Cardiac Versus Renal Response to Volume Expansion in Preclinical Systolic Dysfunction With PDEV Inhibition and BNP.
JACC Basic Transl Sci
; 4(8): 962-972, 2019 Dec.
Article
in En
| MEDLINE
| ID: mdl-31909303
ABSTRACT
Impaired cardiorenal response to acute saline volume expansion in preclinical systolic dysfunction (PSD) may lead to symptomatic heart failure. The objective was to determine if combination phosphodiesterase-V inhibition and exogenous B-type natriuretic peptide (BNP) administration may enhance cardiorenal response. A randomized double-blinded, placebo-controlled study was conducted in 21 subjects with PSD and renal dysfunction. Pre-treatment with tadalafil and subcutaneous BNP resulted in improved cardiac function, as evidenced by improvement in ejection fraction, left atrial volume index, and left ventricular end-diastolic volume. However, there was reduced renal response with reduction in renal plasma flow, glomerular filtration rate, and urine flow. (Tadalafil and Nesiritide as Therapy in Pre-clinical Heart Failure; NCT01544998).
ACC, American College of Cardiology; AHA, American Heart Association; ANP, atrial natriuretic peptide; B-type natriuretic peptide; BNP, B-type natriuretic peptide; GFR, glomerular filtration rate; HF, heart failure; LAVI, left atrial volume index; LVEDV, left ventricular end-diastolic volume; LVEF, left ventricular ejection fraction; LVESV, left ventricular end-systolic volume; NP, natriuretic peptide; PDEV, type V phosphodiesterase; PSD, preclinical systolic dysfunction; RPF, renal plasma flow; SC, subcutaneous; VE, acute saline volume expansion; cGMP, cyclic guanosine monophosphate; cardiorenal; heart failure; nesiritide; phosphodiesterase inhibition; systolic dysfunction
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Clinical_trials
Language:
En
Journal:
JACC Basic Transl Sci
Year:
2019
Document type:
Article