Cinaciguat (BAY 58-2667) is an experimental drug for the treatment of acute decompensated heart failure. Cinaciguat activates the soluble guanylate cyclase (sGC) which is a receptor for nitric oxide. This increases biosynthesis of cyclic GMP, resulting in vasodilation. Cinaciguat (BAY 58-2667) is a novel sGC activator that causes vasodilation, even in the presence of oxidized heme or heme-free sGC, but its hemodynamic effects have not been studied in the perinatal lung. Cinaciguat (0.1–100 μg over 10 min) caused dose-related increases in pulmonary blood flow greater than fourfold above baseline and reduced pulmonary vascular resistance by 80%. Cinaciguat causes potent and sustained fetal pulmonary vasodilation that is augmented in the presence of oxidized sGC and speculate that cinaciguat may have therapeutic potential for severe neonatal pulmonary hypertension.
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