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Heart with circulatory failure secretes and processes atrial natriuretic peptide in a manner different from normal
H Matsubara1, Y Umeda, M Nishikawa
1Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Insights
In heart failure, left atrial pressure, not right, correlates with atrial natriuretic peptide (ANP) secretion, and noradrenaline strongly influences ANP release, unlike in healthy individuals.
Area of Science:
- Cardiology
- Endocrinology
- Physiology
Background:
- The precise role of catecholamines in atrial natriuretic peptide (ANP) secretion and its mechanisms in humans remains unclear.
- Understanding these relationships is crucial for managing cardiovascular conditions.
Purpose of the Study:
- To investigate the interplay between ANP, catecholamines, and atrial pressures in healthy individuals and those with chronic heart failure (CHF).
- To elucidate the secretory mechanisms of ANP in response to physiological stimuli.
Main Methods:
- Studied 25 healthy individuals and 35 patients with CHF (mitral valve disease or dilated cardiomyopathy).
- Measured ANP, catecholamine (adrenalin, noradrenaline) concentrations, and atrial pressures at rest and during exercise.
- Utilized gel chromatography coupled with radioimmunoassay to analyze ANP molecular weight forms.
Main Results:
- In healthy individuals, right atrial pressure positively correlated with ANP; left atrial pressure did not. Exercise enhanced this correlation.
- In CHF patients, left atrial pressure strongly correlated with ANP, while right atrial pressure did not. Exercise further strengthened these correlations.
- Exercise-induced ANP increments were reduced in CHF patients. Noradrenaline, but not adrenaline, showed a strong positive correlation with ANP in CHF patients.
Conclusions:
- Left atrial pressure is a key determinant of ANP secretion in heart failure, unlike in healthy states.
- Noradrenaline plays a significant role in modulating ANP release in patients with CHF.
- The study provides insights into ANP regulation and its alterations in cardiovascular disease.
Abstract:
The role of catecholamine in atrial natriuretic peptide (ANP) secretion and its secretory mechanism in normal humans is not well defined; therefore, we studied the relationship among ANP, catecholamine, and atrial pressures in 25 patients without cardiovascular disease and in 35 patients with chronic congestive heart failure (CHF, 20 in mitral valve disease and 15 in dilated cardiomyopathy). In patients without cardiovascular disease, right atrial pressure at rest showed a positive correlation (r = 0.80, p less than 0.001) with ANP concentration, whereas left atrial pressure did not. The relation narrowed (r = 0.82) when the bicycle ergometer exercise in the supine position was conducted. Neither adrenalin nor noradrenalin significantly correlated with ANP concentration. In patients with mitral valve disease and dilated cardiomyopathy, the significant relations (r = 0.56 p less than 0.001, r = 0.85 p less than 0.001, respectively) between left atrial pressures and ANP concentrations at rest were observed, and following exercise, induced more significant relations. Right atrial pressures did not correlate positively with ANP concentrations. The increments of ANP concentrations induced by exercise load were markedly reduced compared with those of patients without cardiovascular disease. Although concentrations of both noradrenalin and adrenalin in patients with mitral valve disease and dilated cardiomyopathy at rest were much higher than those without cardiovascular disease, only noradrenalin had a highly positive correlation with ANP concentrations (r = 0.88 p less than 0.001, r = 0.78 p less than 0.001, respectively). Furthermore, the circulating ANP molecular weight forms in all patients studied were analyzed by gel chromatography coupled with radioimmunoassay.(ABSTRACT TRUNCATED AT 250 WORDS)