Atrial natriuretic peptide during acute treatment of congestive heart failure.
Atrial natriuretic peptide (ANP) induces potent diuretic/natriuretic, vasorelaxing and aldosterone inhibitory effects. Increased plasma levels in congestive heart failure (CHF) have been reported. The aim of this study was to investigate plasma immunoreactive ANP (ir-ANP) levels during acute treatment of CHF. Seven patients with CHF underwent cardiac catheterization. Ir-ANP plasma levels were followed up to two h after administration of an orally given phosphodiesterase inhibitor (Milrinone); a substance with positive inotropic and peripheral vasodilating properties. In all patients cardiac output increased and cardiac filling pressures decreased markedly. Initially high ir-ANP plasma levels decreased. Our patients did not have an increased blood volume. It is concluded that plasma ir-ANP levels in the pulmonary artery rapidly decrease when atrial pressure is reduced. These data suggest that atrial pressure is the major determinant for release of ir-ANP in man and that the ability to respond quickly to changes in cardiac filling pressures is maintained in patients with severe CHF. Plasma ir-ANP levels may also become useful as an index of the degree of heart failure and serve as a tool in monitoring response to drug therapy.
Berglund
H
H
Department of Clinical Physiology, Karolinska Institute, Södersjukhuset, Stockholm, Sweden.
Bevegård
S
S
Carlens
P
P
Hedner
J
J
Hedner
T
T
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020105:Milrinone; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011728:Pyridones / Q000627:therapeutic use
D010726:Phosphodiesterase Inhibitors; D011728:Pyridones; D009320:Atrial Natriuretic Factor; D020105:Milrinone