The purpose of this study is to look at the safety and effectiveness of longer term
intravenous (IV) infusion of the study drug, nesiritide in patients with acutely
decompensated chronic heart failure. Nesiritide (Natrecor) is a man-made version of a human
hormone that dilates veins and arteries. Nesiritide (Natrecor) is currently FDA-approved for
short-term inpatient IV treatment of acutely decompensated chronic heart failure.
Hypothesis: Nesiritide, administered by continuous intravenous infusion in the outpatient
setting, is a safe treatment for refractory Class III & IV chronic heart failure due to
systolic or diastolic dysfunction, regardless of renal function when administered over a
12-week period.
Corollary #1: Nesiritide, when infused continuously over 12 weeks will improve the overall
condition of patients with chronic heart failure. These mechanisms include reducing
hospitalizations when compared with the previous six months, improving symptoms as measured
by the Minnesota Living with Heart Failure short questionnaire, and improving functional
capacity as measured by 6-minute walk testing.
Corollary #2: Nesiritide infusion will be associated with a statistically significant
decrease in N-terminal pro-BNP levels and cyclic GMP levels compared with patients receiving
placebo infusions.