Journal of Applied Physiology
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J Appl Physiol 89: 458-464, 2000;
8750-7587/00 $5.00
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Vol. 89, Issue 2, 458-464, August 2000

Insufficient secretion of atrial natriuretic peptide at acute phase of myocardial infarction

Keiko Maeda1, Takayoshi Tsutamoto1, Atsuyuki Wada1, Naoko Mabuchi1, Masaru Hayashi1, Tomoko Hisanaga1, Takeshi Kamijo2, and Masahiko Kinoshita1

1 First Department of Internal Medicine, Shiga University of Medical Science, Otsu 520-2192; and 2 Product Planning Department, Chugai Pharmaceutical Company, Ltd., Tokyo 104-8301, Japan

To investigate the secretion of the plasma levels of atrial natriuretic peptide (ANP) in patients with acute myocardial infarction (AMI), we evaluated the relationship between plasma levels of ANP and pulmonary capillary wedge pressure (PCWP) in 45 consecutive patients during the acute phase of AMI (~12 h after the attack) (group 1) and compared data with those obtained after 1 mo (group 2). In both groups 1 and 2, plasma ANP levels significantly correlated with PCWP. The slope of the linear regression line between the PCWP and ANP in group 1 was significantly lower, by about one-third, than that in group 2. In addition, we examined changes in ANP levels and left ventricular end-diastolic pressure (LVEDP) over 180 min after AMI induced by injection of microspheres into the left coronary arteries of three dogs. The LVEDP and ANP levels 30 min after AMI were significantly higher than those before; however, despite the persistent high LVEDP during the 180 min after AMI, ANP levels decreased gradually and significantly to 63% of the peak level at 150 min. These findings suggest that the secretion of ANP during the acute phase of myocardial infarction may be insufficient relative to the chronic phase.

cardiac natriuretic peptides; ischemia; pulmonary capillary wedge pressure; acute heart failure


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