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Glomerular hemodynamics during supraventricular tachycardia

S Kojima1, T Fujii, T Ohe

  • 1Department of Clinical Research, Tohsei National Hospital, Shizuoka, Japan.

Japanese Heart Journal
|July 1, 1995
PubMed
Summary

Supraventricular tachycardia (SVT) significantly increases glomerular pressure and alters renal vascular resistance, possibly due to atrial natriuretic peptide (ANP). However, natriuresis does not occur during SVT, suggesting it

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Area of Science:

  • Cardiology
  • Nephrology
  • Physiology

Background:

  • Supraventricular tachycardia (SVT) is a condition affecting heart rhythm.
  • The impact of SVT on renal function and hemodynamics is not fully understood.
  • Hormonal changes, particularly atrial natriuretic peptide (ANP), may play a role in SVT's effects.

Purpose of the Study:

  • To investigate the effects of induced SVT on glomerular filtration rate (GFR), renal blood flow, and glomerular hemodynamics.
  • To explore the potential role of atrial natriuretic peptide (ANP) in mediating these renal changes during SVT.
  • To determine if observed changes in glomerular hemodynamics during SVT correlate with natriuresis.

Main Methods:

  • SVT was induced in 7 patients using programmed cardiac stimulation via an esophageal lead.

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  • Measurements of blood pressure, renal function (including GFR and renal blood flow), and hormonal factors (ANP) were taken before, during, and after SVT.
  • Glomerular hemodynamic parameters were calculated using the Gomez method.

    • Main Results:

    • Glomerular filtration rate (GFR) increased during SVT, while renal blood flow remained unchanged.
    • Glomerular pressure significantly increased during SVT (from 64 to 76 mmHg, p < 0.01).
    • Afferent vascular resistance decreased, and efferent vascular resistance increased during SVT (p < 0.05 for both), coinciding with a significant rise in ANP levels (p < 0.01).

    Conclusions:

    • The observed changes in glomerular hemodynamics during SVT are likely mediated by the elevated atrial natriuretic peptide (ANP).
    • Despite significant alterations in glomerular hemodynamics during SVT, natriuresis was observed only after the tachycardia episode, not during.
    • These findings suggest that the natriuresis associated with SVT is not directly attributable to the immediate changes in glomerular hemodynamics.