Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Relationship between plasma atrial natriuretic factor and opioid peptide levels in healthy subjects and in patients with acute congestive heart failure
Istituto di Patologia Speciale Medica e Metodologia Clinica, Università degli Studi di Bologna Italy
*Cattedra di Endocrinologia, Università degli Studi di Modena Italy
Laboratorio Centralizzato, Ospedale S. Orsola Bologna, Italy
Dipartimento di Farmacologia, Università degli Studi di Bologna Italy
Received 22 January 1992; revised 28 July 1992; .
Correspondence: Dr Fiorella Fontana, Istituto di Patologia Speciale Medica e Metodologia Clinica, Ospedale S. Orsola, Via Massarenti, 9, 40138 Bologna, Italy
Abstract
We evaluated plasma atrial natriuretic factor (ANF), ß-endorphin, met-enkephalin, dynorphin and noradrenaline levels in 20 healthy subjects and 20 acute congestive heart failure (CHF) patients. In all acute CHF patients plasma values of these hormones were higher than in healthy subjects. The hormonal pattern differed in patients with the more severe acute CHF (group 1) from patients with less severe acute CHF (group 2) (ANF 53.8 ± 1.0 vs 34.6 ± 1.5 pg.ml–1, noradrenaline 563.8 ± 13.4 vs 202.4 ± 10.6 pg.ml–1, met-enkephalin 41.0 ± 3.2 vs 17.0 ± 1.6 fmol. ml–1, dynorphin 46.8 ± 3.7 vs 25.2 ± 2.0 fmol. ml–1, P <0.01; ß-endorphin 50.6 ± 5.2 vs 41.8 ± 4.1 fmol. ml–1, ns). Administration of an opioid antagonist (naloxone, 8 mg i.v.) did not modify ANF or noradrenaline concentration in healthy subjects. in group 1 naloxone administration significantly raised ANF (68.0 ± 1.4 pg. ml–1), noradrenaline (776.6 ± 18.7 pg. ml–1), blood pressure and heart rate, whereas in group 2 it significantly decreased ANF values (21.9 ± 0.5 pg. ml–1)and did not modify the other parameters. Our findings suggest that the opioid system affects ANF release in acute CHF. In patients with severe CHF opioid peptides may attenuate ANF secretion reducing noradrenergic stimulation. On the other hand, when CHF is less severe and the sympathetic activity is moderate, opioid peptides may directly stimulate ANF secretion.
Key Words: Atrial natriuretic factor • ß-endorphin • met-enkephalin • dynorphin • noradrenaline • congestive heart failure
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