Congestive heart failure (CHF) is the most frequent cause of hospitalization for patients >65 years of age and continues to be a major public health burden among the ageing population. Unlike
therapy for chronic CHF, there has been only modest progress in medical treatment for acutely decompensated CHF over the past several decades. Moreover, current treatment-consisting generally of
diuretic, inotropic, and vasodilatory agents-is associated with many limitations in clinical practice.
Natriuretic peptides provide a promising mechanism of action in the pathophysiologic background for CHF treatment based on their vasodilatory and
diuretic properties and effective inhibition of the renin-angiotensin-aldosterone system, which is activated early in the course of CHF.
Nesiritide (Natrecor® or Noratak®) is a recombinant
natriuretic peptide that has the same 32 amino-acid sequence as human
B-type natriuretic peptide.
Nesiritide has been shown to improve
dyspnea and hemodynamic parameters in patients with decompensated
heart failure.
Ularitide is a synthetic form of
urodilatin, a
natriuretic peptide hormone secreted by the kidney. Recent clinical studies suggest that
ularitide may play a role in managing decompensated
heart failure. This review provides an update on
natriuretic peptides and their therapeutic potential in advanced CHF.