科研之友
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摘要
Objectives The purpose of this study is to investigate the effects of urocortin-2 as adjunct therapy in acute decompensated heart failure (ADHF). %26lt;br%26gt;Background Urocortin-2 produced favorable integrated effects in experimental heart failure but there are no equivalent human data. We describe the first therapeutic study of urocortin-2 infusion in ADHF. %26lt;br%26gt;Methods Fifty-three patients with ADHF were randomly assigned to 5 ng/kg/min of urocortin-2 or placebo infusion for 4 h as an adjunct therapy. Changes in vital signs, plasma neurohormonal and renal indices during treatment were compared using repeated-measures analysis of covariance. Ten patients in each arm underwent more detailed invasive hemodynamic evaluation. %26lt;br%26gt;Results Urocortin-2 produced greater falls in systolic blood pressure compared to placebo (16 +/- 5.8 mm Hg, p %26lt; 0.001) with nonsignificant increases in heart rate (5.7 +/- 3.8 beats/min, p = 0.07) and increased cardiac output (2.1 +/- 0.4 l/min vs. -0.1 +/- 0.4 l/min, p %26lt; 0.001) associated with a 47% reduction in calculated total peripheral resistance (p = 0.015). Falls in pulmonary artery and pulmonary capillary wedge pressures did not differ significantly between groups. Urocortin-2 reduced urine volume and creatinine clearance during infusion but these returned to above baseline level in the 8 h after infusion. Plasma renin activity rose briefly with urocortin-2 coinciding with reductions in blood pressure (p %26lt; 0.001). B-type natriuretic peptide levels fell significantly over 24 h with urocortin-2 (p %26lt; 0.01) but not with placebo. %26lt;br%26gt;Conclusions Urocortin-2 infusion in ADHF markedly augmented cardiac output without significant reflex tachycardia. Renal indices fell transiently concurrent with urocortin-2-induced reductions in blood pressure. Further investigations are required to uncover the full potential of urocortin-2 in treating ADHF.
- 出版日期2013-10
