文档介绍：Journal of Cardiac Failure Vol. 12 No. 7 2006
Nesiritide Acutely Increases Pulmonary and Systemic Levels
of Nitric Oxide in Patients With Pulmonary Hypertension
KIRAN K. KHUSH, MD,1 TERESA DE MARCO, MD,1 KALPESH T. VAKHARIA, BA, BSE,1 CYNTHIA HARMON, BA,2
JEFFREY R. FINEMAN, MD,2 KANU CHATTERJEE, MB,1 AND ANDREW D. MICHAELS, MD, MAS3
San Francisco, California; Salt Lake City, Utah
ABSTRACT
Background: Pulmonary hypertension (PH) is characterized by decreased pulmonary vascular expression
of nitric oxide (NOx), a vasodilator that increases levels of smooth muscle cyclic guanosine monophos-
phate (cGMP). This study investigated mechanisms by which the vasodilator B-type natriuretic peptide
(BNP) affects the systemic and pulmonary vasculature in PH patients.
Methods and Results: Twenty PH patients with mean pulmonary artery (PA) pressure O25 mm Hg were
enrolled. Ten had precapillary (pulmonary capillary wedge pressure [PCWP] #15 mm Hg) and 10 had
postcapillary (PCWP O15 mm Hg) PH. Right heart catheterization was performed before and 30 minutes
after intravenous nesiritide infusion. NOx and cGMP levels from the PA and systemic (AO) arteries were
obtained before and after nesiritide infusion. The postcapillary PH patients demonstrated significantly
reduced pulmonary vascular resistance after nesiritide; there was no change in the precapillary PH cohort