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Cinaciguat (BAY 58-2667) improves cardiopulmonary hemodynamics in patients with acute decompensated heart failure
Harald Lapp1, Veselin Mitrovic, Norbert Franz
1HELIOS Clinic Erfurt, Germany. harald.lapp@helios-kliniken.de
Circulation
|May 20, 2009
Summary
Cinaciguat effectively reduced heart pressures and improved cardiac output in patients with acute decompensated heart failure. This soluble guanylate cyclase activator demonstrated potent hemodynamic effects and good tolerability, warranting further investigation.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Cinaciguat (BAY 58-2667) represents a novel class of soluble guanylate cyclase activators.
- It is under clinical development for treating acute decompensated heart failure.
Purpose of the Study:
- To evaluate the hemodynamic effects of intravenous cinaciguat.
- To assess the safety and tolerability of cinaciguat in patients with acute decompensated heart failure.
Main Methods:
- A two-part study involving dose finding (Part A) and a proof-of-concept evaluation (Part B).
- Part B included 33 patients with acute decompensated heart failure, with cinaciguat doses titrated based on hemodynamic response.
- Hemodynamic parameters were monitored during a 6-hour infusion.
Main Results:
- Cinaciguat significantly reduced pulmonary capillary wedge pressure, right atrial pressure, pulmonary artery pressure, and both pulmonary and systemic vascular resistance.
- Cardiac output increased by 1.68 L/min, and heart rate increased by 4.4 bpm.
- A high responder rate (90% by 6 hours) was observed, with cinaciguat being well-tolerated, most commonly causing mild to moderate hypotension.
Conclusions:
- Cinaciguat exhibits significant preload and afterload reducing effects.
- The drug effectively increases cardiac output in patients with acute decompensated heart failure.
- Further research into cinaciguat for acute decompensated heart failure is recommended.
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