Peter Lesný, Eva Goncalvesová, Juraj Fabián
Heart failure (HF) patients suffer from high morbidity and mortality. Acute decompensation of chronic HF is the most frequent form of acute HF. One of features of severe HF is a pathological neurohormonal activation with high plasma concentration of B-type natriuretic peptide (BNP). Nesiritide is a recombinant human BNP for treatment of patients with severe HF with dyspnea at rest or on minimum physical exertion. Nesiritide is a potent vasodilatator, it reduces dyspnea, does not increase myocardial oxygen consumption, is not proarrhythmogenic and supresses neurohormonal activation. It has been in clinical use since 2001, especially in the U.S.A. During the past few years, several reports of possible negative influence of nesiritide on mortality and renal function of patients with decompensated HF have emerged. Clarification of these questions will be of principal importance for approval of nesiritide use in countries of the European Community.