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Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure.

Publication ,  Journal Article
Creager, MA; Hirsch, AT; Nabel, EG; Cutler, SS; Colucci, WS; Dzau, VJ
Published in: J Am Coll Cardiol
June 1988

In patients with congestive heart failure, atrial natriuretic factor may serve as a counter-regulatory hormone, offsetting the vasoconstrictive and volume-retentive effects of the sympathetic nervous system, the renin-angiotensin-aldosterone system and vasopressin. Indeed, the plasma levels of atrial natriuretic factor and the vasoconstrictor hormones are often simultaneously elevated in these patients. It is not known, however, whether atrial natriuretic factor remains responsive to sudden reductions in atrial pressure in patients with chronic heart failure, or is unresponsive like the vasoconstrictor systems. To examine this issue, the plasma concentrations of atrial natriuretic factor and the vasoconstrictor hormones were measured in 20 normal subjects and 12 patients with chronic congestive heart failure during incremental lower body negative pressure, an intervention that lowers atrial pressure. In the normal subjects, incremental lower body negative pressure at -10, -20 and -40 mm Hg decreased central venous pressure and pulse pressure. At maximal lower body negative pressure, plasma atrial natriuretic factor levels decreased from 51 +/- 5 to 27 +/- 3 pg/ml (p less than 0.01), whereas increases occurred in plasma levels of norepinephrine (194 +/- 11 to 385 +/- 70 pg/ml, p less than 0.01), renin activity (1.4 +/- 0.2 to 3.9 +/- 0.1 ng/ml per h, p less than 0.01) and vasopressin (1.3 +/- 0.1 to 6.4 +/- 2.4 pg/ml, p less than 0.05). In the patients with congestive heart failure, lower body negative pressure also reduced central venous pressure. Baseline plasma atrial natriuretic factor levels were markedly elevated, averaging 438 +/- 138 pg/ml, and decreased to 317 +/- 87 pg/ml at maximal lower body negative pressure (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Duke Scholars

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 1988

Volume

11

Issue

6

Start / End Page

1191 / 1198

Location

United States

Related Subject Headings

  • Vasopressins
  • Renin
  • Norepinephrine
  • Middle Aged
  • Male
  • Hypotension
  • Humans
  • Heart Failure
  • Heart Atria
  • Female
 

Citation

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Creager, M. A., Hirsch, A. T., Nabel, E. G., Cutler, S. S., Colucci, W. S., & Dzau, V. J. (1988). Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure. J Am Coll Cardiol, 11(6), 1191–1198. https://doi.org/10.1016/0735-1097(88)90281-1
Creager, M. A., A. T. Hirsch, E. G. Nabel, S. S. Cutler, W. S. Colucci, and V. J. Dzau. “Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure.J Am Coll Cardiol 11, no. 6 (June 1988): 1191–98. https://doi.org/10.1016/0735-1097(88)90281-1.
Creager MA, Hirsch AT, Nabel EG, Cutler SS, Colucci WS, Dzau VJ. Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure. J Am Coll Cardiol. 1988 Jun;11(6):1191–8.
Creager, M. A., et al. “Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure.J Am Coll Cardiol, vol. 11, no. 6, June 1988, pp. 1191–98. Pubmed, doi:10.1016/0735-1097(88)90281-1.
Creager MA, Hirsch AT, Nabel EG, Cutler SS, Colucci WS, Dzau VJ. Responsiveness of atrial natriuretic factor to reduction in right atrial pressure in patients with chronic congestive heart failure. J Am Coll Cardiol. 1988 Jun;11(6):1191–1198.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

June 1988

Volume

11

Issue

6

Start / End Page

1191 / 1198

Location

United States

Related Subject Headings

  • Vasopressins
  • Renin
  • Norepinephrine
  • Middle Aged
  • Male
  • Hypotension
  • Humans
  • Heart Failure
  • Heart Atria
  • Female