Relation of atrial natriuretic peptides to left ventricular systolic and diastolic function in heart failure.
BACKGROUND
Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities.


OBJECTIVE
This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function in heart failure.


METHODS
Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were measured in 63 patients with chronic heart failure and left ventricular systolic dysfunction. According to Doppler transmitral flow measurements, 19 patients had a restrictive and 44 patients had a non-restrictive left ventricular filling pattern.


RESULTS
Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were higher in patients with a restrictive filling pattern than in patients with a non-restrictive filling pattern (197 vs. 75 pmol/l, P<0.0001 and 1.14 vs. 0.45 nmol/l, P<0.0001). In univariate analysis, atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide correlated with deceleration time, E/A ratio and left ventricular ejection fraction. In multivariate analysis, both peptides appeared independently related to left ventricular ejection fraction and left ventricular filling pattern.


CONCLUSIONS
In patients with chronic heart failure, atrial natriuretic peptides provide information on left ventricular systolic as well as diastolic function.
Heart Center, University Hospital Rotterdam, The Netherlands. wybenga@card.azr.nl
A A
AA
Wijbenga
A H
AH
Balk
F A
FA
Jonkman
F
F
Boomsma
M L
ML
Simoons
A J
AJ
Man in t Veld
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000502:physiology*; D003971:Diastole / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D013599:Systole / Q000502:physiology*; D014463:Ultrasonography; D016277:Ventricular Function, Left / Q000502:physiology*
D009320:Atrial Natriuretic Factor