title: Possible vascular role of increased plasma arginine vasopressin in congestive heart failure.
abstract: BACKGROUND
  The present study was undertaken to determine the relation of cardiac dysfunction with hormonal release in patients with congestive heart failure.
  
  
  METHODS
  Seventy-two patients with congestive heart failure were examined, who were divided into four subgroups classified by the criteria of the New York Heart Association (NYHA). Also, 10 age-matched subjects were served as a control. Plasma arginine vasopressin (AVP), norepinephrine, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were determined. Cardiac index and pulmonary capillary wedge pressure (PCWP) were measured in 51 of 72 patients.
  
  
  RESULTS
  Plasma AVP levels were significantly increased according to the severity of NYHA classes; control: 1.7 +/- 0.2; NYHA I: 4.9 +/- 0.8, NYHA II: 5.5 +/- 0.9, NYHA III: 13.4 +/- 2.6 (p < 0.05), NYHA IV: 26.9 +/- 5.6 pmol/l (p < 0.001). Similar results were obtained with plasma norepinephrine, ANP and BNP. Plasma AVP levels had negative correlation with cardiac index (r = -0.36, p < 0.01), but did not with PCWP and plasma osmolality. Plasma BNP levels positively correlated with PCWP (r = 0.44, p < 0.001), but did not with cardiac index. There was no correlation between plasma AVP and BNP. Intensive therapy profoundly reduced all the hormones according to the improvement of cardiac index in the patients with NYHA class III and IV. The percent decrease in plasma AVP was 60.0%, a value greater than that in plasma BNP.
  
  
  CONCLUSIONS
  The present study indicates that increased AVP may deteriorate cardiac function through V(1a) as well as V(2) action, and that plasma AVP level is also a proper marker for the presence and severity of congestive heart failure.
authors.affiliation: Department of Medicine, Jichi Medical School, Omiya Medical Center, Omiya-ku Saitama, Saitama, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funayama
authors.forename: Akio
authors.initials: A
authors.lastname: Yoshimura
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tsuruya
authors.forename: Muneyasu
authors.initials: M
authors.lastname: Saito
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: San-e
authors.initials: SE
authors.lastname: Ishikawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001127:Arginine Vasopressin / Q000097:blood*; D009320:Atrial Natriuretic Factor / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006333:Heart Failure / Q000097:blood*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D009638:Norepinephrine / Q000097:blood
chemical_list: D001127:Arginine Vasopressin; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D009638:Norepinephrine