Atrial natriuretic peptide release is more dependent on atrial filling volume than on filling pressure in chronic congestive heart failure

American Heart Journal
S GlobitsR Pacher

Abstract

The mechanism of atrial natriuretic peptide (ANP) release has been difficult to demonstrate in patient studies because of inaccuracies in measuring atrial volumes using conventional techniques. Magnetic resonance imaging was performed in 28 clinically stable patients (New York Heart Association class 3) with chronic heart failure to determine right atrial (RA), left atrial (LA), and ventricular volumes. In addition, right heart catheterization was serially performed and plasma ANP levels (in picograms per milliliter) were drawn from the right atrium. Five patients had to be excluded from data analysis for technical reasons. The remaining 23 patients had the following hemodynamic measurements (mean +/- SD): RA mean pressure 7+/-5 mm Hg, pulmonary artery mean pressure 28+/-10, pulmonary capillary wedge pressure 21+/-8 mm Hg, and cardiac index 2.9+/-1.4 (L/min/m2), respectively. Plasma ANP levels were significantly elevated at 162+/-117 (normal range 20 to 65 pg/ml, p < 0.05), as were LA and RA volumes compared with healthy controls (RA volume 128+/-64 ml vs 82+/-25 ml, p < 0.05; LA volume 157+/-54 ml vs 71+/-24 ml, p < 0.01, respectively). ANP showed a stronger relation with atrial volumes (RA volume, r = 0.91, p = 0.0001; LA vol...Continue Reading

References

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Citations

Oct 16, 2004·Chest·Lok Bin YapJohn Gerard Coghlan
Apr 12, 2000·Journal of the American College of Cardiology·A RossiJ B Seward
Sep 27, 2012·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Laurent SuissaMarie Hélène Mahagne
Apr 5, 2001·Journal of Clinical Pharmacy and Therapeutics·J Venugopal
Jun 5, 2003·Heart Disease·George Stoupakis, Marc Klapholz
Aug 18, 2001·Journal of Endocrinological Investigation·B Mazul-SunkoE Topic
Apr 3, 2003·Critical Care Nursing Quarterly·Lauren Saul, Melanie Shatzer

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