|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1992; 20:541-546 © 1992 by the American College of Cardiology Foundation |
First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan.
OBJECTIVES. This study was designed to evaluate the role of endogenous atrial natriuretic peptide in the pulmonary circulation in patients with chronic heart failure. BACKGROUND. Plasma atrial natriuretic peptide concentrations in patients with heart failure have been reported to be higher than those in normal subjects and to increase as the severity of heart failure progresses. Although endogenous atrial natriuretic peptide is thought to improve the condition of patients with heart failure by reducing preload and afterload, recent findings have indicated that a high plasma atrial natriuretic peptide level is a prognostic predictor in patients with heart failure. METHODS. To evaluate the pathophysiologic role of endogenous atrial natriuretic peptide in the pulmonary circulation, plasma atrial natriuretic peptide and cyclic guanosine monophosphate (cGMP) levels were determined in the main pulmonary artery and pulmonary capillary wedge region in 80 patients with chronic congestive heart failure (New York Heart Association functional classes II to IV). RESULTS. The plasma atrial natriuretic peptide level decreased significantly from the main pulmonary artery to the pulmonary capillary wedge region, whereas the plasma cGMP level increased significantly from the main pulmonary artery to the pulmonary capillary wedge region. In patients with mild chronic heart failure (n = 50), the plasma atrial natriuretic peptide level correlated with the cGMP level in the main pulmonary artery (gamma = 0.71, p less than 0.001). The atrial natriuretic peptide extraction level, calculated as (Atrial natriuretic peptide in the main pulmonary artery--Atrial natriuretic peptide in the pulmonary capillary wedge region) x Cardiac output x (1-hematocrit/100) (ng/min), also correlated with the cyclic guanosine monophosphate production level, calculated as (cGMP in the pulmonary capillary wedge region--cGMP in the main pulmonary artery) x Cardiac output x (1-hematocrit/100) (nmol/min) (gamma = 0.78, p less than 0.001). In contrast, such correlations were not found in patients with severe chronic heart failure (n = 30). In these patients, the atrial natriuretic peptide extraction level was significantly higher but there was no significant difference in the cGMP production level between the two groups (mild and severe chronic heart failure). Therefore, the molar ratio of cGMP production to atrial natriuretic peptide extraction in the pulmonary circulation was significantly lower in patients with severe chronic heart failure (88 +/- 16 vs. 480 +/- 41, p less than 0.001). CONCLUSIONS. These results indicate that down-regulation of atrial natriuretic peptide receptors coupled to guanylate cyclase may occur in the pulmonary vascular beds of patients with severe chronic heart failure.
This article has been cited by other articles:
|
|
 |
|
  D. L. Dries Relevance of Molecular Forms of Brain Natriuretic Peptide for Natriuretic Peptide Research Hypertension, May 1, 2007; 49(5): 971 - 973. [Full Text] [PDF]
|
|
|
|
 |
|
 P. R. Forfia, M. Lee, R. S. Tunin, M. Mahmud, H. C. Champion, and D. A. Kass Acute Phosphodiesterase 5 Inhibition Mimics Hemodynamic Effects of B-Type Natriuretic Peptide and Potentiates B-Type Natriuretic Peptide Effects in Failing But Not Normal Canine Heart J. Am. Coll. Cardiol., March 13, 2007; 49(10): 1079 - 1088. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M. Costello, C. L. Backer, P. A. Checchia, C. Mavroudis, R. G. Seipelt, and D. M. Goodman Effect of cardiopulmonary bypass and surgical intervention on the natriuretic hormone system in children J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 822 - 829. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Hayashi, M. Ohtani, T. Hiraishi, and Y. Kobayashi Postoperative synthetic human atrial natriuretic peptide infusion and oral spironolactone administration for a patient with giant atria and low plasma level of atrial natriuretic peptide J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 206 - 209. [Full Text] [PDF]
|
|
|
|
|
|
W. Johnson, T. Omland, C. Hall, C. Lucas, O. L. Myking, C. Collins, M. Pfeffer, J.-L. Rouleau, and L. W. Stevenson Neurohormonal activation rapidly decreases after intravenous therapy withdiuretics and vasodilators for class IV heart failure J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1623 - 1629. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Mabuchi, T. Tsutamoto, A. Wada, M. Ohnishi, K. Maeda, M. Hayashi, and M. Kinoshita Relationship Between Interleukin-6 Production in the Lungs and Pulmonary Vascular Resistance in Patients With Congestive Heart Failure* Chest, April 1, 2002; 121(4): 1195 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Peter Brunner-La Rocca, W. Kiowski, D. Ramsay, and G. Sutsch Therapeutic benefits of increasing natriuretic peptide levels Cardiovasc Res, August 15, 2001; 51(3): 510 - 520. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Hayashida, S. Chihara, H. Kashikie, E. Tayama, S. Yokose, K. Akasu, and S. Aoyagi Effects of intraoperative administration of atrial natriuretic peptide Ann. Thorac. Surg., October 1, 2000; 70(4): 1319 - 1326. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Maeda, T. Tsutamoto, A. Wada, N. Mabuchi, M. Hayashi, T. Hisanaga, T. Kamijo, and M. Kinoshita Insufficient secretion of atrial natriuretic peptide at acute phase of myocardial infarction J Appl Physiol, August 1, 2000; 89(2): 458 - 464. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Tsutamoto, A. Wada, K. Maeda, N. Mabuchi, M. Hayashi, T. Tsutsui, M. Ohnishi, M. Sawaki, M. Fujii, T. Matsumoto, et al. Angiotensin II type 1 receptor antagonist decreases plasma levels of tumor necrosis factor alpha, interleukin-6 and soluble adhesion molecules in patients with chronic heart failure J. Am. Coll. Cardiol., March 1, 2000; 35(3): 714 - 721. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Matsumoto, A. Wada, T. Tsutamoto, T. Omura, H. Yokohama, M. Ohnishi, I. Nakae, M. Takahashi, and M. Kinoshita Vasorelaxing effects of atrial and brain natriuretic peptides on coronary circulation in heart failure Am J Physiol Heart Circ Physiol, June 1, 1999; 276(6): H1935 - H1942. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Nishikimi, S. Nagata, T. Sasaki, S. Tomimoto, H. Matsuoka, S. Takishita, K. Kitamura, A. Miyata, H. Matsuo, and K. Kangawa Plasma concentrations of adrenomedullin correlate with the extent of pulmonary hypertension in patients with mitral stenosis Heart, October 1, 1997; 78(4): 390 - 395. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Lainchbury, A. M. Richards, M. G. Nicholls, P. J. Hunt, H. Ikram, E. A. Espiner, T. G. Yandle, and E. Begg The Effects of Pathophysiological Increments in Brain Natriuretic Peptide in Left Ventricular Systolic Dysfunction Hypertension, September 1, 1997; 30(3): 398 - 404. [Abstract] [Full Text]
|
|
|
|
 |
|
 T. Tsutamoto, A. Wada, K. Maeda, T. Hisanaga, Y. Maeda, D. Fukai, M. Ohnishi, Y. Sugimoto, and M. Kinoshita Attenuation of Compensation of Endogenous Cardiac Natriuretic Peptide System in Chronic Heart Failure : Prognostic Role of Plasma Brain Natriuretic Peptide Concentration in Patients With Chronic Symptomatic Left Ventricular Dysfunction Circulation, July 15, 1997; 96(2): 509 - 516. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
