Arthur Mark Richards

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OBJECTIVES The purpose of this study was to compare the effects of N-terminal pro-B-type natriuretic peptide (NT-proBNP)-guided therapy with those of intensive clinical management and with usual care (UC) on clinical outcomes in chronic symptomatic heart failure. BACKGROUND Initial trial results suggest titration of therapy guided by serial plasma B-type(More)
BACKGROUND There is currently no objective practical guide to intensity of drug treatment for individuals with heart failure. We hypothesised that pharmacotherapy guided by plasma concentrations of the cardiac peptide aminoterminal brain natriuretic peptide (N-BNP) would produce a superior outcome to empirical trial-based therapy dictated by clinical(More)
AIM To determine the renal, endocrine and haemodynamic effects of an orally active inhibitor of the neutral endopeptidase EC in essential hypertension. METHODS Two groups of 12 white male patients with essential hypertension were treated with candoxatril at 25 mg every 12 h (group 1) or at 200 mg every 12 h (group 2) for 5 days in double-blind,(More)
AIMS Growth differentiation factor 15 (GDF15), ST2, high-sensitivity troponin T (hsTnT), and N-terminal pro brain natriuretic peptide (NT-proBNP) are biomarkers of distinct mechanisms that may contribute to the pathophysiology of heart failure (HF) [inflammation (GDF15); ventricular remodelling (ST2); myonecrosis (hsTnT); and wall stress (NT-proBNP)]. (More)
Russell's viper is the most important cause of life-threatening snake bite and acute renal failure in Sri Lanka. Only equine polyspecific antivenoms imported from India are available. They have not proved effective clinically or in clearing venom antigenemia and they frequently cause reactions. In an attempt to reduce mortality and morbidity, a new(More)
OBJECTIVE Human brain natriuretic peptide-32 (BNP) (i.e. proBNP(77-108)), the mature form of BNP and secreted predominantly by the cardiac ventricle, is formed from a high molecular weight precursor, proBNP(1-108). We have recently identified the aminoterminal form proBNP(1-76) (NT-proBNP) in human plasma but its source, metabolism and production in(More)
Urotensin II has vasoconstrictive and negative inotropic effects, suggesting a possible role in circulatory regulation and pathophysiology of heart failure. We developed a sensitive specific RIA and measured plasma urotensin II in patients with heart failure and in controls. Plasma urotensin II was higher in heart failure patients (mean 3.9 pmol/L [SD 1.4];(More)
Both Adrenocorticotrophin (ACTH) and glucocorticoids raise blood pressure in man and animals, but the relationship of this and altered renal function to other cardiovascular variables, and the differences and similarities of the effects of the two agonists have not been fully explained. The present study compares the effects of ACTH (0.5 mg i.m; every 12 h)(More)
OBJECTIVES We sought to examine the effects of urocortin (UCN) 2 infusion on hemodynamic status, cardiovascular hormones, and renal function in healthy humans. BACKGROUND Urocortin 2 is a vasoactive and cardioprotective peptide belonging to the corticotrophin-releasing factor peptide family. Recent reports indicate the urocortins exert important effects(More)
BACKGROUND Urocortin 2 (Ucn2) has potent cardiovascular actions and may participate in the pathophysiology of heart failure (HF). The integrated hemodynamic, endocrine, and renal effects of Ucn2 are unknown. METHODS AND RESULTS Eight sheep received incremental intravenous boluses of murine Ucn2 (10, 50, and 100 microg at 2-hour intervals) before (normal)(More)