Hemodynamic and renal effects of atrial natriuretic peptide in congestive heart failure.

The hemodynamic and renal effects of anaritide (human atrial natriuretic peptide 102-126), a synthetic analog of atrial natriuretic peptide, were evaluated in 35 patients with chronic New York Heart Association class II to IV heart failure. There were 32 men and 3 women, aged 33 to 75 (mean +/- standard error of the mean 56 +/- 2) years. In the first phase of the study, right-sided heart catheterization was performed, and anaritide was administered as 1-hour infusions. The rate of the infusion varied among patients from 0.03 to 0.3 micrograms/kg/min. In response to anaritide, there were decreases in mean systemic arterial (94 +/- 2 to 87 +/- 2 mm Hg), right atrial (10 +/- 1 to 8 +/- 1 mm Hg), mean pulmonary arterial (33 +/- 2 to 28 +/- 2 mm Hg) and pulmonary artery wedge (22 +/- 2 to 15 +/- 2 mm Hg) pressures (all p less than 0.05). Cardiac index increased (2.39 +/- 0.15 to 2.62 +/- 0.15 liters/min/m2, p less than 0.05) and heart rate was unchanged. Systemic vascular resistance decreased significantly, but pulmonary vascular resistance was unchanged. There were increases in urine volume (1.6 +/- 0.2 to 2.3 +/- 0.4 ml/min), sodium excretion (47 +/- 13 to 74 +/- 20 muEq/min) and fractional excretion of sodium (0.41 +/- 0.11 to 0.59 +/- 0.14%, all p less than 0.05), while potassium excretion and creatinine clearance did not change. In the second phase of the study, patients received 2-hour infusions of anaritide (0.03 to 0.6 micrograms/kg/min) and placebo with noninvasive monitoring.(ABSTRACT TRUNCATED AT 250 WORDS)
AuthorsM A Fifer, C R Molina, A C Quiroz, T D Giles, H C Herrmann, I R De Scheerder, D L Clement, S Kubo, R J Cody, J N Cohn
JournalThe American journal of cardiology (Am J Cardiol) Vol. 65 Issue 3 Pg. 211-6 (Jan 15 1990) ISSN: 0002-9149 [Print] UNITED STATES
PMID2136969 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Peptide Fragments
  • anaritide
  • Atrial Natriuretic Factor
  • Adult
  • Aged
  • Atrial Natriuretic Factor (administration & dosage, therapeutic use)
  • Drug Administration Schedule
  • Female
  • Heart Failure (drug therapy, physiopathology)
  • Hemodynamics (drug effects)
  • Humans
  • Kidney (drug effects, physiopathology)
  • Male
  • Middle Aged
  • Natriuresis
  • Peptide Fragments (administration & dosage, therapeutic use)
  • Time Factors

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