Brain natriuretic peptide , congestive

Human brain natriuretic peptide (BNP) is a small peptide of 32 amino acids used in the treatment of congestive heat failure. How many nitrogen bases are present in the DNA that codes for BNP ... 

Brain natriuretic peptide (BNP) 3.5 Congestive heart failure... 

A much more serious complication of dobutamine therapy is ventricular dysrhythmias. Of 305 patients with acutely decompensated congestive heart failure, 58 were given dobutamine (although it is difficult to ascertain the dose), 44 were given other standard inotropic drugs such as milrinone, and 203 were treated with brain natriuretic peptide (nesiritide, 0.015 or 0.03 micrograms/kg/minute) (9). Of those given dobutamine 7% had sustained ventricular tachycardia, 17% had non-sustained ventricular tachycardia, and 5% had a cardiac arrest. In contrast. 

Maeda K, Tsutamoto T, Wada A, Mabuchi N, Hayashi M, Tsutsui T, et al. High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortahty in patients with congestive heart failure. J Am Coll Cardiol 2000 36 1587-93. 

Numerous neuroendocrine biomarkers correlate with severity of cardiac dysfunction. Heart failure is associated with increase in peripheral vascular resistance due to increases in sympathetic tone, norepinephrine, renin, angiotensin II, arginine vasopressin, and endothelin-1. The increased venous pressure causes atrial distension that stimulates production and release of atrial and brain natriuretic peptides (ANP, BNP) from the atria and ventricles, respectively. ANP inhibits the renin-angiotensin-aldosterone system. In humans and mammals, BNP has been found to be an early biomarker of left ventricular hypertrophy developing with doxorubicin cardiotoxicity, congestive heart failure, or occult dilated cardiomyopathy (Erkus et al. 2006 Walker 2006 Oyama, Sisson, and Solter 2007). 

NESIRITIDE Nesiritide (natrecor), a recombinant form of human brain natriuretic peptide (BNP), is FDA-approved for treatment of dyspnea due to congestive heart failure. The natriuretic peptides—atrial natriuretic peptide (ANP), BNP, and C-type natriuretic peptide—are a family of endogenous hormones that possess potent natriuretic, diuretic, and vasodilator properties. BNP is secreted by ventricular cardiac myocytes in response to stretch circulating levels of BNP correlate with the severity of heart failure. In the setting of heart failure, the effects of BNP counteract the effects of Angll and NE by producing vasodilation, natriuresis, and diuresis. 

The client diagnosed with stage D congestive heart failure (CHF) has a brain natriuretic peptide (BNP) level greater than 1500. Which medication would the nurse anticipate the HCP prescribing ... 

Some commercially available implantable devices for the treatment of congestive heart failure and/or ventricular tachyarrhythmias now continually monitor intrathoracic impedance and display fluid status trends. This information is then provided to the clinician via direct device interrogation or by remote telemetry. Recent reports based on actual clinical experience with this feature have attested to critical reliability and utility (Vollmann et al., 2007) and good correlation with other traditional tools such as brain natriuretic peptide (Luthje et al., 2007). 

---