Pro-atrial natriuretic peptide hormone from right atria is correlated with cardiac depression in septic patients

Abstract

N-terminal pro-atrial natriuretic peptide [proANP(1-98)] has been extensively investigated in patients with chronic heart failure and ishemic heart disease. It is found to be a better marker of cardiac dysfunction than atrial natriuretic peptide (ANP). The possible involvement of proANP(1-98) in cardiac depression caused by sepsis has not been studied yet. Therefore, we analyzed atrial plasma concentration of proANP(1-98) in 17 septic patients with hemodynamic variables measured or calculated using pulmonary artery catheter. The results of altogether 96 measurements show a significant negative correlation of proANP(1-98) and cardiac index (p<0.024), oxygen delivery (p<0.03) and oxygen consumption (p<0.03). There is also a positive correlation with pulmonary vascular resistance (p<0.03). ProANP(1-98) is significantly higher in patients who developed acute respiratory distress syndrome (ARDS) (p<0.001). This study implies that proANP(1-98) is a possible novel hormone marker of cardiac depression caused by sepsis that could be used for prediction of ARDS.

Prognostic Value of Plasma N-Terminal Pro-Brain Natriuretic Peptide in Patients With Severe Sepsis

“…Moreover, ANP and NT-proANP have been shown to be negatively correlated to cardiac index and LVSWI, suggesting that natriuretic peptides may serve as markers of cardiac depression in septic patients. 25,29 The results of our study agree with these previous examinations demonstrating that increased plasma levels of NT-proBNP are very likely related to cardiovascular (dys)function as determined from hemodynamic and echocardiographic assessment. We calculated LVSWI to further elucidate left ventricular systolic function because reduced cardiac function is commonly masked by a concomitant elevated cardiac index at the onset of sepsis.…”

Natriuretic Peptides in Septic Patients

“…A similar association of cardiac depression in septic shock has been described for NT-pro-ANP in 17 patients [64,65].…”

“…The number of people developing sepsis is still increasing [64,67]. Approximately 750,000 cases of sepsis occur annually in the United States [61,64,68].…”

Circulating levels of pro‐atrial natriuretic peptide in lower respiratory tract infections

“…Also, after excluding patients with congestive heart failure the results were similar, suggesting that the prognostic accuracy of MR-proANP is not due to the presence of clinically evident congestive heart failure per se. Accordingly, ANP and MR-proANP were recently shown to be helpful in the prognostic assessment of sepsis [3,[34][35][36][37][38]. For optimal preventive measures, it is crucial to assess the risk of patients presenting with lower respiratory tract infections, i.e.…”