Comparison of the effects of dobutamine and nesiritide (B-type natriuretic peptide) on ventricular ectopy in acutely decompensated ischemic versus nonischemic cardiomyopathy.
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Mary R Burger
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New therapies for the treatment of congestive heart failure.
Heart failure is characterized by sodium and fluid retention, sympathetic overactivity, parasympathetic withdrawal, vasoconstrictor activation and cytokine elevation. New therapies for heart failure attempt to control neurohormonal activation and limit progressive left ventricular dysfunction. Nesiritide (human B-type natriuretic peptide) is a recently approved new vasodilator that has been given to almost 1,000 patients in numerous clinical investigations; it belongs to a new class of heart failure drugs known as natriuretic peptides. Nesiritide decreases pulmonary capillary wedge pressure, systemic vascular resistance, mean right atrial pressure and pulmonary artery pressure, while improving cardiac index, stroke volume and heart failure symptoms. Many endothelin receptor antagonists are in various stages of development. Early clinical studies have demonstrated beneficial cardiovascular hemodynamic effects. Other new drugs for heart failure also include calcium sensitizers, neutral endopeptidase and vasopeptidase inhibitors, aldosterone receptor antagonists, vasopressin antagonists and cytokine inhibitors. All are being actively investigated and many show significant promise as beneficial therapies in the treatment of heart failure.
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Nesiritide (Scios).
Nesiritide is a recombinant B-type (brain) natriuretic peptide developed by Scios for the potential treatment of congestive heart failure (CHF). In August 2001, the product was approved and launched in the US for the intravenous treatment of patients with acute decompensated congestive heart failure (ADCHF) who have dyspnea at rest or at minimal activity [418946], [420072]. By March 2002, Scios' European development partner, GlaxoSmithKline, expected to file a Marketing Authorization Application (MAA) for nesiritide in Europe in 2002 [446957].
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