Intact negative feedback of four cardiac hormones in congestive heart failure.
In 30 individuals with class III congestive heart failure (CHF), negative feedback of 4 cardiac peptide hormones, ie, long-acting natriuretic peptide (LANP), vessel dilator, kaliuretic peptide, and atrial natriuretic factor (ANF) from the same 126-amino acid (aa) prohormone were studied with the infusion of 100 ng/kg body weight (BW) for 60 minutes of each of the 4 cardiac hormones and a saline control (n = 6 for each). LANP decreased the circulating concentrations of vessel dilator, kaliuretic peptide, and ANF by 24%, 55%, and 30%, respectively. Vessel dilator decreased the circulating concentrations of ANF, kaliuretic peptide, and LANP 27%, 12%, and 62%, respectively. Kaliuretic peptide decreased the circulating concentrations of LANP, ANF, and vessel dilator 89%, 67%, and 70%, respectively. ANF decreased the circulating concentrations of LANP, vessel dilator, and kaliuretic peptide 88%, 59%, and 98%, respectively. Infusion of each of these 4 cardiac hormones decreased the excretion of the other 3 hormones into the urine by 11% to 92%. These results suggest that the respective cardiac hormones inhibit the release of each other rather than their breakdown, which would have increased their urinary concentrations. The feedback regulation of these hormones found previously in healthy humans is, thus, preserved in persons with CHF despite their increased endogenous circulating concentrations.
Vesely, DL; San Miguel, GI; Hassan, I; Schocken, DD
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