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Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels.

Publication ,  Journal Article
Kharasch, ED; Yeo, KT; Kenny, MA; Amory, DW
Published in: Can J Anaesth
September 1989

Atrial natriuretic factor (ANF) is a peptide released from the heart in response to atrial distension. This peptide causes diuresis, vasodilatation, decreased blood pressure, and antagonizes the renin-aldosterone and antidiuretic hormone neuraxes. The influence of cardiopulmonary bypass and cardiac surgery on the circulation and release of ANF is unknown. Plasma ANF concentrations were therefore determined in patients undergoing coronary artery revascularization (CABG) and mitral valve replacement (MVR). Peptide levels were unchanged following anaesthetic induction. Plasma ANF concentrations decreased significantly during hypothermic (less than or equal to 28 degrees C) cardiopulmonary bypass in both patient groups. After 60 minutes of cardiac bypass, ANF declined from (mean +/- SEM) 512 +/- 132 to 20 +/- 6 pg.ml-1 (P less than 0.05) during MVR, and from 178 +/- 41 to 110 +/- 48 pg.ml-1 during CABG (P less than 0.05). Rewarming during bypass was associated with an increase in ANF concentration in both groups. Heparin anticoagulation and protamine reversal had no effect on immunoreactive ANF levels. In patients undergoing CABG, there was a linear relationship between plasma ANF concentration (pg.ml-1) and right atrial pressure (mmHg) prior to cardiopulmonary bypass (r = 0.86, P less than 0.005). However, one and three hours after cardiopulmonary bypass there was no significant relationship between right atrial pressure and ANF plasma levels. These results suggest that reduction in plasma ANF concentration occurs during hypothermic cardiopulmonary bypass. Furthermore, the proportional relationship between atrial distension and circulating ANF concentration was altered following cardiac surgery.

Duke Scholars

Published In

Can J Anaesth

DOI

ISSN

0832-610X

Publication Date

September 1989

Volume

36

Issue

5

Start / End Page

545 / 553

Location

United States

Related Subject Headings

  • Pulmonary Wedge Pressure
  • Myocardial Revascularization
  • Mitral Valve
  • Middle Aged
  • Male
  • Hypothermia, Induced
  • Humans
  • Heparin
  • Heart Valve Prosthesis
  • Heart Rate
 

Citation

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Kharasch, E. D., Yeo, K. T., Kenny, M. A., & Amory, D. W. (1989). Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels. Can J Anaesth, 36(5), 545–553. https://doi.org/10.1007/BF03005384
Kharasch, E. D., K. T. Yeo, M. A. Kenny, and D. W. Amory. “Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels.Can J Anaesth 36, no. 5 (September 1989): 545–53. https://doi.org/10.1007/BF03005384.
Kharasch ED, Yeo KT, Kenny MA, Amory DW. Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels. Can J Anaesth. 1989 Sep;36(5):545–53.
Kharasch, E. D., et al. “Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels.Can J Anaesth, vol. 36, no. 5, Sept. 1989, pp. 545–53. Pubmed, doi:10.1007/BF03005384.
Kharasch ED, Yeo KT, Kenny MA, Amory DW. Influence of hypothermic cardiopulmonary bypass on atrial natriuretic factor levels. Can J Anaesth. 1989 Sep;36(5):545–553.
Journal cover image

Published In

Can J Anaesth

DOI

ISSN

0832-610X

Publication Date

September 1989

Volume

36

Issue

5

Start / End Page

545 / 553

Location

United States

Related Subject Headings

  • Pulmonary Wedge Pressure
  • Myocardial Revascularization
  • Mitral Valve
  • Middle Aged
  • Male
  • Hypothermia, Induced
  • Humans
  • Heparin
  • Heart Valve Prosthesis
  • Heart Rate