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European Heart Journal 1990 11(9):779-787;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Plasma atrial natriuretic factor in patients with acute myocardial infarction

F. FONTANA, P. BERNARDI, N. SPAGNOLO and M. CAPELLI*

Istututo di Patologia Speciale Medica e Metodologia Clinica, Universitá degli Studi di Bologna Ospedale S. Orsola, Bologna, Italy
*Laboratorio Centralizzato Ospedale S. Orsola, Bologna, Italy

Received 24 February 1989; revised 23 December 1989; .

Correspondence. Dr Fiorella Fontana, Istituto di Patologia Speciale Medica e Metodologia Clinica, Opedale S. Orsola, Via Massarernti 9, 40138 Bologna, Italy.

Abstract

Plasma atrial natriuretic factor (ANF), renin activity (PRA), aldosterone and antidiuretic hormone (ADH) were determined in 16 patients with uncomplicated acute myocardial infarction (AMI) for 7 days in all patients and in six patients for 8 more days. Echocardiograms were performed and central venous pressure (CVP) was measured on the 2nd, 7th and 15th days. On admission, plasma ANF was higher in patients with AMI (129.8 ± 70.6 pg ml–1, mean ± SD) than in healthy volunteers (50.6 ± 10.0 pg ml–1) (P < 0.05). Arterial pressure, heart rate, CVP were normal. Left atrial (LAD) and left ventricular diameters (LVDD) were increased in six patients. Ejection fraction (EF) was reduced in all. A significant inverse relationship between ANF and EF was observed. Patients with EF < 45%, high LAD and LVDD had the highest plasma ANF and showed steady high plasma ANF for 15 days. Patients with EF > 45%, normal LAD and LVDD had elevated plasma levels only for 10 days, rising significantly on days 3–7 after admission. PRA and ADH values were normal throughout the study, whereas aldosterone was above the normal range only on admission. These findings suggest that the reduction in myocardial contractility induced by the infarction may account for the rise in ANF secretion via increased left atrial pressure or left atrial dilatation.

Key Words: Atrial natriuretic factor • acute myocardial infarction • ejection fraction • aldosterone • antidiuretic hormone


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