[Secretion of atrial natriuretic peptide from the left ventricle and heart in patients with hypertrophic cardiomyopathy: relationship with hemodynamic and echocardiographic profiles].
This study investigated whether atrial natriuretic peptide (ANP) secretion from the left ventricle occurs and correlated any secretion with the hemodynamic or echocardiographic parameters in patients with hypertrophic non-obstructive cardiomyopathy (HNCM). Volume overload was induced by intravenous injection of low-molecular weight dextran in 19 patients with HNCM and seven normal subjects (control group). Simultaneous measurements of plasma ANP concentrations in the aortic root, anterior interventricular vein and coronary sinus, and hemodynamic parameters were performed before and after volume overload. Echocardiographic parameters were measured under the basal conditions in the HNCM group. There was no difference in ANP concentrations between the aorta and anterior interventricular vein either before or after volume overload in the control group, whereas they were significantly higher in the anterior interventricular vein than in the aorta both before and after volume overload in the HNCM group, suggesting increased ANP secretion from the left ventricle. Moreover, the difference in ANP concentrations between these locations was enhanced by volume overload. In the HNCM group, the differences in ANP concentrations between these locations were positively correlated with the pulmonary capillary wedge pressure and left ventricular end-diastolic pressure before and after volume overload, but not with left ventricular thickness or left atrial dimension. These results suggest that enhanced ANP secretion from the left ventricle in both basal and volume overloaded states occurs in HNCM, and this ANP secretion from the left ventricle is closely related to left ventricular end-diastolic pressure but not to wall thickness and mass index of left ventricle.
Ishii
Y
Y
First Department of Internal Medicine, Asahikawa Medical College.
Kawashima
E
E
Kawabe
J
J
Kikuchi
K
K
D001011:Aorta; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000378:metabolism*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003911:Dextrans / Q000494:pharmacology; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006352:Heart Ventricles / Q000378:metabolism; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure
D003911:Dextrans; D009320:Atrial Natriuretic Factor