Beneficial effects of intermittent carperitide therapy in an outpatient with old broad myocardial infarction

The patient, who was a 57-year-old male had broad anterior old myocardial infarction. We found that he had severe pulmonary hypertension and high plasma BNP level although he had received the maximum medical therapy in the chronic phase of myocardial infarction. Worsening of heart failure was repeated under the tailored therapy. We tried intermittent out-patient therapy to avoid his readmission for worsening heart failure. The pulmonary artery pressure and the plasma BNP level were decreased after a half-year of treatment with intermittent carperitide therapy (0.0125 ∼0.025 μg/min/kg, for 3 hours, 3 times a week). The patient has needed no hospitalization for worsening of heart failure and is stable in the NYHA functional class II. We assess the possibility for one therapeutic modality of intermittent carperitide therapy in outpatients with severe chronic heart failure.