Comparison of vessel dilator and long-acting natriuretic peptide in the treatment of congestive heart failure

Background long-acting natriuretic peptide (LANP; proANF 1-30) and vessel d ilator (proANF 31-67) enhance sodium and water excretion in healthy human b eings. The current investigation was designed to compare the beneficial eff ects of LANP and vessel dilator in persons with congestive heart failure (C HF). Methods and Results LANP and vessel dilator (100 ng/kg body weight/min, res pectively) were given intravenously for 60 minutes to subjects with New Yor k Heart Association class III CHF (n = 17) while their urine volume and sod ium and potassium excretion were monitored. Vessel dilator increased urine flow more than 5-fold, which was still increased (P < .001) 3 hours after s topping its infusion. Vessel dilator enhanced sodium excretion 3-fold in su bjects with CHF (P < .01), which was still significantly (P < .01) elevated 3 hours after infusion. The effects of LANP were diminished, with urine fl ow only increasing 2-fold (P < .05). The fractional excretion of sodium inc reased maximally 6-fold secondary to vessel dilator and 3-fold with LANP. T he CHF control patients had no changes in the above parameters. Part of the diminished response to LANP was found to be caused by its rapid decrease i n the circulation of individuals with CHF. Conclusions These results indicate that vessel dilator has significant bene ficial diuretic and natriuretic properties, which are not diminished, where as the effects of LANP are diminished in human beings with CHF compared wit h healthy individuals.