[Increased plasma level of atrial natriuretic peptide in patients with stress-induced coronary insufficiency: stretch-independent release of atrial natriuretic peptide?].
Plasma levels of atrial natriuretic peptide (ANP) were determined in 34 male patients undergoing diagnostic right heart catheterization. Patients with effort angina exhibited significant higher ANP levels at rest (259 +/- 42 pg/ml; n = 7) than patients without signs of coronary heart disease (78 +/- 30 pg/ml; n = 8). Patients with effort angina also had higher ANP levels at rest than patients exhibiting impaired cardiac function on exertion without signs of ischemia (105 +/- 15 pg/ml; n = 4), patients with only minimal functional alterations due to infarction residues (95 +/- 27 pg/ml; n = 7), or patients with only borderline changes of ST-segments during exertion (61 +/- 19 pg/ml; n = 8). In contrast, mean pulmonary capillary or right atrial pressures were not significantly different between the various groups of patients. The patients with effort angina also exhibited the highest ANP levels during bicycle exercise (846 +/- 238 pg/ml). There was only a weak to moderate linear correlation between ANP levels and pulmonary or right atrial pressures in the whole group of patients (r = 0.1-0.6). The plasma levels of epinephrine and norepinephrine and of ANP were not significantly correlated, with the exception of norepinephrine levels during exercise (r = 0.54). Our observations suggest that in patients with effort angina there may exist additional stretch-independent factors stimulating the release of ANP, possibly associated with repetitive myocardial ischemia.
Pohl
U
U
Institut für Angewandte Physiologie, Universität Freiburg.
Schuon
J
J
Weidemann
H
H
Bassenge
E
E
D000787:Angina Pectoris / Q000097:blood; D009320:Atrial Natriuretic Factor / Q000097:blood*; D003327:Coronary Disease / Q000097:blood*; D004837:Epinephrine / Q000097:blood; D005080:Exercise Test; D006333:Heart Failure / Q000097:blood*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D009638:Norepinephrine / Q000097:blood
D009320:Atrial Natriuretic Factor; D009638:Norepinephrine; D004837:Epinephrine
Erhöhte Plasmaspiegel des atrialen natriuretischen Peptids (ANP) bei Patienten mit Belastungskoronarinsuffizienz: Dehnungsunabhängige ANP-Freisetzung?