Effects of human atrial natriuretic peptide on cardiac function and hemodynamics in patients with high plasma BNP levels
- 作者：Kazuki Nakajima ; Katsuya Onishi ; Kaoru Dohi ; Masaki Tanabe ; Tairo Kurita ; Takashi Yamanaka ; Masaaki Ito ; Naoki Isaka ; Tsutomu Nobori and Takeshi Nakano
- 关键词：Atrial natriuretic peptide ; Brain natriuretic peptide ; Congestive heart failure ; Left ventricular function ; Patients
- 刊名：International Journal of Cardiology
- 出版年：2005
- 期刊代码：128_01675273
- 类别：med
- 出版时间：2005
- 卷：104
- 期：3
- 页码：332-337
- 文件大小：115 K
摘要
Both atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) bind preferentially to the natriuretic peptide A receptor. Therefore, we hypothesized that the positive inotropic and lusitropic effects of ANP might be blunted in patients with moderate congestive heart failure and high BNP levels. Micromanometers and conductance catheters were used to obtain relatively load-insensitive left ventricular pressure–volume analysis in order to compare the myocardial and load-altering actions of ANP in 20 patients with low and high plasma BNP levels. In the low-BNP group (plasma BNP levels <230 pg/ml), ANP infusion significantly decreased end-systolic pressure and end-diastolic pressure and volume, increased end-systolic elastance, and shortened left ventricular relaxation. By contrast, in the high-BNP group (plasma BNP levels >230 pg/ml), the effect of ANP infusion on LV contractility was blunted but its beneficial effects on LV diastolic function and LV-arterial coupling remained. Thus, ANP infusion may improve LV diastolic function even in patients with moderate heart failure and high plasma BNP levels.