The plasma concentration of N-terminal proatrial natriuretic factor ANF(1-98) is related to prognosis in severe heart failure.
Due to its longer halflife, the N-terminal of ANF prohormone, ANF(1-98), has plasma concentrations that exceed those of ANF itself by a factor of 10 or more. It is also less prone to rapid changes secondary to hemodynamic alterations. To evaluate the prognostic significance of ANF(1-98) plasma levels in severe heart failure (NYHA IV), the peptide was measured by radioimmunoassay in plasma samples from patients randomized to additional treatment with enalapril (n = 78) or placebo (n = 61) (CONSENSUS study). In the placebo group there was a positive relation between mortality after 6 months and baseline ANF(1-98) level. Because of a reduced mortality, especially among patients with high ANF(1-98) levels, there was no such relation in the patients treated with enalapril. For both groups there was a positive relationship between increase in ANF(1-98) after 6 weeks of treatment and mortality, while a decrease signaled a favorable prognosis. It is concluded that the magnitude and changes of plasma ANF(1-98) provide information on prognosis and therapeutic effects with respect to mortality in patients with severe heart failure. Plasma ANF(1-98) may serve as a useful clinical biochemical parameter in the treatment of heart failure.
Hall
C
C
Institute for Surgical Research, National Hospital, University of Oslo, Norway.
Kjekshus
J
J
Eneroth
P
P
Snapinn
S
S
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D015993:Life Tables; D008297:Male; D009638:Norepinephrine / Q000097:blood; D010446:Peptide Fragments; D010919:Placebos; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D015996:Survival Rate
D010446:Peptide Fragments; D010919:Placebos; D011498:Protein Precursors; C055659:atrial natriuretic factor prohormone (1-98); D004656:Enalapril; D009320:Atrial Natriuretic Factor; D009638:Norepinephrine