Chronic subcutaneous brain natriuretic peptide therapy in asymptomatic systolic heart failure

European Journal of Heart Failure
Paul M McKieHorng H Chen

Abstract

We have previously reported that asymptomatic systolic heart failure (HF) is characterized by an impaired renal response to volume expansion due to lack of activation of urinary cGMP which is corrected by subcutaneous (SQ) BNP. In the current study, we sought to define the cardiorenal response to intravascular volume expansion after 12 weeks of SQ BNP therapy. We utilized a double-blinded, placebo-controlled study to compare 12 weeks of twice-daily SQ BNP 10 µg/kg (n = 22) or placebo (n = 12) in asymptomatic systolic HF. Subjects underwent two study visits: baseline and after 12 weeks of therapy. At each study visit, echocardiography, renal, and neurohumoral assessments were performed before and after intravascular volume expansion. The primary endpoint was change in urinary sodium excretion in response to volume expansion at 12 weeks, and we observed a greater increase in urinary sodium excretion [166 (77, 290) vs. 15 (-39, 72) mEq/min; P = 0.02] with SQ BNP treatment vs. placebo. Secondary endpoints included change in urine flow and glomerular filtration rate (GFR) in response to volume expansion at 12 weeks. We observed a significant increase in urine flow (P < 0.01) and trend for differential response in GFR (P = 0.08) with...Continue Reading

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Citations

May 21, 2016·European Journal of Heart Failure·Marco Metra
Apr 7, 2017·Canadian Journal of Physiology and Pharmacology·Domenico Regoli, Fernand Gobeil
Feb 26, 2019·Hypertension·Laura M G MeemsJohn C Burnett
Aug 21, 2019·International Journal of Molecular Sciences·Speranza Rubattu, Massimo Volpe
May 21, 2016·European Journal of Heart Failure·Massimo VolpeVittoria Mastromarino
Jul 25, 2019·International Journal of Molecular Sciences·Ryuji OkamotoMasaaki Ito
Jun 5, 2019·Journal of Cardiovascular Pharmacology and Therapeutics·Hongyan ZhaoWeimin Li
May 13, 2017·JACC. Basic to Translational Science·Laura M G Meems, John C Burnett
Jul 6, 2021·JACC. Basic to Translational Science·Valentina CannoneKenneth McDonald

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