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Sustained hemodynamic effects of an infusion of nesiritide (human b-type natriuretic peptide) in heart failure

A randomized, double-blind, placebo-controlled clinical trial

Roger M. Mills, MD, FACC^*, Thierry H. LeJemtel, MD, Darlene P. Horton, MD, Chang-seng Liang, MD, PhD, FACC, Roberto Lang, MD, FACC^||, Marc A. Silver, MD, FACC^¶, Charles Lui, MD, FACC^#, Kanu Chatterjee, MD, FACC^** on Behalf of the Natrecor Study Group¹

^* Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
Division of Cardiology, Albert Einstein College of Medicine, Bronx, New York, USA
Clinical Research Division, Scios Inc., Mountain View, California, USA
Cardiology Unit, University of Rochester Medical Center, Rochester, New York, USA
^|| Section of Cardiology, University of Chicago, Chicago, Illinois, USA
^¶ Division of Cardiology, Loyola University Medical Center, Maywood, Illinois, USA
^# Division of Cardiology, University of Arizona, Tucson, Arizona, USA
^** Division of Cardiology, University of California San Francisco, San Francisco, California, USA

View larger version (24K): [in a new window]   Figure 1 Flow diagram of subjects from randomization through the treatment period. 1Did not meet entry hemodynamic criteria. 2Subjects whose infusion terminated before 22 h. BP = blood pressure; CHF = worsening heart failure; CI = cardiac index; NA = not applicable; PCWP = pulmonary capillary wedge pressure. Downward arrows: excessively decreased.

View larger version (29K): [in a new window]   Figure 2 Mean observed hemodynamic values: results from baseline (BL) through 24 h of infusion (inf) and 4 h postinfusion. (A) Pulmonary capillary wedge pressure units are mm Hg. (B) Cardiac index units are liters/min/m2. (C) Systemic systolic blood pressure units are mm Hg. (D) Systemic vascular resistance units are dyn/s/cm–5. Open squares: placebo; closed circles: 0.015 µg/kg/min; closed triangles: 0.03 µg/kg/min; open circles: 0.06 µg/kg/min.