Microvascular effects of atrial natriuretic peptide (ANP) in man: studies during high and low salt diet

Houben, A. J. H. M.; Krekels, M.; Schaper, Nicolaas C.; Fuss-Lejeune, M. J.M.J.; Rodriguez, SA; Leeuw, Peter W. de

doi:10.1016/s0008-6363(98)00072-8

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…Infusion of a low dosage of BNP (4 pmol/kg/min) for 1 h in healthy volunteers did not induce changes in the microcirculation [27]. In contrast, a 4‐h low dose (2.5 pmol/kg/min) infusion of ANP in healthy volunteers resulted in vasoconstriction of the microcirculation, predominantly on the venular side [57]. This would increase hydraulic pressure in the capillary bed and thereby contribute to shifting fluid from the vascular compartment to the extravascular compartment [58] leading to a reduction in preload.…”

Section: Vascular Effects Of Bnpmentioning

confidence: 99%

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Houben¹,

Zander²,

Leeuw³

2005

Fundamemntal Clinical Pharma

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During the last decade brain natriuretic peptide (BNP) has received increasing attention as a potential marker of cardiovascular disease. BNP may act as a compensating mechanism in cardiovascular diseases in order to reduce preload. However, the increase in endogenous BNP is often not sufficient to compensate for volume overload in diseases like established hypertension and heart failure. The reported hemodynamic and renal effects of BNP in man differ largely between studies, because of differences in design and doses of BNP employed. In the pharmacological range, BNP has clear blood pressure and afterload lowering effects, and in the kidney blood flow and filtration is increased with concomitant natriuresis and diuresis. While in the physiological range BNP does not affect blood pressure and reduces preload only, and induces natriuresis/diuresis without changes in renal blood flow and filtration. There is increasing evidence from vascular studies that BNP preferentially acts on the venous system resulting in preload reduction, in contrast to atrial natriuretic peptide which acts preferentially on the arterial system to reduce afterload. This review summarizes our current understanding of BNP, and discuss its regulation and mechanisms of action on the vasculature and the kidneys.

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Section: Vascular Effects Of Bnpmentioning

confidence: 99%

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Houben¹,

Zander²,

Leeuw³

2005

Fundamemntal Clinical Pharma

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“…It is beneficial in the sense that it may help to relax the pulmonary vasculature and lower pulmonary artery pressure [48,49]. At the same time, however, it constricts systemic postcapillary vessels [50], thereby further enhancing filtration and aggravating transcapillary fluid movements into the tissues. Experimental evidence supports this notion that ANP mediates the contraction of plasma volume during episodes of hypoxaemia [51].…”

Section: Neurohumoral Factorsmentioning

confidence: 99%

Fluid homeostasis in chronic obstructive lung disease

Leeuw¹,

Dees²

2003

Eur Respir J

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Chronic obstructive pulmonary disease (COPD) often leads to massive oedema and the development of what is usually called cor pulmonale. The mechanisms by which patients with COPD retain salt and water are not completely understood. Several abnormalities have been found including reduced renal blood flow with relatively preserved glomerular filtration rate and elevated levels of renin, aldosterone, arginine vasopressin and atrial natriuretic peptide. Generally, these abnormalities worsen with the severity of COPD and are most marked during the oedematous phases.Cardiac output is remarkably normal, suggesting that “cor pulmonale” is not primarily a cardiac disorder but rather a condition of volume overload due to activation of sodiumretaining mechanisms. The stimulus for this activation could be underfilling of the arterial system (reduced effective circulating volume) secondary to a fall in total peripheral vascular resistance. The latter is caused by hypercapniainduced dilation of the precapillary sphincters. Apparently, the massive sodium retention by the kidney is not able to restore the circulating volume and a vicious cycle ensues ultimately leading to a clinical picture which resembles rightsided heart failure. Predictably, only blockade of the effects of carbon dioxide at the level of the precapillary sphincters would be able to halt this process.

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“…ANP reduced basal skin blood flow, nailfold capillary red blood cell velocity and conjunctival capillary density only in the high salt group as compared to placebo. In contrast, low-dose ANP did not exert any effect on microcirculation in subjects under low salt diet [31].…”

Section: Evidence In Humansmentioning

confidence: 62%

Atrial natriuretic peptide and regulation of vascular function in hypertension and heart failure

Rubattu¹,

Calvieri²,

Pagliaro³

et al. 2013

Journal of Hypertension

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Atrial natriuretic peptide (ANP) plays a pivotal role in modulation of vascular function and it is also involved in the pathophysiology of several cardiovascular diseases. We provide an updated overview of the current appraisal of ANP vascular effects in both animal models and humans. We describe the physiological implications of ANP vasomodulatory properties as well as the involvement of ANP, through its control of vascular function, in hypertension and heart failure. The principal molecular mechanisms underlying regulation of vascular tone, that is natriuretic peptide receptor type A/cyclic guanylate monophosphate, natriuretic peptide receptor type C, nitric oxide system, are discussed. We review the literature on therapeutic implications of ANP in hypertension and heart failure, examining the potential use of ANP analogues, neutral endopeptidase (NEP) inhibitors, ACE/NEP inhibitors, angiotensin receptor blocker (ARB)/NEP inhibitors, the new dual endothelin-converting enzyme (ECE)/NEP inhibitors and ANP-based gene therapy. The data discussed support the role of ANP in different pathological conditions through its vasomodulatory properties. They also indicate that ANP may represent an optimal therapeutic agent in cardiovascular diseases.

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Microvascular effects of atrial natriuretic peptide (ANP) in man: studies during high and low salt diet

Abstract: Infusion of low doses of ANP into humans on an ad libitum salt diet results in vasoconstriction of the microcirculation, probably on the venular side. The lack of effect of ANP on the microcirculation during low salt diet may be related to a higher vascular tone prior to infusion.

Cited by 17 publications

References 31 publications

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Fluid homeostasis in chronic obstructive lung disease

Atrial natriuretic peptide and regulation of vascular function in hypertension and heart failure

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