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Atrial natriuretic peptide during different pacing modes in a comparison with hemodynamic changes
M T Baratto1, S Berti, A Clerico
1Institute of Clinical Physiology, National Research Council, Pisa, Italy.
Pacing and Clinical Electrophysiology : PACE
|April 1, 1990
Summary
Cardiac pacing affects atrial natriuretic peptide (ANP) levels. Ventricular pacing significantly increases ANP and pulmonary capillary wedge pressure (PCWP), suggesting a compensatory response to hemodynamic disadvantages.
Area of Science:
- Cardiology
- Physiology
Background:
- Atrial natriuretic peptide (ANP) plays a role in cardiovascular homeostasis.
- Cardiac pacing modes can influence hemodynamic parameters and neurohormonal responses.
Purpose of the Study:
- To investigate the impact of different cardiac pacing modes on atrial natriuretic peptide (ANP) secretion.
- To compare hemodynamic changes during atrioventricular (AV) and ventricular (V) pacing.
Main Methods:
- Ten patients undergoing pacemaker implantation were studied.
- Swan-Ganz catheterization was used for hemodynamic monitoring (PCWP, PAP, CO).
- ANP levels were measured basally and during AV and V pacing at varying rates (80, 100, 110 ppm).
Main Results:
- Atrioventricular pacing increased cardiac output (CO) significantly without altering ANP, PCWP, or PAP.
- Ventricular pacing, particularly at 110 ppm, led to significant increases in PCWP and ANP.
- Ventricular pacing resulted in a significant decrease in CO and showed a positive correlation between ANP and PCWP.
Conclusions:
- Atrioventricular pacing offers hemodynamic advantages over ventricular pacing.
- Ventricular pacing significantly stimulates ANP secretion, potentially as a compensatory mechanism for reduced cardiac output and hemodynamic asynchrony.