Key result
Pre-treatment with tadalafil and subcutaneous BNP improved cardiac function but reduced renal response in subjects with preclinical systolic dysfunction and renal dysfunction.
Why the study?
Impaired cardiorenal response to acute saline volume expansion in preclinical systolic dysfunction may lead to symptomatic heart failure, and whether combination phosphodiesterase-V inhibition and exogenous BNP enhances this response was unknown.
Does combination tadalafil and subcutaneous BNP improve cardiorenal response to acute volume expansion in subjects with preclinical systolic dysfunction and renal dysfunction?
RCT (n=21)
Double-blind
Randomized
Does combination tadalafil and subcutaneous BNP improve cardiorenal response to acute volume expansion in subjects with preclinical systolic dysfunction and renal dysfunction?
In patients with preclinical systolic dysfunction, combined tadalafil and BNP improves cardiac parameters but paradoxically worsens renal hemodynamics during acute volume expansion.
May augment cardiorenal response in PSD; leaves open whether this prevents symptomatic HF in larger trials.
Impaired cardiorenal response to acute saline volume expansion in preclinical systolic dysfunction (PSD) may lead to symptomatic heart failure. The objective was to determine if combination phosphodiesterase-V inhibition and exogenous B-type natriuretic peptide (BNP) administration may enhance cardiorenal response. A randomized double-blinded, placebo-controlled study was conducted in 21 subjects with PSD and renal dysfunction. Pre-treatment with tadalafil and subcutaneous BNP resulted in improved cardiac function, as evidenced by improvement in ejection fraction, left atrial volume index, and left ventricular end-diastolic volume. However, there was reduced renal response with reduction in renal plasma flow, glomerular filtration rate, and urine flow. (Tadalafil and Nesiritide as Therapy in Pre-clinical Heart Failure; NCT01544998).
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Wan et al. (2019) conducted an RCT in Preclinical systolic dysfunction and renal dysfunction (n=21). Tadalafil and subcutaneous BNP (Nesiritide) vs. Placebo was evaluated on Cardiorenal response to acute saline volume expansion. Pre-treatment with tadalafil and subcutaneous BNP improved cardiac function but reduced renal response in subjects with preclinical systolic dysfunction and renal dysfunction.
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