Nesiritide for the treatment of diastolic dysfunction

Despite advances in the treatment of left ventricular diastolic dysfunction, therapy is still primarily empiric and readmission rates remain high, with up to half of patients discharged with the diagnosis of congestive heart failure being rehospitalized within 6 months due to recurrent decompensation. Even with this high economic burden, no effective, long-term therapies have been developed. The authors present a patient with recurrent hospitalizations for decompensated congestive heart failure due to left ventricular diastolic dysfunction becoming refractory to parenteral diuretic therapy. The patient exhibited a dramatic response to a 96-hour intravenous infusion of nesiritide and experienced prolonged clinical benefit, remaining in New York Heart Association functional class I for more than 6 months after the infusion.