[Atrial natriuretic factor levels and pressure in the pulmonary circulation before and after coronary dilatation]

According to several reports of close correlations between pulmonary artery pressure and ANF plasma levels it would be convenient to replace invasive pressure monitoring by ANF determination. Mean pulmonary artery and right atrial pressures and pulmonary artery as well as peripheral venous ANF plasma concentrations were measured in 24 patients before and after coronary angioplasty (PTCA) continuously at rest and during exercise: At rest, both pressure and ANF-values remained unchanged before and after PTCA. At exercise, there was a decrease of mean pulmonary artery pressure (from 41.3 +/- 8.6 to 31.5 +/- 7.4 mmHg, p less than 0.001), mean right atrial pressure (from 11.9 +/- 3.0 to 9.0 +/- 2.3 mmHg, p less than 0.001), pulmonary artery (282.5 +/- 191.0 to 207.3 +/- 157.2 pg/ml, p less than 0.05) and peripheral venous (112.7 +/- 48.0 to 97.1 +/- 53.2 pg/ml, n.s.) ANF concentration after PTCA. We found no correlation between PTCA-induced changes of right arterial pressures and ANF concentrations, while changes of pulmonary artery pressures were significantly correlated to changes of peripheral venous (r = 0.79, p less than 0.001) as well as pulmonary artery (r = 0.59, p less than 0.01) ANF concentrations at exercise. In 6 of the 24 patients, however there was an inverse relationship between changes of pulmonary artery pressures and ANF concentrations. - Our data demonstrate a significant correlation between changes of ANF plasma level and pulmonary artery pressure values at exercise after PTCA. In the individual case however invasive pressure monitoring cannot be replaced by determination of ANF plasma levels.