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Kim, Kim, Bae, Soung, and Seo: Clinical Significance of Plasma Atrial Natriuretic Polypeptide Concentration in Cardiac Diseases. Relationship between Intracardiac Plasma Atrial Natriuretic Polypeptide Concentration and Intracardiac Pressures
Original Article
Korean Circulation Journal

Korean Circulation Journal 1988; 18(1): 1-22.

Published online: 31 March 1988

DOI: https://doi.org/10.4070/kcj.1988.18.1.1

Clinical Significance of Plasma Atrial Natriuretic Polypeptide Concentration in Cardiac Diseases. Relationship between Intracardiac Plasma Atrial Natriuretic Polypeptide Concentration and Intracardiac Pressures

Kwon Sam Kim, M.D., Myung Sik Kim, M.D., Jong Hoa Bae, M.D., Jung Sang Soung, M.D., Jung Don Seo, M.D.

Copyright © 1988 The Korean Society of Circulation

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To study factors related to release of atrial natriuretic polypeptide(ANP) in human subjects, instracardiac pressure and plasma ANP concentration in peripheral and central circulation were measured in patients with various heart disease (18 valvular heart disease, 4 congenital heart disease, 2 cardiomyopathy).
1) The concentration in peripheral venous plasma were increased in 14 patients with New York Heart Associaion (NYHA) functional class III-IV (87±38 pg/ml) as compared with that in 10 patients with NYHA functional class I-II (39±21 pg/ml, P<0.005)and 15 normal subjects (51±21 pg/ml, P<0.01).
2)The concentration of plasma ANP in inferior vena cava, right ventricle, pulonary artery, left ventricle and aorta were markedly increased in patient with NYHA functional class III-IV, elevated mean right atrial pressure (MRAP≥8 mmHg) elevated mean pulmonary capllary wedge pressure (MPCWP≥15 mmHg) and/or elevated pulminary artery systolic pressure (PASP≥35 mmHg), as compared with those in patients with NYHA functional class I-II and/or lower intracardiac pressure (MRAP<8 mmHg, MPCWP<15 mmHg, and/or PASP<35 mmHg).
3) A step up in ANP concentration between inferior vena cava and right atrium was seen in patients with elevated MRAP (81±28pg/ml, 137±60pg/ml, P<0.05), MPCWP (74±37pg/ml,112±62pg/ml, P<0.05) and/or PASP (75±29 pg/ml,119±64 pg/ml, P<0.05). But there were no differences among intracardiac ANP concentrations from right atrium though aorta.
4) Plasma concentrations in right atrium, pulmonary artery, left ventricle and aorta correlated with MRAP (r=0.82, 0.63, 0.56, p<0.005 and r=0.52, P<0.01, respectively), MPCWP (r=0.86, 0.75, 0.73 and 0.72 respectively, P<0.005 in all) and PASP (r=0.73, 0.57, 0.68 and 0.59 respectively P<0.005 in all).
5) Left atrial diameter correlated with plasma ANP concentration in peripheral plasma (r=0.55, P<0.01), inferior vena cava (r=0.51, P<0.025), right atrium (r=0.45, P<0.05), right ventricle (r=0.55, P<0.01), pulmonary artery (r=0.52, P<0.01), left ventricle (r=0.55, P<0.01) and aorta (r=0.56, P<0.005).
These results suggest that the heart secrets atrial natriuretic polypeptide into right atrium in response to increased mean right atrial pressure, mean pulmonary capillary wedge pressure, pulmonary artery systolic pressure and/or left atrial distention.

Keywords: Cardiac disease, Plasma ANP concentration

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