Atrial natriuretic peptide and nitric oxide in children with pulmonary hypertension after surgical repair of congenital heart disease

Ivy, D. Dunbar; Kinsella, John P.; Wolfe, Robert R.; Abman, Steven H.

doi:10.1016/s0002-9149(97)89147-3

Cited by 25 publications

(10 citation statements)

References 24 publications

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“…[10][11][12][13] Moreover, the period during and after corrective operations for congenital heart disease in children is characterized by a complex pathophysiologic condition with diminished performance of the myocardium, increased capillary permeability, and disturbed volume homeostasis. [14][15][16][17] Only very limited data exist regarding the role of the natriuretic peptide family in such patients. Pfenninger and associates, 15 who studied 22 children with various types of congenital heart disease, concluded that plasma ANP concentrations are increased after cardiac surgery in children and that this increase is moderately correlated with the blood volume status of the patient.…”

Section: Discussionmentioning

confidence: 99%

Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection

Yoshimura

Yamaguchi

Oshima

et al. 2000

The Journal of Thoracic and Cardiovascular Surgery

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Section: Discussionmentioning

confidence: 99%

Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection

Yoshimura

Yamaguchi

Oshima

et al. 2000

The Journal of Thoracic and Cardiovascular Surgery

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“…Since ANP is a potent vasodilator in the pulmonary circulation (28) increased levels in patients with pulmonary hypertension may be regarded as an attempt of the body to counteract increased pulmonary artery pressure. In contrast to others we were unable to demonstrate ANP extraction or cGMP production during passage of blood through the lung (29).…”

Section: Discussionmentioning

confidence: 99%

Oxygen-mediated pulmonary vasodilation and plasma levels of endothelin-1, atrial natriuretic peptide and cyclic GMP in patients with left-to-right shunt and pulmonary hypertension

Gorenflo¹,

Bettendorf

He³

et al. 2000

Z Kardiol

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This study was performed to evaluate the role of endogenous endothelin-1 (ET-1), atrial natriuretic peptide (ANP) and cyclic guanosine monophosphate (cGMP) in patients with left-to-right shunt and pulmonary hypertension. Further objectives were to study a possible feedback mechanism between ANP and ET-1 and to examine the influence of ANP on cGMP plasma levels. Finally, the role of these hormones in oxygen-mediated pulmonary vasodilation was examined. Plasma concentrations of ET-1, ANP and cGMP were studied in 39 patients with congenital heart disease and left-to-right shunt. Blood samples were taken from the pulmonary artery and pulmonary vein at cardiac catheterization at baseline and after breathing oxygen for 20 min. Patients were grouped according to the presence or absence of pulmonary hypertension (defined as mean Pp/Ps > or = 0.5). Patients with pulmonary hypertension (n = 18) were found to have significantly higher plasma ANP (665 [59-1358] versus 267 [47-832] pg/ml) and cGMP (21.5 [3.6-82.2] versus 7.8 [0-14.6] nM/L) levels than patients without pulmonary hypertension (n = 21). Pulmonary venous ET-1 plasma concentrations were above normal limits in one patient only. ANP plasma levels were not related to ET-1 and cGMP concentrations. There was no transpulmonary gradient for any of the factors. Pulmonary vasodilation in response to oxygen was found in 7 of 18 patients with PH, but was not associated with significant changes in ET-1, ANP or cGMP plasma concentrations. Patients with congenital heart disease and PH show an increase both in vasoconstrictive and vasodilating factors. The mechanism of oxygen-mediated vasodilation in these patients remains to be elucidated.

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“…Nitro‐glycerine is one of the widely used drugs for the treatment of AMI, but has several side‐ effects. In a study that compared nitro‐glycerine and ANP in their ability to reduce blood pressure in AMI patients (79), ANP was found to activate ‘particular guanylyl cyclase’, whereas nitro‐ glycerine activated ‘soluble guanylyl cyclase’ (80, 81). A comparative profile between the two drugs (see Table 5) points to some of the advantages ANP has over nitro‐glycerine as a pharmacotherapeutic agent for AMI.…”

Section: Clinical Rolesmentioning

confidence: 99%

“…Rats with induced pulmonary hypertension had increased levels of ANP, and ANP infusion was found to decrease prostaglandin‐induced hypertension (76). The authors of a study which probed into the pulmonary vasodilatory function of ANP commented that the vasodilatory action and pharmacokinetic profiles of ANP were inferior to those of clinically prevailing pulmonary vasodilators as well as nitric oxide (80). In a clinical study, the extent of reduction of blood pressure during the treatment of intraoperative hypertension was similar with ANP and nicardipine, the latter being an established L‐type calcium channel blocker used for the treatment of hypertension and angina pectoris (91).…”

Section: Clinical Rolesmentioning

confidence: 99%

Cardiac natriuretic peptides - hope or hype?

Venugopal

2008

Journal of Clinical Pharmacy and Therapeutics

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In recent years, biomedical science has witnessed the emergence of peptide biochemicals as significant topics of research. Some of these peptides are of little potential clinical use, while others, of which cardiac natriuretic peptides are an example, appear to be promising. This particular group of peptides (i.e. ANP, BNP and CNP) shows promising diagnostic as well as therapeutic potential for various pathological conditions. In the case of acute myocardial infarction, these peptides have significant diagnostic and predictive properties, more so than other biochemicals such as adrenaline, renin and aldosterone. In addition, ANP is found to have significant benefits over the classical anti‐anginal drug glyceryl trinitrate. However, as is the case with other peptides, applying these benefits clinically may not be easy because of the structure of the compounds, but various strategies are now being applied to solve this problem. These include the use of non‐peptide receptor ligands, inhibitors of ANP metabolism, gene therapy and so on. The development of drugs in clinical practice, which exploits the natriuretic peptides system therefore seems to be promising, and this article reviews advances in our understanding of these compounds.

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Atrial natriuretic peptide and nitric oxide in children with pulmonary hypertension after surgical repair of congenital heart disease

Cited by 25 publications

References 24 publications

Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection

Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection

Oxygen-mediated pulmonary vasodilation and plasma levels of endothelin-1, atrial natriuretic peptide and cyclic GMP in patients with left-to-right shunt and pulmonary hypertension

Cardiac natriuretic peptides - hope or hype?

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