Document Detail

Decreased plasma atriopeptin response to volume-overloading maneuvers and exercise after atriopulmonary anastomosis of Fontan.
MedLine Citation:
PMID:  1533989     Owner:  NLM     Status:  MEDLINE    
Atriopulmonary anastomosis results in a chronic right atrial pressure-volume overload. Water and salt retention is a frequent clinical observation in patients after atriopulmonary anastomosis. The purpose of this study was to examine if this could be related to an inability to increase already elevated circulating atriopeptin (ANP) in response to central volume-overloading conditions. Eighteen patients (mean age 16 +/- 6 years) with an atriopulmonary anastomosis underwent routine cardiac catheterization during which a 5-minute head-down 10 degrees tilt was performed. Peripheral venous and right atrial blood samples were obtained under basal conditions, and after tilting and angiography for determination of ANP concentrations. At a different time, circulating ANP levels were measured during a maximal graded exercise protocol. Increased circulating ANP concentrations were found under basal conditions (114 +/- 10 pg/ml). Tilting and cardioangiography resulted in significant increases in mean atrial pressure (basal: 12 +/- 0.7 mm Hg; tilt: 13.4 +/- 0.63 mm Hg; after angiography: 15.8 +/- 0.8 mm Hg), but not in atrial or peripheral ANP. Compared with the expected threefold increase in plasma ANP induced by maximal exercise in healthy control subjects, only a slight (0.25-fold) increase was found in patients. These observations suggest a reduced stimulus-release response after atriopulmonary anastomosis, which could be related to a loss of atrial stretch receptor sensitivity, achievement of the limit for maximal right atrial secretion, or an alteration in right atrial compliance, or a combination.
H Perrault; J Miró; A Davignon; M Béland; B Armstrong; G Thibault; M Cantin; C Chartrand
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  69     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1992 May 
Date Detail:
Created Date:  1992-06-16     Completed Date:  1992-06-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1325-8     Citation Subset:  AIM; IM    
Physical Education Department, McGill University, Montréal, Québec, Canada.
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MeSH Terms
Anastomosis, Surgical
Atrial Natriuretic Factor / blood*
Diuresis / physiology
Exercise Test
Heart Atria / surgery*
Natriuresis / physiology
Postoperative Complications / blood*,  physiopathology
Pulmonary Artery / surgery*
Water-Electrolyte Imbalance / blood*,  etiology,  physiopathology
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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