Acute Hemodynamic Effects of Alpha Human Atrial Natriuretic Polypeptide in Patients with Congestive Heart Failure

Takashi SERIZAWA; Yasunobu HIRATA; Osami KOHMOTO; Masahiko IIZUKA; Hiroaki MATSUOKA; Hiroshi SATO; Toshiyuki TAKAHASHI; Takatoshi MOCHIZUKI; Masao ISHII; Tsuneaki SUGIMOTO; Kenji KANGAWA; Hisayuki MATSUO

doi:10.1536/ihj.29.143

Takashi SERIZAWA, Yasunobu HIRATA, Osami KOHMOTO, Masahiko IIZUKA, Hiroaki MATSUOKA, Hiroshi SATO, Toshiyuki TAKAHASHI, Takatoshi MOCHIZUKI, Masao ISHII, Tsuneaki SUGIMOTO, Kenji KANGAWA, Hisayuki MATSUO

Author information

Takashi SERIZAWA
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Yasunobu HIRATA
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Osami KOHMOTO
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Masahiko IIZUKA
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Hiroaki MATSUOKA
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Hiroshi SATO
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Toshiyuki TAKAHASHI
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Takatoshi MOCHIZUKI
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Masao ISHII
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Tsuneaki SUGIMOTO
Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo
Kenji KANGAWA
Second Department of Biochemistry, Miyazaki Medical College
Hisayuki MATSUO
Second Department of Biochemistry, Miyazaki Medical College

Keywords: Alpha human atrial natriuretic polypeptide, Congestive heart failure, Plasma norepinephrine, Systemic vascular resistance, Venodilator

JOURNAL FREE ACCESS

1988 Volume 29 Issue 2 Pages 143-149

DOI https://doi.org/10.1536/ihj.29.143

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Abstract

Acute hemodynamic and humoral effects of synthesized alpha human atrial natriuretic polypeptide (α-hANP, 0.025μg/kg/min for 40 min) on 6 patients with severe congestive heart failure were assessed. Plasma α-hANP concentration was high in patients and increased further (from 463±360 to 1, 282±670pg/ml, mean±SD, p<0.01) following α-hANP infusion, but plasma norepinephrine (1, 030±865 to 971±785pg/ml) was not changed. Increases in urine output (1.0±0.8 to 2.6±2.3ml/min) and Na⁺ excretion rate (87±89 to 257±211mEq/min/m²) were statistically insignificant. A significant reduction was induced in mean aortic pressure (99±25 to 96±26mmHg, p<0.05), mean right atrial pressure (11±9 to 7±8mmHg, p<0.01), mean pulmonary arterial pressure (39±13 to 33±12mmHg, p<0.05) and mean pulmonary capillary wedge pressure (27±8 to 20±7mmHg, p<0.01). Heart rate, cardiac index, systemic vascular resistance and pulmonary vascular resistance were not altered. In conclusion, α-hANP induced decreases in left ventricular filling pressure and rightside heart pressure which were attributed to venodilatation rather than natriuretis in patients with congestive heart failure. Preserved cardiac output with decreased preload suggested that α-hANP improved cardiac function.

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