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Treatment with darusentan over 21 days improved cGMP generation in patients with chronic heart failure

Item Type:Article
Title:Treatment with darusentan over 21 days improved cGMP generation in patients with chronic heart failure
Creators Name:Philipp, S. and Monti, J. and Pagel, I. and Langenickel, T. and Notter, T. and Ruschitzka, F. and Luescher, T. and Dietz, R. and Willenbrock, R.
Abstract:In heart failure, the cGMP to natriuretic peptide ratio is decreased and infusion of atrial natriuretic peptide (ANP) induces less cGMP generation. The ratio of the second messenger cGMP to plasma concentrations of ANP or brain natriuretic peptide (BNP) correlates with the effectiveness of natriuretic peptides. It was investigated whether blockade of the ET(A) receptor might improve the cGMP:NP ratio in heart failure. Patients with chronic heart failure (n = 142; mean age = 57 years) received oral treatment with the ET(A) antagonist darusentan (either 30, 100, 300mg/day or placebo) on top of standard therapy over a period of 21 days in a randomized, double-blind, placebo-controlled, multicentre study. Plasma concentrations of ANP, BNP and cGMP were determined before randomization and after 21 days of treatment. In parallel with decreased pulmonary and systemic vascular resistance, 3 weeks of oral treatment with the ET(A) receptor antagonist darusentan reduced BNP plasma levels and increased the cGMP:BNP ratio significantly. The improved cGMP:BNP ratio might reflect the ability of chronic ET(A) receptor blockade to facilitate the generation of the second messenger cGMP, which points towards a favourable modulation of the natriuretic peptide effector system, in addition to haemodynamic improvement in heart failure patients.
Keywords:Atrial Natriuretic Peptide, Brain Natriuretic Peptide, Congestive Heart Failure, Endothelin
Source:Clinical Science
ISSN:0143-5221
Publisher:Portland Press (U.K.)
Volume:103
Number:Suppl 48
Page Range:249S-253S
Date:1 September 2002
Official Publication:https://doi.org/10.1042/CS103S249S
PubMed:View item in PubMed

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