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Atrial natriuretic peptide and hemodynamic changes during normal human pregnancy
Hypertension (Dallas, Tex. : 1979)
|April 1, 1995
Summary
During pregnancy, plasma atrial natriuretic peptide (ANP) and cGMP levels increase, correlating with hemodynamic changes. These levels normalize postpartum, with posture influencing their expression and relation to cardiovascular adjustments.
Area of Science:
- Cardiovascular Physiology
- Reproductive Endocrinology
Background:
- Normal pregnancy involves significant hemodynamic alterations, including hypervolemia, increased cardiac output, and decreased vascular resistance.
- Atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) are key regulators of fluid and electrolyte balance, and vascular tone.
Purpose of the Study:
- To compare plasma ANP and cGMP levels during normal pregnancy with postpartum levels.
- To assess the relationship between ANP, cGMP, and pregnancy-induced hemodynamic changes.
Main Methods:
- Measurements of humoral and hemodynamic variables were taken in healthy women during each trimester of pregnancy and postpartum.
- Data were collected in both supine and upright postures to evaluate postural effects.
Main Results:
- Plasma ANP and cGMP levels were elevated throughout pregnancy compared to postpartum levels.
- Increases in ANP and cGMP were directly correlated (r = .68, P < .01).
- Postural changes (standing) did not significantly alter ANP and cGMP levels from postpartum values, but stroke volume and cardiac index showed distinct postural responses, particularly in late pregnancy.
Conclusions:
- Elevated ANP and cGMP are characteristic of normal pregnancy, reflecting adaptation to altered hemodynamics.
- The direct relationship between ANP and cGMP suggests a coordinated hormonal response.
- Hemodynamic adjustments, including stroke volume and cardiac index, exhibit complex postural dependencies during pregnancy, which may be influenced by ANP and cGMP signaling.