Effects of human atrial natriuretic peptide on myocardial performance and energetics in heart failure due to previous myocardial infarction.

Abstract

BACKGROUND:

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).

METHODS:

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 (Ees: slope of end-systolic pressure-volume relation) and the ratio of LV stroke work (SW) to myocardial oxygen consumption (SW/MVO2=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.

RESULTS:

SNP had no effect on Ees, SW, or MVO2, thus SW/MVO2 remained unchanged (40.54±5.84% to 36.59±5.72%, p=0.25). ANP increased Ees, and decreased MVO2 with preserved SW, resulting in improved SW/MVO2 (40.49±6.35% to 50.30±7.96%, p=0.0073). Infusion of ANP (10.42-34.95 pmol/ml, p=0.0003) increased cGMP levels, whereas infusion of SNP had no effect (10.42-12.23 pmol/ml, p=0.75).

CONCLUSIONS:

Compared to SNP, the ANP-dependent increase in cGMP may ameliorate myocardial inotropy and energetics in HF.

• Authors: Toru Ozawa, Toshiro Shinke, Junya Shite, Hideyuki Takaoka, Nobutaka Inoue, Hidenari Matsumoto, Satoshi Watanabe, Ryohei Yoshikawa, Hiromasa Otake, Daisuke Matsumoto, Daisuke Ogasawara, Mitsuhiro Yokoyama, Ken-ichi Hirata
• Journal: Journal of cardiology (J Cardiol) Vol. 66 Issue 3 Pg. 232-8 (Sep 2015) ISSN: 1876-4738 [Electronic] Netherlands
• PMID: 25722046 (Publication Type: Journal Article)
• Copyright: Copyright © 2015. Published by Elsevier Ltd.

Chemical References

• Nitric Oxide Donors
• Vasodilator Agents
• Nitroprusside
• Atrial Natriuretic Factor
• Cyclic GMP

Topics

• Atrial Natriuretic Factor (administration & dosage)
• Blood Pressure (drug effects)
• Cyclic GMP (blood)
• Heart Failure (drug therapy, etiology)
• Humans
• Infusions, Intravenous
• Myocardial Contraction (drug effects)
• Myocardial Infarction (complications)
• Myocardium (metabolism)
• Nitric Oxide Donors (administration & dosage)
• Nitroprusside (administration & dosage)
• Oxygen Consumption
• Stroke Volume (drug effects)
• Vasodilator Agents (administration & dosage)
• Ventricular Dysfunction, Left (drug therapy)