title: Relationship between Doppler transmitral flow velocity pattern and plasma atrial and brain natriuretic peptide concentrations in anuric patients on maintenance hemodialysis.
abstract: Plasma atrial (ANP) and brain (BNP) natriuretic peptide levels were compared to determine if transmitral flow velocity pattern is an instantaneous marker of body fluid balance in anuric patients on hemodialysis (HD). We measured plasma ANP and BNP levels and performed Doppler echocardiography in 38 anuric patients before and after HD. Patients with valvular disease, left ventricular systolic dysfunction having a fractional shortening < 0.3, arrhythmia, or left ventricular hypertrophy were excluded. The relationships between plasma ANP or BNP levels and the transmitral flow velocity pattern were evaluated. We also determined if the magnitude of the decrease in plasma ANP level was related to that in the early peak of transmitral flow velocity (peak E). The mean age of the subjects was 61.1 +/- 9.7 years. The ANP level of 213.6 +/- 146.1 pg/mL was related to peak E of 61 +/- 15 cm/s before HD (R = 0.504, P < 0.001), but not after HD. Plasma ANP level was not related to peak late transmitral flow velocity (peak A) or peak E/peak A before or after HD. BNP level was not related to the transmitral flow velocity pattern. The magnitude of decrease in hANP level during HD was significantly related to that in peak E (R = 0.342, P < 0.05). Before HD, peak E was related to the plasma ANP level, reflecting volume overload. Change in peak E showed a weak relationship with that of plasma ANP level in the same HD patient. The measurement of peak E during a HD session may potentially enable the assessment of hydration status during HD.
authors.affiliation: Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ito
authors.forename: Sumiko
authors.initials: S
authors.lastname: Murai
authors.forename: Norio
authors.initials: N
authors.lastname: Takada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ozasa
authors.forename: Mayumi
authors.initials: M
authors.lastname: Hanada
authors.forename: Masaya
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Kaoru
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nagae
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Inagaki
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takeda
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Fukutomi
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000150:complications; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D006435:Renal Dialysis; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000150:complications
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor