Effects of human atrial natriuretic peptide on myocardial performance and energetics in heart failure due to previous myocardial infarction. Issue 3 (September 2015)

• Record Type: Journal Article
• Authors: Ozawa, Toru; Shinke, Toshiro; Shite, Junya; Takaoka, Hideyuki; Inoue, Nobutaka; Matsumoto, Hidenari; Watanabe, Satoshi; Yoshikawa, Ryohei; Otake, Hiromasa; Matsumoto, Daisuke; Ogasawara, Daisuke; Yokoyama, Mitsuhiro; Hirata, Ken-ichi
• Is Part Of: Journal of cardiology. Volume 66:Issue 3(2015:Sep.)
• Page Start: 232
• Page End: 238
• Publication Date: 2015-09
• Subjects: Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2014.12.020
• Languages: English
• ISSNs: 0914-5087

Abstract

<abstract abstract-type="author" id="abs0005"> <title id="sect0005">Abstract</title> <sec> <title id="sect0010">Background</title> <p id="spar0005">Human atrial natriuretic peptide (hANP) and spontaneous nitric oxide (NO) donor share cyclic guanosine monophosphate (cGMP) as a second messenger, but their effect on myocardium may differ. We compared the effect of hANP and sodium nitroprusside (SNP) on left ventricular (LV) mechano-energetics in heart failure (HF).</p> </sec> <sec> <title id="sect0015">Methods</title> <p id="spar0010">Ten patients with HF due to previous myocardial infarction (LV ejection fraction: 45 ± 3%) were instrumented with conductance and coronary sinus thermodilution catheters. LV contractility (<italic>E</italic><sub>es</sub>: slope of end-systolic pressure–volume relation) and the ratio of LV stroke work (SW) to myocardial oxygen consumption (SW/MVO<sub>2</sub> = mechanical efficiency) were measured in response to intravenous infusion of ANP (0.05 μg/kg/min) or SNP (0.3 μg/kg/min) to lower blood pressure by at least 10 mmHg, and changes in plasma cGMP.</p> </sec> <sec> <title id="sect0020">Results</title> <p id="spar0015">SNP had no effect on <italic>E</italic><sub>es</sub>, SW, or MVO<sub>2</sub>, thus SW/MVO<sub>2</sub> remained unchanged (40.54 ± 5.84% to 36.59 ± 5.72%, <italic>p</italic> = 0.25). ANP increased <italic>E</italic><sub>es</sub>, and decreased MVO<sub>2</sub> with preserved SW, resulting in improved SW/MVO<sub>2</sub> (40.49 ± 6.35% to 50.30 ± 7.96%, <italic>p</italic> = 0.0073). Infusion of ANP (10.42–34.95 pmol/ml, <italic>p</italic> = 0.0003) increased cGMP levels, whereas infusion of SNP had no effect (10.42–12.23 pmol/ml, <italic>p</italic> = 0.75).</p> </sec> <sec> <title id="sect0025">Conclusions</title> <p id="spar0020">Compared to SNP, the ANP-dependent increase in cGMP may ameliorate myocardial inotropy and energetics in HF.</p> </sec> </abstract>