Effects of lidocaine on atrial natriuretic peptide concentrations in plasma and urine

The antiarrhythmic agent lidocaine reduces inward sodium current and increases outward potassium current. Described studies investigated the effect of lidocaine on circulating and urinary levels of atrial natriuretic peptides in an intact canine model. Surface electrocardiography was monitored along with right ventricular, left ventricular and aortic pressures, and cardiac output. Plasma and urine atrial natriuretic peptides were measured immediately before and five minutes after a five minute, 2 mg/min, intravenous lidocaine infusion. Long acting natriuretic peptide (LANP), vessel dilator, and atrial natriuretic factor (ANF) were monitored by RIA. There were no measured hemodynamic or cardiomechanical changes noted after lidocaine infusion. Similarly, there was no change in plasma sodium or potassium, or urine sodium. There was, however, an increase in urine potassium levels. Additionally, plasma and urine LANP and ANF peptide levels were increased following lidocaine infusion, while plasma and urine concentrations of vessel dilator were not changed. These data suggest that lidocaine increases plasma and urine atrial natriuretic peptides by mechanisms other than cardiodepression and/or vasodilation.