PMID- 7528846
OWN - NLM
STAT- MEDLINE
DCOM- 19950131
LR  - 20190724
IS  - 0160-2446 (Print)
IS  - 0160-2446 (Linking)
VI  - 24
IP  - 4
DP  - 1994 Oct
TI  - Kinetic study of atrial natriuretic peptide in patients with idiopathic dilated 
      cardiomyopathy: evidence for resistance to biologic effects of the hormone even 
      in patients with mild myocardial involvement.
PG  - 626-37
AB  - Atrial natriuretic peptide (ANP) kinetics was studied in 12 patients with 
      idiopathic dilated cardiomyopathy at different sodium excretion (30-175 mmol/day) 
      and variable degrees of hemodynamic dysfunction [New York Heart Association 
      (NYHA) class range I-III] to investigate whether differences in renewal and 
      distribution of this hormone (as compared with those of a control group) play a 
      role in pathogenesis and evolution of heart failure. [125I]Labeled ANP was 
      injected as a bolus, and a high-performance liquid chromatography (HPLC) 
      procedure was used to purify the labeled hormone in venous plasma samples 
      collected for < or = 50 min after injection; the main ANP kinetic parameters were 
      then derived from the disappearance curve of the labeled hormone. As in controls, 
      a positive linear regression between ANP metabolic clearance rate (MCR, 
      ml/min/m2) values and daily urinary excretion of sodium (NaUE, mmol/day) was 
      noted in patients. The different linear regression coefficients between normal 
      subjects (MCR = 365 +/- 8.08 NaUE, r = 0.986, p < 0.0001) and patients (MCR = 497 
      + 18.5 NaUE, r = 0.867, p = 0.001) indicate that in patients a higher peptide 
      clearance rate is needed to obtain the same biologic effect (sodium excretion) 
      and suggest that resistance to biologic effects of the hormone exists in patients 
      at an early stage of disease (NYHA class I). When the efficiency of the ANP 
      system in excreting sodium was expressed as the ratio of NaUE to ANP production 
      rate (PR = MCR x ANP plasma concentration, microgram/day/m2) patients showed 
      significantly lower values (p = 0.0126) than normal volunteers, thus confirming 
      resistance to the hormone effects. Significantly lower values for ANP total 
      distribution volume (16.5 +/- 8.4 L/m2), mean residence time in the sampling 
      space (4.04 +/- 1.14 min), mean residence time in the body (7.25 +/- 2.13 min), 
      and fewer recycles through the initial (sampling) space (0.27 +/- 0.16) were 
      noted in patients, indicating an altered mechanism regulating distribution of the 
      hormone. The positive correlations between ANP MCR (L/min/m2) values and cardiac 
      index (CI, L/min/m2) (MCR = -1.24 + 1.17 CI, r = 0.689, p = 0.0092) and between 
      initial distribution volume (IDV, L/m2) and CI (IDV = -11.2 + 6.85 CI, r = 0.730, 
      p = 0.0046) in all patients indicate that hemodynamic factors contribute to the 
      progressive reduction in MCR and IDV values throughout the progression of 
      myocardial involvement.(ABSTRACT TRUNCATED AT 400 WORDS)
FAU - Iervasi, G
AU  - Iervasi G
AD  - CNR Institute of Clinical Physiology, Pisa, Italy.
FAU - Clerico, A
AU  - Clerico A
FAU - Pilo, A
AU  - Pilo A
FAU - Berti, S
AU  - Berti S
FAU - Vitek, F
AU  - Vitek F
FAU - Biagini, A
AU  - Biagini A
FAU - Bianchi, R
AU  - Bianchi R
FAU - Donato, L
AU  - Donato L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Pharmacol
JT  - Journal of cardiovascular pharmacology
JID - 7902492
RN  - 4964P6T9RB (Aldosterone)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
RN  - 9NEZ333N27 (Sodium)
RN  - EC 3.4.23.15 (Renin)
SB  - IM
MH  - Adult
MH  - Aldosterone/blood
MH  - Atrial Natriuretic Factor/*pharmacokinetics/physiology
MH  - Cardiomyopathies/complications
MH  - Cardiomyopathy, Dilated/complications/diagnostic imaging/*metabolism
MH  - Chromatography, High Pressure Liquid
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Metabolic Clearance Rate
MH  - Middle Aged
MH  - Radioimmunoassay
MH  - Radionuclide Angiography
MH  - Renin/blood
MH  - Sodium/metabolism
EDAT- 1994/10/01 00:00
MHDA- 1994/10/01 00:01
CRDT- 1994/10/01 00:00
PHST- 1994/10/01 00:00 [pubmed]
PHST- 1994/10/01 00:01 [medline]
PHST- 1994/10/01 00:00 [entrez]
AID - 10.1097/00005344-199410000-00014 [doi]
PST - ppublish
SO  - J Cardiovasc Pharmacol. 1994 Oct;24(4):626-37. doi: 
      10.1097/00005344-199410000-00014.