Copyright © 2000 by the European Society of Cardiology.
Is the secretion of atrial natriuretic peptide in man under neural control?
a Department of Medicine, Royal Victoria Hospital, Belfast, U.K.
b Cardiac Surgery Unit, Papworth Hospital, Cambridge, U.K.
revised August 3, 1999; accepted August 4, 1999
Abstract
Aims Previous work has described short-term variation in the circulating plasma level of atrial natriuretic peptide (ANP), but the mechanism remains unknown. Our aim was to investigate the role of cardiac innervation in this variability.
Methods and Results Blood samples were obtained from the right atrium via a pulmonary artery flotation catheter every 2min over a 90min period. Seven patients who underwent cardiac transplantation by the standard biatrial technique (partial innervation) and ten patients who underwent transplantation by the bicaval technique (total denervation) were studied. ANP levels were measured by radioimmunoassay. The median ANP levels were somewhat higher in the biatrial group compared to the bicaval group [470 (150–1095) vs 216 (100–605) pg.ml–1; median (range);P=ns], and both were much higher than normal levels in the pulmonary artery (40 (24, 56) pgml–1; median and interquartile range). In both transplant groups circulating plasma ANP levels showed considerable variability. The median number of ‘peaks’ and ‘troughs’, as counted by visual inspection, were not significantly different between the two groups. Computer analysis identified 12–16 and 6–15 ‘pulses’ in the biatrial and bicaval group, respectively. Further analysis revealed that pulse amplitude, height and area were significantly higher in the biatrial compared to the bicaval group.
Conclusion It would appear that variability of circulating plasma levels of ANP is preserved despite complete or partial cardiac denervation, and so a neural mechanism does not appear to account for such variation.
Key Words: Atrial natriuretic peptide, heart transplantation, chronobiology
f1 Correspondence: Professor D. P. Nicholls, Royal Victoria Hospital, Belfast, BT12 6BA, U.K.
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