Document Detail


Influence of cardiac failure on atrial natriuretic peptide responses in patients undergoing vascular surgery.
MedLine Citation:
PMID:  1834463     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sixteen patients presenting for abdominal aortic surgery were divided into two groups according to whether or not there was a history and clinical evidence of chronic heart failure (CHF). Atrial natriuretic peptide (ANP) and catecholamines were measured during a preoperative exercise test and then with induction of anaesthesia and surgery. Patients in the CHF group (n = 8) had a much-reduced cardiac output (CO) rise in response to exercise compared to the control group (13% vs. 75%, P less than 0.05). This difference was due to the absence of a stroke volume increase in the CHF group. Induction of anaesthesia resulted in a greater fall in mean arterial pressure in the CHF group prior to the start of surgery, due to a greater fall in CO. Plasma ANP levels were higher in the CHF group at rest and at each exercise stage (P less than 0.05). ANP levels were not altered by induction of anaesthesia or intubation, but increased with the start of surgery in the CHF group (P less than 0.05). Increases in plasma catecholamine levels in response to exercise and to surgery were similar in the two groups. Changes in endogenous ANP may be important in counteracting the undesirable effects of vasoconstrictor hormones during physical exercise or surgical stress.
Authors:
D W Blake; B P McGrath; G B Donnan; S Smart; D Way; K A Myers; M Fullerton
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  8     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  1991 Sep 
Date Detail:
Created Date:  1991-12-03     Completed Date:  1991-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  365-71     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Monash Medical Centre, Prince Henry's Hospital, Melbourne, Victoria, Australia.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Anesthesia, Intravenous
Aorta, Abdominal / surgery*
Atrial Natriuretic Factor / blood*
Blood Pressure / physiology
Cardiac Output / physiology
Cardiac Output, Low / blood*,  physiopathology
Electrocardiography
Epinephrine / blood
Exercise Test
Heart Rate / physiology
Humans
Intraoperative Care
Intubation, Intratracheal
Middle Aged
Norepinephrine / blood
Preoperative Care
Pulmonary Wedge Pressure / physiology
Time Factors
Vascular Resistance / physiology
Chemical
Reg. No./Substance:
51-41-2/Norepinephrine; 51-43-4/Epinephrine; 85637-73-6/Atrial Natriuretic Factor

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


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