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Plasma cyclic guanosine monophosphate in chronic heart failure: hemodynamic and neurohormonal correlations and response to nitrate therapy.

Abstract
This study evaluated the relation between plasma cyclic guanosine monophosphate (cGMP) and hemodynamic and neurohormonal parameters in patients with chronic congestive heart failure and assessed the effect of organic nitrate on plasma cGMP levels. Plasma cGMP was fourfold higher in 18 patients with congestive heart failure compared with 15 control subjects (16.7 +/- 9.7 versus 4.0 +/- 1.0 pmol/ml; p < 0.0001) but did not correlate with plasma levels of catecholamines, renin, atrial natriuretic peptide, or with baseline hemodynamic values. The administration of a hemodynamically effective dose of oral isosorbide dinitrate (40 mg) resulted in a transient reduction in plasma cGMP from 16.7 +/- 9.7 pmol/ml at baseline to 13.0 +/- 6.6 pmol/ml at 1 hour (p < 0.05). This change was associated with small and statistically insignificant changes in neurohormonal values and had no relation to any of the hemodynamic changes. We concluded that (1) elevated plasma cGMP in congestive heart failure does not correlate with other neurohormonal or hemodynamic parameters and may be an independent parameter of heart failure, (2) in contrast to previously documented nitrate-mediated increases in intracellular cGMP, nitrate therapy results in a reduction in plasma cGMP, and (3) changes in plasma cGMP cannot serve as a surrogate measurement of changes in intracellular cGMP.
AuthorsA Shotan, A Mehra, E Ostrzega, W Hsueh, Y S Do, D A Fisher, A Hurst, J V Johnson, U Elkayam
JournalClinical pharmacology and therapeutics (Clin Pharmacol Ther) Vol. 54 Issue 6 Pg. 638-44 (Dec 1993) ISSN: 0009-9236 [Print] United States
PMID7903916 (Publication Type: Clinical Trial, Comparative Study, Journal Article)
Chemical References
  • Neurotransmitter Agents
  • Cyclic GMP
  • Isosorbide Dinitrate
Topics
  • Administration, Oral
  • Adult
  • Aged
  • Chronic Disease
  • Cyclic GMP (blood)
  • Female
  • Heart Failure (blood, drug therapy, physiopathology)
  • Hemodynamics (drug effects, physiology)
  • Humans
  • Isosorbide Dinitrate (therapeutic use)
  • Male
  • Middle Aged
  • Neurotransmitter Agents (blood)

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