Heart failure & cardiomyopathies
Renal Effects of Combination Phosphodiesterase V Inhibition and Low-Dose B-Type Natriuretic Peptide in Acute Heart Failure: A Randomized Clinical Trial
Authors' conclusion
BNP and combination BNP/PDEV inhibition increased plasma cGMP in patients with acute HF but did not improve renal function or urinary sodium/cGMP excretion.
Study context
- Population
- Patients hospitalised with acute heart failure (HF) and renal dysfunction
- Participants
- 67 patients
- Comparison
- Low-dose IV BNP alone or with PDEV inhibition vs standard care
- Primary endpoint
- Coprimary: percent change in eGFR and in blood urea nitrogen from baseline
- Follow-up
- 48 hours
Methodological detailsopen-label
- Open-label
Primary result
As reported in the abstract
| Group | eGFR % change | BUN % change |
|---|---|---|
| Standard care | 0 (−10.8%, +12.7%) | −1.4% (−10.7%, +12.0%) |
| BNP | 0 (−15.3%, +11.8%) | −5.9% (−14.6%, +9.4%) |
| BNP/PDEV | −8.8% (−14.3%, +8.3%) | +6.9% (−5.3%, +18.8%) |
eGFR % change
Standard care0 (−10.8%, +12.7%)
BNP0 (−15.3%, +11.8%)
BNP/PDEV−8.8% (−14.3%, +8.3%)
BUN % change
Standard care−1.4% (−10.7%, +12.0%)
BNP−5.9% (−14.6%, +9.4%)
BNP/PDEV+6.9% (−5.3%, +18.8%)
- All groups: P = 0.60 — eGFR, no significant change
- All groups: P = 0.38 — BUN, no significant change
Further findings
| Outcome | Standard care | BNP | BNP/PDEV | P value |
|---|---|---|---|---|
| Plasma cGMP change · 24 hoursBNP and BNP/PDEV vs Standard care | −13.5% (range as printed −29.1%, +14.2%) | +25.6% (range as printed +9.8%, +84.7%) | +60.8% (range as printed +32.3%, +103.8%) | P = 0.001 |
Safety
- Hypotension more common with BNP/PDEV
Original publication
Renal Effects of Combination Phosphodiesterase V Inhibition and Low-Dose B-Type Natriuretic Peptide in Acute Heart Failure: A Randomized Clinical Trial. Circ Heart Fail. Published 8 November 2024. doi:10.
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