Atrial natriuretic factor during exercise in patients with congestive heart failure

Keller, Niels; Larsen, Jacob; Sykulski, R.; Thamsborg, Gorm

doi:10.1530/acta.0.1180168

Cited by 29 publications

(18 citation statements)

References 7 publications

(9 reference statements)

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“…In the intermittent LBPP study median CVP rose 2.5 mmHg during the first as well as the second inflation, whereas the third inflation only raised CVP by 1 mmHg. The very slow increase in plasma ANF is in full accordance with an early report on the effect of LBPP on plasma ANF levels (Wilkins et al, 1986) and is in agreement with the theory that a sustained pressure stimulus will augment ANF synthesis and release since high ANF levels are found consistently in congestive heart failure (Bates et al, 1986;Keller et al, 1988). These findings are in accordance with those reported by Shenker er al.…”

Section: Discussionsupporting

confidence: 92%

Atrial natriuretic factor and central venous pressure during intermittent and continuous lower‐body positive pressure in healthy humans

Kellers

1990

Clinical Physiology

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In eight healthy volunteers undergoing 16 experiments in a cross-over design central venous pressure (CVP) and atrial natriuretic factor (ANF) in central venous plasma were measured during a 30 min control period followed by three separated periods of 10 min lower-body positive pressure (LBPP) or 90 min continuous LBPP induced by inflation of a military anti-G suit to evaluate the effect of short repeated and of extended increases in right atrial pressure on plasma ANF levels. CVP increased significantly during each of three separate periods of intermittent LBPP, and 15 min after application of continuous LBPP (P less than 0.025 for all). Blood pressure and heart rate did not change. During intermittent LBPP plasma ANF levels increased 10 min after the first inflation of the MAGT-suit (P = 0.013), but not after the second or third inflation. During continuous LBPP plasma ANF remained unchanged until 90 min after application of LBPP where a significant rise was observed (P = 0.023). The data demonstrate that the ANF response to short-term increases in right atrial pressure, as small as 2.5 mmHg, is maximal within 10 min and that repeated pressure stimuli may decrease ANF release. Sustained increases in right atrial pressure are not associated with increases in plasma ANF until long after initiation of the pressure stimulus suggesting rapid receptor-binding of ANF and that the ANF receptors might be saturated during continuously elevated ANF levels.

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Section: Discussionsupporting

confidence: 92%

Atrial natriuretic factor and central venous pressure during intermittent and continuous lower‐body positive pressure in healthy humans

Kellers

1990

Clinical Physiology

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“…The basal plasma NtproANP remained unchanged in our study. This result is shared by Coats et al [20] and is in accordance with our results that in patients with congestive heart failure physical training does not cause any alterations in cardiac volumes or pressures at rest [8] , which are known to be the determinants of ANP release [21,22] . The stable …”

Section: Factors Related To the Severity Of Congestive Heart Failuresupporting

confidence: 94%

The effect of physical training on hormonal status and exertional hormonal response in patients with chronic congestive heart failure

Kiilavuori

Näveri²,

Leinonen³

et al. 1999

European Heart Journal

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Background Physical training improves exercise capacity in patients with chronic heart failure. It decreases plasma noradrenaline at rest, which may be prognostically favourable. The effect on atrial natriuretic peptide, another prognostic factor, and on catabolic and anabolic hormones remains unknown. Furthermore, to our knowledge, the contribution of exertional hormonal responses to the improved exercise capacity has not been evaluated.Methods 27 patients with stable chronic heart failure (New York Heart Association class II-III) were randomized to training (n=12) and control (n=15) groups. The training group exercised on a bicycle ergometer for 30 min three times a week for 3 months. The load corresponded to 50-60% of their peak oxygen consumption. For the next 3 months they exercised at home according to personal instructions. The control group did not change its physical activities. The levels of hormones regulating the cardiovascular system and metabolism were determined at rest and after graded maximal exercise and during exercise with constant submaximal workload.Results Submaximal exercise capacity increased significantly and peak oxygen consumption tended to improve by 12% in the training group. The plasma noradrenaline at rest tended to decrease by 19%. The plasma level of N-terminal pro atrial natriuretic peptide did not change. Serum cortisol, a catabolic hormone, was normal at baseline and remained unchanged. The serum levels of anabolic hormones, growth hormone and insulin, as well as dehydroepiandrosteronesulfate and free testosterone were within a normal range at baseline. They were not altered by training. The dehydroepiandrosteronesulfate/cortisol, and the free testosterone/cortisol ratios, reflecting anabolic/catabolic balance, did not change, either. Training resulted in a higher peak noradrenaline response during graded maximal exercise. The rise in serum cortisol during exercise tended to attenuate.Conclusion Physical training, which improves exercise capacity, does not have an unfavourable effect on anabolic/ catabolic balance or neurohumoral activation in patients with congestive heart failure. It decreases plasma noradrenaline at rest. Minor changes in hormonal responses during exercise emerged after physical training which unlikely contribute to the improved exercise capacity. (Eur Heart J 1999; 20: 456-664)

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“…The elevated plasma ANP at rest combined with a significant increase during exercise found in the present study resembles the secretion pattern reported in exercise studies in patients with left ventricular dysfunction and CHF [22][23][24][25][26]. The mechanisms of exercise-induced increase in AF are probably similar to the mechanisms in patients with left ventricular dysfunction and CHF where Nishikimi et al [27] reported a positive correlation between pulmonary capillary wedge pressure and plasma ANP level during exercise, emphasizing the importance of left atrial pressure i.e.…”

Section: P=002supporting

confidence: 89%

Natriuretic peptide response to dynamic exercise in patients with atrial fibrillation

Engelmann

Niemann

Kanstrup

et al. 2005

International Journal of Cardiology

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Atrial natriuretic factor during exercise in patients with congestive heart failure

Cited by 29 publications

References 7 publications

Atrial natriuretic factor and central venous pressure during intermittent and continuous lower‐body positive pressure in healthy humans

Atrial natriuretic factor and central venous pressure during intermittent and continuous lower‐body positive pressure in healthy humans

The effect of physical training on hormonal status and exertional hormonal response in patients with chronic congestive heart failure

Natriuretic peptide response to dynamic exercise in patients with atrial fibrillation

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