Correlation analysis of atrial natriuretic peptide concentration, echocardiographic left atrial and left ventricular dimensions, and renal function parameters in patients after permanent pacemaker implantation.
BACKGROUND
Atrial endocrine function was established in the second half of the 20th century, confirming the role of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in the physiology of the cardiovascular system. The present study was undertaken to evaluate changes in ANP and echocardiographic parameters within the first month after VVI and DDD pacemaker implantation and to evaluate correlations between the parameters.


METHODS
The study population consisted of group I--20 VVI patients aged 71-90 years (mean age 77.5 +/- 5.9) and group II--20 DDD/VDD patients aged 49-81 years (mean age 68.9 +/- 11). Fifteen healthy volunteers aged 58-80 years (mean age 72.7 +/- 2.8) served as controls. Correlations between ANP levels and cardiac cavity dimensions and between ANP and parameters of renal function were studied.


RESULTS
Blood levels of ANP decreased after pacemaker implantation: in the VVI group from 168.61 +/- 81.95 pg/1000 microL to 118.04 +/- 61.06 pg/1000 microL at 7 days and to 121.4 +/- 71.90 pg/1000 microL at 30 days; and in the DDD/VDD group from 134.89 +/- 83.11 pg/1000 microL to 104.96 +/- +/- 57.09 pg/1000 microL at 7 days and to 110.82 +/- 53.32 pg/1000 microL at 30 days. There was a significant correlation between ANP levels and left atrial size in the DDD/VDD group--0.598 (p = 0.005) and 0.593 (p = 0.005) and left ventricular dimensions--0.499 (p = 0.024) and 0.485 (p = 0.030).


CONCLUSIONS
ANP decreases significantly after pacing implementation in patients selected for implantation of VVI and DDD/VDD pacemakers. ANP correlates significantly with echocardiographic measurements in patients selected for DDD/VDD pacemakers, but no significant correlation is observed in VVI patients qualifying for permanent pacemaker due to atrioventricular block.
Sielski
Janusz
J
Department of Cardiology, Regional District Hospital, Kielce, Poland. jsielski7@interia.pl
Janion
Marianna
M
Gawor
Zenon
Z
Ciuraszkiewicz
Katarzyna
K
Sielska
Maria Rebeka
MR
D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D015536:Down-Regulation; D006325:Heart Atria / Q000000981:diagnostic imaging; D006327:Heart Block / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008875:Middle Aged; D010138:Pacemaker, Artificial; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography
D015415:Biomarkers; D009320:Atrial Natriuretic Factor