Nesiritide shows benefit in patients with acute CHF

A study by University of Alabama at Birmingham (UAB) cardiologists shows that the investigational drug nesiritide improved the condition of patients with either moderate or severe acute CHF.

The study, presented at the recent American Heart Association Scientific Sessions in Dallas, showed that nesiritide, a genetically engineered form of the naturally occurring cardiac hormone BNP (b-type natriuretic peptide), alleviates the symptoms of CHF by dilating blood vessels, restoring salt and water balance, and improving heart function. BNP is produced naturally in increased amounts by the ventricles of the heart in response to heart failure.

"Nesiritide improved heart function in acute CHF patients exhibiting a wide range of disease severity," says Robert Bourge, MD, lead author of the study and director of the UAB division of cardiovascular disease. "The new drug may, in many cases, replace the use of intravenous vasodilators, IV diuretics, and especially IV inotropic drugs, which can cause severe and sometimes fatal arrhythmias in up to 5% of patients."

In the study, 127 hospitalized patients, average age 59 and suffering from acute CHF, were given one of two dosing levels of nesiritide. For six hours, diuretic and vasoactive therapies were withheld while nesiritide was administered. During this time, investigators monitored changes in three key parameters used to assess CHF severity: pulmonary capillary wedge pressure (PCWP), cardiac index, and blood pressure. Results showed a dose-related improvement in both PCWP and cardiac index, while blood pressure decreased minimally among all groups.

In another study led by researchers at Beth Israel Deaconess Medical Center in Boston, nesiritide demonstrated clinical advantages over dobutamine, currently a prime choice in CHF treatment.