PMID: 15235055Jul 6, 2004Paper

Effects of intravenous atrial natriuretic peptide on cardiac sympathetic nerve activity in patients with decompensated congestive heart failure

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
Shu KasamaMasahiko Kurabayashi

Abstract

The activation of the renin-angiotensin-aldosterone system (RAAS) prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, has vasodilatory and diuretic properties and can inhibit the RAAS. However, its effect on cardiac sympathetic nerve activity has not been determined. We studied 58 patients with decompensated nonischemic acute heart failure who were treated with intravenous low-dose dopamine and diuretics. Twenty-nine patients (group A) were assigned to also receive intravenous ANP, whereas the remaining 29 patients (group B) continued their established drug regimen. The dopamine or ANP was continuously infused for >96 h. The left ventricular end-diastolic volume and ejection fraction were determined by echocardiography before and 4 wk after treatment. The delayed heart-to-mediastinum (H/M) count ratio, delayed total defect score, and washout rate were determined from (123)I-metaiodobenzylguanidine (MIBG) images 3 wk after treatment. Fifty-six patients enrolled in the trial completed the entire protocol. After treatment of group A (n = 28), the left ventricular end-diastolic volume decreased from 186 +/- 42 to 174 +/- 48 mL (P < 0.05), and left ventr...Continue Reading

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