Chronic heart failure as a state of reduced effectiveness of the natriuretic peptide system: implications for therapy.

A randomized, placebo‐controlled study of 40 patients with CHF and reduced ejection fraction (HFrEF), in which nesiritide was given subcutaneously for 8 weeks, showed a trend to improved estimated GFR compared with placebo. 57 Nesiritide administration resulted in an increase in plasma cGMP levels both at the time of the first dose and at the last dose, 8 weeks later, suggesting a maintained response to the peptide. 57 Interestingly, a greater and significant decrease i

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