Effects of human atrial natriuretic peptide on cardiac function and hemodynamics in patients with high plasma BNP levels.
Both atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) bind preferentially to the natriuretic peptide A receptor. Therefore, we hypothesized that the positive inotropic and lusitropic effects of ANP might be blunted in patients with moderate congestive heart failure and high BNP levels. Micromanometers and conductance catheters were used to obtain relatively load-insensitive left ventricular pressure-volume analysis in order to compare the myocardial and load-altering actions of ANP in 20 patients with low and high plasma BNP levels. In the low-BNP group (plasma BNP levels <230 pg/ml), ANP infusion significantly decreased end-systolic pressure and end-diastolic pressure and volume, increased end-systolic elastance, and shortened left ventricular relaxation. By contrast, in the high-BNP group (plasma BNP levels >230 pg/ml), the effect of ANP infusion on LV contractility was blunted but its beneficial effects on LV diastolic function and LV-arterial coupling remained. Thus, ANP infusion may improve LV diastolic function even in patients with moderate heart failure and high plasma BNP levels.
Nakajima
Kazuki
K
First Department of Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu 514-0823, Japan.
Onishi
Katsuya
K
Dohi
Kaoru
K
Tanabe
Masaki
M
Kurita
Tairo
T
Yamanaka
Takashi
T
Ito
Masaaki
M
Isaka
Naoki
N
Nobori
Tsutomu
T
Nakano
Takeshi
T
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D017023:Coronary Angiography; D006152:Cyclic GMP / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects / Q000502:physiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011863:Radioimmunoassay; D013318:Stroke Volume / Q000187:drug effects / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology; D017725:Ventricular Pressure / Q000187:drug effects / Q000502:physiology
D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D006152:Cyclic GMP