Marked and prompt hemodynamic improvement by carperitide in refractory congestive heart failure due to dilated cardiomyopathy

A 16-year-old Japanese male diagnosed with congestive heart failure (CHF) d ue to dilated cardiomyopathy was treated by conventional intensive treatmen t such as intravenous infusion of diuretics, catecholamines, and phosphodie sterase inhibitors with vasodilators. However, he developed a low output sy ndrome with appearances of hyponatremia and hypochloremia. As a consequence , intravenous infusion of carperitide (synthetic atrial natriuretic peptide ) was added to the therapy. Thereafter his symptoms and hemodynamic paramet ers promptly and dramatically improved without significant diuresis, and th is amelioration persisted for more than 20 days without drug intolerance. T his outcome suggests that use of carperitide may be a safe and efficacious means to reduce cardiac preload without hypotension and tachycardia in pati ents with refractory CHF in whom intensive treatment has already been perfo rmed.