title: Effects of human atrial natriuretic peptide on myocardial performance and energetics in heart failure due to previous myocardial infarction.
abstract: BACKGROUND
  Human atrial natriuretic peptide (hANP) and spontaneous nitric oxide (NO) donor share cyclic guanosine monophosphate (cGMP) as a second messenger, but their effect on myocardium may differ. We compared the effect of hANP and sodium nitroprusside (SNP) on left ventricular (LV) mechano-energetics in heart failure (HF).
  
  
  METHODS
  Ten patients with HF due to previous myocardial infarction (LV ejection fraction: 45±3%) were instrumented with conductance and coronary sinus thermodilution catheters. LV contractility (Ees: slope of end-systolic pressure-volume relation) and the ratio of LV stroke work (SW) to myocardial oxygen consumption (SW/MVO2=mechanical efficiency) were measured in response to intravenous infusion of ANP (0.05 μg/kg/min) or SNP (0.3 μg/kg/min) to lower blood pressure by at least 10 mmHg, and changes in plasma cGMP.
  
  
  RESULTS
  SNP had no effect on Ees, SW, or MVO2, thus SW/MVO2 remained unchanged (40.54±5.84% to 36.59±5.72%, p=0.25). ANP increased Ees, and decreased MVO2 with preserved SW, resulting in improved SW/MVO2 (40.49±6.35% to 50.30±7.96%, p=0.0073). Infusion of ANP (10.42-34.95 pmol/ml, p=0.0003) increased cGMP levels, whereas infusion of SNP had no effect (10.42-12.23 pmol/ml, p=0.75).
  
  
  CONCLUSIONS
  Compared to SNP, the ANP-dependent increase in cGMP may ameliorate myocardial inotropy and energetics in HF.
authors.affiliation: Kobe Rosai Hospital, Department of Cardiology, Kobe, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan. Electronic address: shinke@med.kobe-u.ac.jp.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shinke
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Shite
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Takaoka
authors.affiliation: Kobe Rosai Hospital, Department of Cardiology, Kobe, Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Inoue
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Hidenari
authors.initials: H
authors.lastname: Matsumoto
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Yoshikawa
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Otake
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumoto
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ogasawara
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.affiliation: Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe, Japan.
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Hirata
mesh_terms: D009320:Atrial Natriuretic Factor / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D006152:Cyclic GMP / Q000097:blood; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007262:Infusions, Intravenous; D009200:Myocardial Contraction / Q000187:drug effects; D009203:Myocardial Infarction / Q000150:complications; D009206:Myocardium / Q000378:metabolism; D020030:Nitric Oxide Donors / Q000008:administration & dosage; D009599:Nitroprusside / Q000008:administration & dosage; D010101:Oxygen Consumption; D013318:Stroke Volume / Q000187:drug effects; D014665:Vasodilator Agents / Q000008:administration & dosage*; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
chemical_list: D020030:Nitric Oxide Donors; D014665:Vasodilator Agents; D009599:Nitroprusside; D009320:Atrial Natriuretic Factor; D006152:Cyclic GMP
keywords: Cardiac mechano-energetics; Conductance catheter; Cyclic guanosine monophosphate; E(es)