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European Journal of Heart Failure 2004 6(5):611-613; doi:10.1016/j.ejheart.2003.12.005
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© 2004 European Society of Cardiology

Clinical improvement with repeated courses of intravenous B-type natriuretic peptide in refractory heart failure

Daniel M. Spevack, Todd Matros, Alan Shah, Ezra Dweck and Paul A. Tunick*

New York University Medical Center 550 First Avenue, New York, NY 10016, USA

* Corresponding author. Tel.: +1-212-263-5665; Fax: +1-212-263-8461. E-mail address: Paul.Tunick@med.nyu.edu

Received June 25, 2003; Revised June 27, 2003; Accepted December 7, 2003

The first 10% of the full text of this article appears below.


   1. Introduction
 
Congestive heart failure (CHF) is characterized by increased salt and water retention by the kidneys in response to decreased renal blood flow. Increased sympathetic nerve activity is also seen in response to a low cardiac output. Although these compensatory mechanisms are initially important for augmenting cardiac output in a failing ventricle, they ultimately lead to volume overload. B-type natriuretic peptide (BNP), a hormone secreted by the heart in response to increased left ventricular wall tension, is now available as a pharmacolgic agent. BNP interferes with renal mechanisms for salt and water retention and may also inhibit sympathetic nerve activity. We report a patient with New York Heart Association (NYHA) class IV CHF who had dramatic, cyclic clinical improvement due to three repeated courses of intravenous BNP. This patient's . . . [Full Text of this Article]


   2. Case presentation
 

   3. Discussion
 

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