Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nesiritide (B-type natriuretic peptide) is one of the newest therapies available in the treatment of adults with decompensated congestive heart failure (CHF). It rapidly improves hemodynamics and induces diuresis in adult patients with moderate to severe CHF. This report details our experience with nesiritide in 4 pediatric cases in 3 subjects with chronic CHF of various causes. As described in adults, our patients generally diuresed and had symptomatic improvement in response to the infusion with only dose-related hypotension and asymptomatic hyponatremia as recognized side effects. Given the number of pediatric patients who progress to CHF as a result of myocarditis, cardiomyopathy, or failed palliation for complex congenital heart disease, we believe nesiritide has a role in managing acutely decompensated CHF in the pediatric population.
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PMID:Nesiritide use in pediatric patients with congestive heart failure. 1560 80

Nesiritide (Natrecor, Scios Inc), human B-type natriuretic peptide, has hemodynamic effects that may be beneficial in pediatric patients after cardiac surgery. Experience with nesiritide and pediatrics is limited. The purpose of this study was to evaluate perioperative effects and safety of nesiritide in pediatric cardiothoracic surgery. Seventeen patients with congenital heart disease undergoing cardiac surgery were given a loading dose (1 microg/kg) while on cardiopulmonary bypass (constant flow) followed by continuous infusion for 24 hours (0.01 microg/kg/min x 6 hours, then 0.02 microg/kg/min x 18 hours). A 7% decrease in mean blood pressure was seen following nesiritide loading dose on cardiopulmonary bypass. No patient required intervention for hypotension while receiving nesiritide load or infusion. Nesiritide load during surgery and continuous infusion after cardiac surgery in pediatric patients resulted in no significant hemodynamic compromise.
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PMID:Perioperative effects and safety of nesiritide following cardiac surgery in children. 1669 41

Discoveries of the cardiac natriuretic peptides ANP, BNP, and CNP along with studies of their function and regulation in health and disease, have led to breakthroughs in the understanding and clinical management of heart failure. Analysis of the ANP and BNP promoters and patterns of expression uncovered a set of key regulators and pathways that converge onto these sensitive markers of early myocyte differentiation and cardiac stress. Among the most studied are the transcription factors GATA4, TBX5, and NKX2-5, which are central to cardiac development and mutations of which are associated with congenital heart disease. In clinical practice, plasma natriuretic peptides levels have been used as quantitative biomarkers of heart failure and proved to be highly effective for the diagnosis of heart failure, for risk-stratification of patients and guided therapy, as well as for screening for subclinical cardiac stress. Emerging studies are revealing the cardioprotective attributes of these peptides and may offer new therapeutic venues for myocardial infarction and heart failure. Clinical trials have documented the benefits and risks of the use of synthetic ANP (Anaritide) and BNP (Nesiritide) for treating heart failure, renal failure, and hypertension. This review summarizes the function and regulation of cardiac natriuretic peptides and the translation of the basic biochemical discoveries into clinical practice both at the diagnostic and therapeutic level.
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PMID:Cardiac natriuretic peptides: from basic discovery to clinical practice. 2043 83