Acute hemodynamic effects of alpha human atrial natriuretic polypeptide in patients with congestive heart failure.

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概要

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• Acute hemodynamic and humoral effects of synthesized alpha human atrial natriuretic polypeptide (α-hANP, 0.025μg/kg/min for 40 min) on 6 patients with severe congestive heart failure were assessed. Plasma α-hANP concentration was high in patients and increased further (from 463±360 to 1, 282±670pg/ml, mean±SD, p<0.01) following α-hANP infusion, but plasma norepinephrine (1, 030±865 to 971±785pg/ml) was not changed. Increases in urine output (1.0±0.8 to 2.6±2.3ml/min) and Na+ excretion rate (87±89 to 257±211mEq/min/m2) were statistically insignificant. A significant reduction was induced in mean aortic pressure (99±25 to 96±26mmHg, p<0.05), mean right atrial pressure (11±9 to 7±8mmHg, p<0.01), mean pulmonary arterial pressure (39±13 to 33±12mmHg, p<0.05) and mean pulmonary capillary wedge pressure (27±8 to 20±7mmHg, p<0.01). Heart rate, cardiac index, systemic vascular resistance and pulmonary vascular resistance were not altered. In conclusion, α-hANP induced decreases in left ventricular filling pressure and rightside heart pressure which were attributed to venodilatation rather than natriuretis in patients with congestive heart failure. Preserved cardiac output with decreased preload suggested that α-hANP improved cardiac function.

• International Heart Journal刊行会の論文

著者

• Iizuka Masahiko

  Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

• Kohmoto Osami

  Second Department of Internal Medicine

• Serizawa Takashi

  Second Department of Internal Medicine

• Takahashi Toshiyuki

  Second Department Of Surgery Hokkaido University School Of Medicine

• Kangawa Kenji

  Second Division, Department of Medicine, Kyoto University School of Medicine, Kyoto, and Department

• Matsuo Hisayuki

  Second Division, Department of Medicine, Kyoto University School of Medicine, Kyoto, and Department

• HIRATA Yasunobu

  Second Department of Internal Medicine, Faculty of Medicine

• Sugimoto Tsuneaki

  Second Department Of Internal Medicine Faculty Of Medicine Toyama Medical And Pharmaceutical Univers

• Ishii Masao

  Second Department Of Internaal Medicine Yokohama City University

• Sato Hiroshi

  Second Department Of Internal Medicine And Department Of Biology Shiga University Of Medical Science

• MATSUOKA Hiroaki

  Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

• HIRATA Yasunobu

  Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

• KOHMOTO Osami

  Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

• MOCHIZUKI Takatoshi

  Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo

• MATSUO Hisayuki

  Second Department of Biochemistry, Miyazaki Medical College

• KANGAWA Kenji

  Second Department of Biochemistry, Miyazaki Medical College

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