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Published on: December 13, 2019
Acute effects of atrial natriuretic peptide on left ventricular diastolic function. a pulsed wave Doppler study in
P B Clarkson1, N M Wheeldon, C Macleod
1University Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee, Scotland, U.K.
Insights
Atrial natriuretic peptide infusions improved diastolic function in healthy males by speeding myocardial relaxation. This peptide significantly reduced isovolumic relaxation time and increased early to late transmitral flow velocity ratios.
Area of Science:
- Cardiology
- Physiology
- Pharmacology
Background:
- Atrial natriuretic peptide (ANP) plays a role in cardiovascular homeostasis.
- Understanding ANP's effects on diastolic function is crucial for cardiovascular health.
- Previous research indicates ANP influences systemic hemodynamics.
Purpose of the Study:
- To investigate the effects of ANP on diastolic function and systemic hemodynamics in healthy individuals.
- To determine the dose-response relationship of ANP on cardiac indices.
- To assess changes in myocardial relaxation and transmitral flow patterns.
Main Methods:
- Ten healthy male subjects received infusions of ANP at varying doses (0.5-5 pmol.kg-1.min-1) and placebo.
- Doppler echocardiography was used to measure diastolic function indices, including isovolumic relaxation time and transmitral flow velocities.
- Systemic hemodynamic parameters such as heart rate, blood pressure, and aortic stroke distance were monitored.
Main Results:
- ANP infusion resulted in a significant, dose-dependent reduction in isovolumic relaxation time.
- A significant increase in the ratio of early to late transmitral peak velocities was observed with ANP.
- No significant changes in heart rate, blood pressure, or aortic stroke distance were noted compared to placebo.
Conclusions:
- Pathophysiological plasma concentrations of ANP enhance diastolic function in healthy individuals.
- ANP improves diastolic function primarily by increasing the rate of myocardial relaxation.
- These findings highlight ANP's potential therapeutic role in diastolic dysfunction.
Abstract:
Doppler echocardiographic indices of diastolic function and systemic haemodynamics were studied in response to infusions of atrial natriuretic peptide (0.5, 1, 2, 5 pmol.kg-1.min-1) and placebo (0.9% (w/v) saline) in ten normal male subjects. Compared with placebo, atrial natriuretic peptide infusion produced a significant and dose-related reduction in the isovolumic relaxation time [(mean and 95% CI) -5.9 (-9.2 to -2.6) ms (P < 0.01) at 5 pg.kg-1 min-1] and a significant increase in the ratio between early and late transmitral peak velocities [0.46 (0.02 to 0.89) (P < 0.05) at 5 pg.kg-1 min-1]. No significant changes in heart rate, blood pressure or aortic stroke distance were observed with infusion of atrial natriuretic peptide compared with placebo. These data suggest that pathophysiological plasma concentrations of atrial natriuretic peptide improve diastolic function by increasing the rate of myocardial relaxation.
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