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European Heart Journal 1993 14(5):682-686;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The Europen Society of Cardiology

Release of atrial natriuretic peptide in relation to metabolic changes during myocardial ischaemia induced by coronary angioplasty

P. A. UUSIMAA*, M. J. IKÄHEIMO{dagger}, H. RUSKOAHO{ddagger}, K. E. J. AIRAKSINEN{dagger}, H. V. HUIKURI{dagger}, M. K. LINNALUOTO{dagger}, J. T. TAKKUNEN{dagger} and K. J. PEUHKURINEN{dagger},

*Department of Medical Biochemistry, University of Oulu SF-90220 Oulu, Finland
{ddagger}Pharmacology and Toxicology, University of Oulu SF-90220 Oulu, Finland
{dagger}Department of Internal Medicine, Division of Cardiology, Oulu University Central Hospital SF-90220 Oulu, Finland

Received 20 March 1992; revised 16 November 1992; .

Correspondence Dr Keijo Peuhkurinen. Division of Cardiology, Department of Internal Medicine, Oulu University Central Hospital, Kajaamntie 50. SF-90220 Oulu. Finland

Abstract

The inter-relationships between ischaemia-induced metabolic changes and atrial natriuretic peptide (ANP) release were studied in 18 patients undergoing elective percutaneous transluminal coronary angioplasty (PTC A). Transcardiac differences in ANP, lactate, pH, pCO2 and O2 saturation were analysed before and after balloon inflation. The patients were divided into ischaemia and non-ischaemia groups on the basis of the change in lactate extraction ratio during balloon inflation. The ischaemia group (patients with a decrease in lactate extraction ratio) showed an increase of 27±15 pg. ml–1 in the transcardiac ANP difference, whereas a decrease of 27±17pg.ml–1 occurred in the non-ischaemia group (no decrease in lactate extraction ratio). The change between the two patient groups was statistically significant (P<0.05). Metabolic ‘pre-conditioning’ was not observed in patients with successive dilatations, therefore data from all the dilatations were combined and evaluated by regression analysis. A correlation coefficient of 0.40 (P<0.05) was obtained between the PTCA-induced changes in transcardiac ANP and lactate differences. We conclude that transient myocardial ischaemia induced by PTCA increases circulating ANP concentrations in patients with signs of metabolic ischaemia, but not in those without.

Key Words: Atrial natriuretic peptide • ischaemia • coronary angioplasty • energy metabolism


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