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Does atrial appendectomy aggravate secretory function of atrial natriuretic polypeptide?
K Nishimura1, Y Saito, T Hidaka
1Department of Cardiovascular Surgery, Kyoto University School of Medicine, Japan.
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1991
Summary
Atrial appendectomy in dogs with heart failure reduced atrial natriuretic polypeptide secretion and cardiac output. This procedure impaired the heart
Area of Science:
- Cardiovascular Physiology
- Cardiac Surgery
- Endocrinology
Background:
- The failing heart exhibits altered hemodynamics and hormone secretion.
- Atrial natriuretic polypeptide (ANP) plays a crucial role in cardiovascular homeostasis.
- The contribution of atrial appendages to ANP secretion in heart failure is not fully understood.
Purpose of the Study:
- To investigate the impact of atrial appendectomy on hemodynamics.
- To assess the effect of atrial appendectomy on atrial natriuretic polypeptide (ANP) secretion in experimental heart failure.
- To determine the role of atrial appendages in ANP release during cardiac stress.
Main Methods:
- Created a high-output heart failure model in mongrel dogs using arteriovenous fistulas.
- Performed bilateral atrial appendectomies in a subset of dogs.
- Measured hemodynamic indices and plasma ANP levels at baseline and during pacing-induced tachycardia.
Main Results:
- Atrial appendectomy significantly decreased basal plasma ANP levels (292 to 188 pg/ml) and cardiac output (3.7 to 3.0 L/min).
- Pacing-induced peak ANP levels were significantly lower in appendectomized dogs compared to controls (593 vs 1170 pg/ml).
- Excised atrial appendages contained approximately 30% of total ANP.
Conclusions:
- Atrial appendectomy impairs the secretory function of atrial natriuretic polypeptide in experimental heart failure.
- Surgical removal of atrial appendages reduces cardiac output in this model.
- Atrial appendages are a significant source of ANP, particularly under stress conditions.