Document Detail


Atrial natriuretic peptide during different pacing modes in a comparison with hemodynamic changes.
MedLine Citation:
PMID:  1692127     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The study investigates the response of atrial natriuretic peptide (ANP) to different cardiac pacing modes in comparison with hemodynamic changes. Ten patients underwent Swan-Ganz catheterization during pacemaker implant. Atrioventricular and ventricular pacing were performed consecutively at three pacing rate levels (80, 100, and 110 ppm). Blood samples were taken from the pulmonary artery for ANP determination, both basally and at the end of each pacing period. Concomitantly, mean pulmonary capillary wedge pressure (PCWP) and mean pulmonary artery pressure (PAP) were measured. Cardiac output (CO) was determined by thermodilution both basally and during the 110 ppm steps. During atrioventricular pacing, whereas no significant changes were observed for ANP, PCWP and PAP, CO increased significantly (P less than 0.0005). At the beginning of ventricular pacing hemodynamic parameters and ANP levels were comparable with those of baseline conditions. During subsequent ventricular pacing PCWP and ANP increased significantly at the 110 ppm rate step (P less than 0.05). PAP did not change significantly, whereas CO decreased in all cases (P less than 0.01). A positive correlation was observed between ANP and PCWP during ventricular (P less than 0.001), but not atrioventricular pacing. The results, while confirming the hemodynamic advantages of atrioventricular pacing, point to a major stimulation of ANP secretion during ventricular pacing. This fact, together with the observed drop in CO and the correlation between ANP and PCWP, suggest that the increase of ANP in ventricular pacing may be the expression of a compensatory mechanism to the hemodynamic disadvantages of atrioventricular asynchrony.
Authors:
M T Baratto; S Berti; A Clerico; E Fommei; M G Del Chicca; C Contini
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  13     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1990 Apr 
Date Detail:
Created Date:  1990-06-07     Completed Date:  1990-06-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  432-42     Citation Subset:  IM    
Affiliation:
Institute of Clinical Physiology, National Research Council, Pisa, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Atrial Natriuretic Factor / blood*
Atrioventricular Node
Blood Pressure / physiology
Cardiac Output / physiology
Cardiac Pacing, Artificial* / methods
Female
Heart Block / therapy
Heart Rate / physiology
Heart Ventricles
Hemodynamics / physiology*
Humans
Male
Middle Aged
Pulmonary Artery / physiopathology
Pulmonary Wedge Pressure / physiology
Sick Sinus Syndrome / therapy
Chemical
Reg. No./Substance:
85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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