| Uncoupling of atrial natriuretic peptide extraction and cyclic guanosine monophosphate production in the pulmonary circulation in patients with severe heart failure. | |
| | |
MedLine Citation:
|
PMID: 1324959 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: This study was designed to evaluate the role of endogenous atrial natriuretic peptide in the pulmonary circulation in patients with chronic heart failure. BACKGROUND: Plasma atrial natriuretic peptide concentrations in patients with heart failure have been reported to be higher than those in normal subjects and to increase as the severity of heart failure progresses. Although endogenous atrial natriuretic peptide is thought to improve the condition of patients with heart failure by reducing preload and afterload, recent findings have indicated that a high plasma atrial natriuretic peptide level is a prognostic predictor in patients with heart failure. METHODS: To evaluate the pathophysiologic role of endogenous atrial natriuretic peptide in the pulmonary circulation, plasma atrial natriuretic peptide and cyclic guanosine monophosphate (cGMP) levels were determined in the main pulmonary artery and pulmonary capillary wedge region in 80 patients with chronic congestive heart failure (New York Heart Association functional classes II to IV). RESULTS: The plasma atrial natriuretic peptide level decreased significantly from the main pulmonary artery to the pulmonary capillary wedge region, whereas the plasma cGMP level increased significantly from the main pulmonary artery to the pulmonary capillary wedge region. In patients with mild chronic heart failure (n = 50), the plasma atrial natriuretic peptide level correlated with the cGMP level in the main pulmonary artery (gamma = 0.71, p less than 0.001). The atrial natriuretic peptide extraction level, calculated as (Atrial natriuretic peptide in the main pulmonary artery--Atrial natriuretic peptide in the pulmonary capillary wedge region) x Cardiac output x (1-hematocrit/100) (ng/min), also correlated with the cyclic guanosine monophosphate production level, calculated as (cGMP in the pulmonary capillary wedge region--cGMP in the main pulmonary artery) x Cardiac output x (1-hematocrit/100) (nmol/min) (gamma = 0.78, p less than 0.001). In contrast, such correlations were not found in patients with severe chronic heart failure (n = 30). In these patients, the atrial natriuretic peptide extraction level was significantly higher but there was no significant difference in the cGMP production level between the two groups (mild and severe chronic heart failure). Therefore, the molar ratio of cGMP production to atrial natriuretic peptide extraction in the pulmonary circulation was significantly lower in patients with severe chronic heart failure (88 +/- 16 vs. 480 +/- 41, p less than 0.001). CONCLUSIONS: These results indicate that down-regulation of atrial natriuretic peptide receptors coupled to guanylate cyclase may occur in the pulmonary vascular beds of patients with severe chronic heart failure. |
| | |
Authors:
|
T Tsutamoto; T Kanamori; A Wada; M Kinoshita |
Related Documents
:
|
20453389 - Impact of metalloproteinases on left ventricular remodeling and heart failure events in... 17874709 - Predicting outcome in patients with acute coronary syndrome: evaluation of b-type natri... 10520779 - Angiotensin-converting enzyme inhibition reduces monocyte chemoattractant protein-1 and... 9257259 - Altered myocardial phenotype after mechanical support in human beings with advanced car... 21729499 - Successful surgical excision of a large left ventricular fibroma in a child. 19360469 - Utility of natriuretic peptide testing in the evaluation and management of acute decomp... 11486109 - Effect of hemiparetic stroke on pulse oximetry readings on the affected side. 15296469 - Is growth hormone deficiency contributing to heart failure in patients with beta-thalas... 21660969 - Pkcε promotes cardiac mitochondrial and metabolic adaptation to chronic hypobaric hypo... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 20 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1992 Sep |
Date Detail:
|
Created Date: 1992-09-30 Completed Date: 1992-09-30 Revised Date: 2010-03-24 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 541-6 Citation Subset: AIM; IM |
Affiliation:
|
First Department of Internal Medicine, Shiga University of Medical Science, Otsu, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Atrial Natriuretic Factor / blood*, metabolism, physiology Chronic Disease Cyclic GMP / biosynthesis, blood* Female Heart Failure / blood*, physiopathology Hemodynamics Humans Male Middle Aged Pulmonary Artery Pulmonary Circulation / physiology* |
| Chemical | |
Reg. No./Substance:
|
7665-99-8/Cyclic GMP; 85637-73-6/Atrial Natriuretic Factor |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A statistical study of cochlear nerve discharge patterns in response to complex speech stimuli.
Next Document: Cloning and primary structural analysis of the bullous pemphigoid autoantigen BP180.