Relationship Between Doppler Transmitral Flow Velocity Pattern and Plasma Atrial and Brain Natriuretic Peptide Concentrations in Anuric Patients on Maintenance Hemodialysis
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概要
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Plasma atrial (ANP) and brain (BNP) natriuretic peptide levels were compared to determine if transmitral flow velocity pattern is an instantaneous marker of body fluid balance in anuric patients on hemodialysis (HD). We measured plasma ANP and BNP levels and performed Doppler echocardiography in 38 anuric patients before and after HD. Patients with valvular disease, left ventricular systolic dysfunction having a fractional shortening < 0.3, arrhythmia, or left ventricular hypertrophy were excluded. The relationships between plasma ANP or BNP levels and the transmitral flow velocity pattern were evaluated. We also determined if the magnitude of the decrease in plasma ANP level was related to that in the early peak of transmitral flow velocity (peak E). The mean age of the subjects was 61.1 ± 9.7 years. The ANP level of 213.6 ± 146.1 pg/mL was related to peak E of 61 ± 15 cm/s before HD (R = 0.504, P < 0.001), but not after HD. Plasma ANP level was not related to peak late transmitral flow velocity (peak A) or peak E/peak A before or after HD. BNP level was not related to the transmitral flow velocity pattern. The magnitude of decrease in hANP level during HD was significantly related to that in peak E (R = 0.342, P < 0.05). Before HD, peak E was related to the plasma ANP level, reflecting volume overload. Change in peak E showed a weak relationship with that of plasma ANP level in the same HD patient. The measurement of peak E during a HD session may potentially enable the assessment of hydration status during HD.
著者
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Joh Takashi
Department Of Gastroenterology And Metabolism Nagoya City University Graduate School Of Medical Scie
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SUGIYAMA Masaya
Division of Hypertension and Vascular Research, Internal Medicine and Molecular Science. Graduate Sc
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Ito Shigenori
Division Of Cardiology Nagoya City Moriyama Municipal Hospital
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Murai Sumiko
Hemodialysis Center Jinseikai Nishio Clinic
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Takeda Yutaka
Department Of Cardio-renal Medicine And Hypertension Nagoya City University Graduate School Of Medic
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Fukutomi Tatsuya
Department Of Cardiology Nagoya City University
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Ozasa Atsushi
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Takada Norio
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Hanada Mayumi
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Suzuki Kaoru
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Nagae Yuji
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Inagaki Toshiaki
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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Fukutomi Tatsuya
Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences
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Takeda Yutaka
Department of Internal Medicine and Bioregulation, Nagoya City University Graduate School of Medical Sciences
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Sugiyama Masaya
Division of Internal Medicine, Nagoya City Moriyama Municipal Hospital
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