PMID- 15809819
OWN - NLM
STAT- MEDLINE
DCOM- 20051004
LR  - 20181113
IS  - 1382-4147 (Print)
IS  - 1382-4147 (Linking)
VI  - 9
IP  - 3
DP  - 2004 Jul
TI  - Treatment with B-type natriuretic peptide for chronic decompensated heart 
      failure: insights learned from the follow-up serial infusion of nesiritide 
      (FUSION) trial.
PG  - 209-16
AB  - Several evidence-based treatment regimens are modestly effective in patients with 
      moderately severe to severe heart failure, but truly effective therapies that 
      improve symptoms, reduce hospitalizations, and extend meaningful survival do not 
      exist for these patients. Only ventricular replacement therapy, with either heart 
      transplantation or left ventricular assist devices, has been shown to 
      significantly improve outcomes. Nesiritide, a recombinant B-type natriuretic 
      peptide, is associated with significant reductions in filling pressure, with 
      corresponding relief of symptoms, and diminished neurohormonal levels and has no 
      inotropic effects and no evidence of proarrhythmia when given to patients with 
      decompensated acute heart failure. Results of the Follow-Up Serial Infusion of 
      Nesiritide (FUSION) trial suggest that a regimen incorporating nesiritide can be 
      accomplished with a reasonable assurance of safety and tolerability; pre-study 
      concerns regarding hypotension were not realized. A qualified look at outcomes 
      data within FUSION I suggests that further study of this paradigm is reasonable, 
      especially if the studied patient population includes patients with a low left 
      ventricular ejection fraction and New York Heart Association (NYHA) class III 
      disease with renal insufficiency, or patients with low left ventricular ejection 
      fraction and NYHA class IV heart failure. Therefore, FUSION II, a double-blind, 
      placebo-controlled trial, will randomly assign approximately 900 such patients to 
      treatment with usual care plus nesiritide or usual care plus placebo and will use 
      mortality/cardiorenal hospitalization as a composite end point. If positive data 
      emerge from FUSION II that either confirm or strengthen the data in FUSION I, a 
      new therapeutic option may be available for patients with chronic decompensated 
      heart failure.
FAU - Yancy, Clyde W
AU  - Yancy CW
AD  - University of Texas Southwestern Medical Center, Dallas, TX, USA. 
      clyde.yancy@utsouthwestern.edu
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 0 (Natriuretic Agents)
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Chronic Disease
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*drug therapy
MH  - Humans
MH  - Infusions, Intravenous
MH  - Male
MH  - Natriuretic Agents/*administration & dosage
MH  - Natriuretic Peptide, Brain/*administration & dosage
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2005/04/06 09:00
MHDA- 2005/10/05 09:00
CRDT- 2005/04/06 09:00
PHST- 2005/04/06 09:00 [pubmed]
PHST- 2005/10/05 09:00 [medline]
PHST- 2005/04/06 09:00 [entrez]
AID - 10.1007/s10741-005-6132-9 [doi]
PST - ppublish
SO  - Heart Fail Rev. 2004 Jul;9(3):209-16. doi: 10.1007/s10741-005-6132-9.