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Elevated atrial natriuretic peptide after the Fontan procedure
Circulation
|September 1, 1987
Summary
Atrial natriuretic peptide (ANP) significantly increases with elevated right atrial pressure during the Fontan procedure. Postoperative ANP levels suggest a complex release pattern, but fluid balance effects remain unclear.
Area of Science:
- Cardiology
- Physiology
- Endocrinology
Background:
- Atrial natriuretic peptide (ANP) plays a role in cardiovascular homeostasis.
- The Fontan procedure significantly alters atrial pressures, potentially impacting ANP release.
Purpose of the Study:
- To evaluate the in vivo response of ANP to acute changes in right atrial pressure.
- To compare ANP levels in patients undergoing the Fontan procedure versus controls.
Main Methods:
- Measurement of ANP levels in 15 Fontan procedure patients and 9 controls.
- Correlation of ANP levels with right and left atrial pressures during and after surgery.
Main Results:
- Preoperative ANP levels were similar between groups.
- Fontan procedure significantly increased ANP (333 pg/ml) correlating with elevated right atrial pressure (14 mm Hg).
- Postoperative ANP showed a biphasic pattern, suggesting complex intracellular pool dynamics.
Conclusions:
- The Fontan procedure induces pharmacologically significant ANP release tied to increased right atrial pressure.
- The precise relationship between ANP and post-Fontan fluid derangements requires further investigation.