Plasma levels of atrial natriuretic peptide during myocardial ischemia induced by percutaneous transluminal coronary angioplasty or dynamic exercise.
To study the effects of myocardial ischemia on plasma atrial natriuretic peptide (ANP) levels, immunoreactive ANP levels in the pulmonary artery (ANP-PA) and femoral vein (ANP-V) were measured before and during percutaneous transluminal coronary angioplasty (PTCA). Ten patients (group 1), seven of whom had no symptoms during PTCA, maintained a normal mean pulmonary capillary wedge pressure (PCWP) of less than or equal to 13 mm Hg during PTCA, whereas five patients (group 2), all of whom had symptoms and signs of ischemia during PTCA, had an increased PCWP of greater than or equal to 20 mm Hg. ANP levels did not differ significantly between the two groups before PTCA, but ANP-PA (p less than 0.02) and ANP-V (p less than 0.01) during PTCA were higher in group 2 than in group 1. ANP-V at rest and during exercise was measured in 11 patients with and 14 patients without anginal symptoms and ischemic ST changes on the ECG during exercise. The values did not change significantly in either group, and there were no difference between the groups. Thus myocardial ischemia during PTCA may lead to left ventricular dysfunction serious enough to increase PCWP and subsequently plasma ANP levels in some patients. Myocardial ischemia induced by dynamic exercise seems to be unrelated to significant changes in the plasma ANP level.
Ikäheimo
M J
MJ
Department of Medicine, University of Oulu, Finland.
Ruskoaho
H J
HJ
Airaksinen
K E
KE
Huikuri
H V
HV
Korhonen
U R
UR
Leppäluoto
P J
PJ
Tuominen
M O
MO
Takkunen
J T
JT
D000328:Adult; D000800:Angioplasty, Balloon; D009320:Atrial Natriuretic Factor / Q000097:blood*; D003327:Coronary Disease / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D005268:Femoral Vein; D006801:Humans; D008875:Middle Aged; D005082:Physical Exertion; D011651:Pulmonary Artery; D011669:Pulmonary Wedge Pressure
D009320:Atrial Natriuretic Factor