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Background— The renal actions of brain natriuretic peptide (BNP) in congestive heart failure (CHF) are associated with increased diuresis and natriuresis, preserved glomerular filtration rate (GFR), and lack of activation of the renin-angiotensin-aldosterone system (RAAS). In contrast, diuretic-induced natriuresis may be associated with reduced GFR and RAAS activation. The objective of this study was to test the hypothesis that exogenous BNP enhances the renal diuretic and natriuretic actions of furosemide (Fs) and retards the activation of aldosterone in a model of CHF.

Methods and Results— CHF was produced in 2 groups of dogs by ventricular pacing. One group received continuous (90-minute) intravenous Fs (1 mg · kg⁻¹ · h⁻¹). A second group (Fs+BNP) received 45-minute intravenous coinfusion of Fs (1 mg · kg⁻¹ · h⁻¹) and low-dose (2 pmol · kg⁻¹ · min⁻¹) BNP followed by 45-minute coinfusion of Fs …