. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yamamoto, J. C. Burnett Jr., and M. M. Redfield Effect of endogenous natriuretic peptide system on ventricular and coronary function in failing heart Am J Physiol Heart Circ Physiol, November 1, 1997; 273(5): H2406 - H2414. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Lainchbury, A. M. Richards, M. G. Nicholls, P. J. Hunt, H. Ikram, E. A. Espiner, T. G. Yandle, and E. Begg The Effects of Pathophysiological Increments in Brain Natriuretic Peptide in Left Ventricular Systolic Dysfunction Hypertension, September 1, 1997; 30(3): 398 - 404. [Abstract] [Full Text]
|
|
|
|
 |
|
 R. O. Bonow New Insights Into the Cardiac Natriuretic Peptides Circulation, June 1, 1996; 93(11): 1946 - 1950. [Full Text]
|
|