The relationship between plasma levels of immunoreactive atrial natriuretic hormone and hemodynamic function in man.
To evaluate the relationship between plasma levels of immunoreactive atrial natriuretic hormone (IR-ANH) and different hemodynamic parameters in man, we studied 34 patients undergoing right heart catheterization. Plasma levels of IR-ANH in blood samples withdrawn from the femoral vein (n = 28), right ventricle (n = 27), and left ventricle (n = 17) were determined by radioimmunoassay. Right atrial pressure, pulmonary arterial wedge pressure, heart rate, and mean arterial pressure were found to be independent and significant predictors of IR-ANH plasma levels. The closest correlations were between right atrial pressure and either right ventricular IR-ANH levels (r = .78, p greater than .001) or femoral vein IR-ANH levels (r = .52, p less than .006). Five patients with isolated left ventricular failure had elevated IR-ANH levels out of proportion to their right atrial pressure levels. Pulmonary arterial wedge pressure also correlated with right ventricular IR-ANH levels (r = .46, p less than .002) and with femoral vein IR-ANH levels (r = .58, p less than .002). A single patient with isolated right heart failure had markedly elevated IR-ANH levels despite normal pulmonary arterial wedge pressure. Right ventricular levels were twice femoral vein levels and were closely correlated (181 +/- 40 vs 90 +/- 20 pmol/liter; r = .90, p less than .001). Right ventricular and left ventricular levels were almost identical (155 +/- 46 vs 146 +/- 43 pmol/liter; r = .99, p less than .001). Patients with volume overload states had elevated IR-ANH levels.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D006328:Cardiac Catheterization; D003327:Coronary Disease / Q000097:blood / Q000503:physiopathology; D005260:Female; D005268:Femoral Vein; D006331:Heart Diseases / Q000097:blood / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000097:blood / Q000503:physiopathology; D006352:Heart Ventricles / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology
D009320:Atrial Natriuretic Factor