[Atrial natriuretic peptide in patients with acute myocardial infarction]

The aim of the study was to investigate the plasma concentration of atrial natriuretic peptide (ANP) in acute myocardial infarction (AMI), its association with age, sex, essential hypertension, infarct localization, complications of AMI, infarct size, left atrial and ventricular chamber sizes and therapy of AMI. I studied 40 pts (9 female, 31 male, mean 56.9 + 10 years) with first AMI up to 6 hours onset the first symptoms (mean 2.4 + 1.2 hours). The ANP concentration was measured at the time of admission to the hospital (ANP 0) and at time 4, 8, 16, 24, 48, 72 hours after admission (ANP mean). Arrhythmias was assessed by 24 hour ecg Holter monitoring. Infarct size was assessed by serial CK-MB measurement in first 72 hours of AMI. Contractility disturbances and left atrial and ventricular chamber sizes was assessed by echocardiography. The average plasma concentration of ANP was significantly elevated (28.1 +/- 4.3 fmol/ml). The mean ANP concentration was significantly higher in pts with essential hypertension than in pts without hypertension (36.1 + 7.7 vs 21.7 + 4.2 fmol/ml). The ANP concentration in pts with inferior myocardial infarction was significantly higher than in pts with anterior myocardial infarction (32.1 + 6.1. vs 20.9 + 4.1 fmol/ml). The ANP mean in pts with complications of AMI (congestive heart failure, arrhythmias, reinfarction, death) was significantly higher than in pts without complications (49.5 + 13.3 vs 21.6 + 7.1 fmol/ml). I observed positive correlation between plasma ANP and left atrial chamber sizes (r = 0.59) and diastolic ventricular dimension (r = 0.56).(ABSTRACT TRUNCATED AT 250 WORDS)