Endogenous sodium-potassium-chloride cotransport inhibitor in congestive heart failure.
OBJECTIVE
This study sought to evaluate the relation, if any, between fluid overload in congestive heart failure (CHF) and a newly discovered endogenous natriuretic factor acting like loop diuretic drugs: cotransport inhibitory factor (CIF).


BACKGROUND
The humoral mechanisms regulating volume overload in CHF are not fully understood. Therefore, we investigated whether there is a role for CIF in this pathologic condition.


METHODS
Plasma and urinary CIF levels were investigated in 23 patients with chronic CHF and compared with changes in plasma atrial natriuretic peptide (ANP). Twelve patients without CHF served as control subjects.


RESULTS
CHF was associated with a highly significant threefold increase in both plasma CIF levels (mean +/- SD 7.10 +/- 3.01 vs. 2.28 +/- 0.92 U/ml, p < 0.0001) and urinary CIF excretion (7,849 +/- 3,600 vs. 2,351 +/- 1,297 U/day, p < 0.0001) with respect to patients without CHF. CIF increased as a function of impairment in left ventricular ejection fraction (r = -0.703, p < 0.0001) and the severity of clinical status. Plasma ANP was also increased in patients with CHF, although to a lesser extent (68%, p = 0.0501) than plasma CIF, and was also significantly correlated with left ventricular ejection fraction (r = -0.552, p = 0.0004).


CONCLUSIONS
Plasma and urinary CIF activities were strongly and very significantly increased in chronic CHF. In addition to ANP, this long-term natriuretic agent may be of potential importance in reducing fluid overload in CHF.
INSERM U400, Créteil, France.
J L
JL
Dubois-Randé
O
O
Montagne
M
M
Alvarez-Guerra
C
C
Nazaret
B
B
Crozatier
P
P
Gueret
A
A
Castaigne
R P
RP
Garay
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood; D001685:Biological Factors / Q000097:blood / Q000378:metabolism* / Q000652:urine; D002352:Carrier Proteins / Q000037:antagonists & inhibitors*; D002712:Chlorides / Q000037:antagonists & inhibitors*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000378:metabolism* / Q000652:urine; D006801:Humans; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000037:antagonists & inhibitors*; D012964:Sodium / Q000037:antagonists & inhibitors*; D028021:Sodium-Potassium-Chloride Symporters
D001685:Biological Factors; D002352:Carrier Proteins; D002712:Chlorides; D028021:Sodium-Potassium-Chloride Symporters; D009320:Atrial Natriuretic Factor; D012964:Sodium; D011188:Potassium