Document Detail


Relationship of renin, angiotensin II and atrial natriuretic factor to clinical status in the early post-infarct period in patients with left ventricular dysfunction.
MedLine Citation:
PMID:  8088268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The vasoconstrictor and cardiotoxic effects of angiotensin II may be particularly harmful in the early post-infarct period, but could be partially offset by the release of atrial natriuretic factor. We studied the relationship of renin, angiotensin II and atrial natriuretic factor to clinical status in the first 72 h after infarction in 36 patients not requiring treatment with diuretics on clinical grounds. Since these patients were treated with streptokinase, 16 non-thrombolysed patients were included to control for the acute effects of streptokinase on plasma hormones. Streptokinase caused transient fluctuations in plasma renin and atrial natriuretic factor but did not limit the subsequent development of supranormal hormone levels. Streptokinase-treated patients were divided on the basis of the highest recorded Killip class. Activation of the renin angiotensin system occurred only in those patients in Killip class 2 (n = 11), was maximal at 24-72 h and was proportional to the extent of left ventricular dysfunction. Plasma levels of atrial natriuretic factor were elevated on admission, even in patients in Killip class 1 (n = 25), but declined within an hour before rising again to supranormal levels at 24-72 h. Cumulative release of renin and angiotensin II, but not atrial natriuretic factor, were significantly greater in patients in Killip class 2. Heart rate was greater in Killip class 2 at 24 and 72 h but there was no difference in mean arterial pressures. We conclude that the renin angiotensin system is activated in the early post-infarction phase, but only in patients in Killip class 2, possibly as a result of increased sympathetic activity and reduced renal perfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S G Ray; J J Morton; H J Dargie
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  15     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-10-17     Completed Date:  1994-10-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  793-800     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Western Infirmary, Glasgow, U.K.
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MeSH Terms
Descriptor/Qualifier:
Atrial Natriuretic Factor / blood*,  drug effects
Coronary Angiography
Female
Humans
Male
Middle Aged
Myocardial Infarction / blood,  drug therapy*,  physiopathology*
Radionuclide Angiography
Renin-Angiotensin System / drug effects,  physiology*
Streptokinase / therapeutic use*
Time Factors
Ventricular Function, Left / physiology*
Chemical
Reg. No./Substance:
85637-73-6/Atrial Natriuretic Factor; EC 3.4.-/Streptokinase

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


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