Document Detail

Effect of atrial natriuretic peptide on muscle sympathetic activity and its reflex control in human heart failure.
MedLine Citation:
PMID:  10199876     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The purpose of this study was to determine if atrial natriuretic peptide (ANP) exerts a relative inhibitory effect on muscle sympathetic nerve activity (MSNA) at rest and during nonhypotensive lower body negative pressure (LBNP) in heart failure, as in healthy subjects. METHODS AND RESULTS: Fifteen men (age 39+/-2 years [mean+/-SE]) with dilated cardiomyopathy (ejection fraction 18+/-3%) received intravenous ANP (50 microgram bolus, then 50 ng. kg-1. min-1) and nitroglycerin (NTG, 8 mg/min) as a hemodynamic control. During each infusion MSNA, blood pressure (BP), central venous pressure (CVP), and heart rate (HR) were recorded before and during LBNP at -6 and -12 mm Hg. NTG and ANP caused similar and significant reductions in CVP and diastolic BP, but resting MSNA did not increase with either infusion. LBNP at -6 mm Hg lowered CVP (P<0.05), whereas LBNP at -12 mm Hg caused significant reductions in CVP, systolic BP, and diastolic BP. These effects of nonhypotensive and hypotensive LBNP on CVP and BP were similar during ANP and NTG infusions, yet MSNA was lower both before and with LBNP during ANP (P<0.02). Nonhypotensive LBNP increased MSNA during NTG (+133+/-68 Units; P<0.001) but not during ANP infusion (+24+/-23 Units; P=NS). CONCLUSIONS: These observations are consistent with the concept that ANP exerts a sympathoinhibitory action in heart failure. This is most evident in response to reductions in atrial pressures that do not affect systemic BP.
B L Abramson; S Ando; C F Notarius; G A Rongen; J S Floras
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  99     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-06     Completed Date:  1999-05-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1810-5     Citation Subset:  AIM; IM    
Divisions of Cardiology, the Toronto Hospital and Mount Sinai Hospital, and the Centre for Cardiovascular Research, University of Toronto.
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MeSH Terms
Atrial Natriuretic Factor / therapeutic use*
Cardiac Output, Low / drug therapy*,  etiology,  physiopathology*
Cardiomyopathy, Dilated / complications
Hemodynamics / drug effects
Lower Body Negative Pressure
Middle Aged
Muscle, Skeletal / innervation*
Nitroglycerin / therapeutic use
Reflex / physiology*
Sympathetic Nervous System / drug effects*,  physiopathology
Reg. No./Substance:
55-63-0/Nitroglycerin; 85637-73-6/Atrial Natriuretic Factor

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

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