Plasma levels of atrial natriuretic factor (ANF) and urinary excretion of ANF, arginine vasopressin and catecholamines in children with congenital heart disease: effect of cardiac surgery

Abstract

We studied the changes in the plasma concentration of atrial natriuretic factor (ANF) and the urinary excretion of ANF, arginine vasopressin (AVP) and catecholamines in 22 children with congenital heart disease, divided into two groups. Group 1 included 11 children with congestive heart failure (CHF), treated with digitalis and diuretics. Group 2 included 11 children without CHF and without medical treatment. Each group was compared with a control group of 15 healthy, age-matched children. The plasma concentration of ANF was raised in both groups, but it was significantly higher in group 1 (235.5 +/- 82.9 pg/ml), compared to group 2 (48.4 +/- 29.4 pg/ml, P < 0.002). Urinary excretion of ANF was measurable in both groups and higher in group 1 (185.9 +/- 116.2 pg/kg per h) than in group 2 (48.5 +/- 30.7 pg/kg per h), but not significantly so. Urinary excretion of AVP and catecholamines was not different in children with congenital heart disease and healthy children. Twenty-four hours after surgery, plasma ANF diminished in group 1 (from 235.5 +/- 82.9 to 93.4 +/- 53.8 pg/ml, P < 0.003), but did not change in group 2. The urinary excretion of ANF was unchanged in both groups. In contrast, urinary excretion of AVP and catecholamines rose significantly in both groups. These data show that plasma ANF is increased in children with congenital heart disease, even in the absence of CHF. The measurement of urinary ANF is less reliable than a plasma assay. The postoperative increases in AVP and catecholamine urinary excretions could be responsible for the vasoconstriction and water retention typical of the postoperative period.

Increased circulating big endothelin-1, endothelin-1 and atrial natriuretic peptide in infants and children with heart failure secondary to congenital heart disease

“…Increments in plasma ANP levels contribute to the compensatory actions in CHF. Plasma ANP levels have been found increased in children with CHD, even in the absence of CHF by some investigators [22]. However, our study found increases only in those patients with CHF.…”

Serum N‐terminal atrial natriuretic peptide in adult patients late after surgical repair of atrial septal defect

“…High atrial peptide concentrations have been reported in children with congenital heart diseases with pressure and/or volume overload, especially when heart failure is present []. In children the plasma concentrations of atrial peptide may diminish [,] or remain elevated [] 24–48 h after an operation for congenital heart disease. These studies, however, were done with children under the age of 15 years and several types of congenital heart diseases were included.…”

Plasma Atrial Natriuretic Peptide in Fetuses with Cardiac Disease

“…The overall recovery of ANP ( 8 SD) was 94.8% (5.9) with a detection limit of 1 pg/ml. Using previously reported data [14,15] , we calculated that a sample of 26 cases and 13 controls was needed to show a difference with an ␣ level of 0.05 and a power (1 -␤ ) of 80%. We enrolled 1 more woman in each group to account for withdrawals.…”