Effect of endoscopic transthoracic sympathicotomy on plasma natriuretic peptide concentrations in humans.
BACKGROUND
The effects of endoscopic transthoracic sympathicotomy (ETS) on plasma natriuretic peptides concentrations in humans were examined in order to elucidate the role of the sympathetic nervous system in their regulation.


RESULTS
Thirty-seven patients with palmar hyperhidrosis underwent ETS. Cardiac functional indices were assessed by echocardiography, and plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) concentrations were measured before and after ETS. ETS caused decreases in heart rate, mean arterial pressure, systemic vascular resistance, and increases in left ventricular (LV) end-diastolic volume, stroke index, ejection fraction, and left atrial diameter. LV end-systolic volume and cardiac index remained unchanged. Following ETS, ANP increased from 10.7+/-5.9 to 24.7+/-16.8 pg/ml (p < 0.01), and BNP increased from 5.1+/-4.2 to 19.7+/-21.5 pg/ml (p < 0.01). From the multivariate regression analysis, ETS, age and gender were determined to be significant predictors of changes in the ANP and BNP concentrations. None of the hemodynamic parameters were useful as independent predictors.


CONCLUSIONS
The plasma concentrations of ANP and BNP increased after ETS, independent of hemodynamic changes, and apparently because of the release of the inhibitory effects of the cardiac sympathetic nerves on natriuretic peptide secretion.
Nakamura
Yukio
Y
Department of Cardiology, National Hospital Organization, Kanazawa Medical Center, Kanazawa Medical Center, Kanazawa, Japan. nakay@kinbyou.hosp.go.jp
Yoshizawa
Hisashi
H
Hirasawa
Motoaki
M
Kida
Hiroshi
H
Matsumoto
Yasushi
Y
Ueyama
Takeshi
T
D000328:Adult; D009320:Atrial Natriuretic Factor / Q000097:blood*; D019723:Endoscopes; D005260:Female; D006339:Heart Rate; D006801:Humans; D006945:Hyperhidrosis / Q000097:blood* / Q000601:surgery; D008297:Male; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013562:Sympathectomy / Q000379:methods; D019616:Thoracic Surgical Procedures / Q000379:methods
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor