TY - JOUR
T1 - Atrial natriuretic peptide
T2 - relation to left ventricular filling properties in patients with systemic sclerosis
AU - Kazzam, Elsadig
AU - Caidahl, Kenneth
AU - Hedner, Thomas
AU - Hedner, Jan
AU - Waldenström, Anders
N1 - Funding Information:
This study was supported by the Torsten och Ragnar Soderbergs Foundation, the Swedish Heart and Lung Foundation, the Ake Wisberg Foundation, Uppsala University Medical Faculty, the Eris 50-yearsF und, the Lisa Verdins Fund, the Swedish Medical Association and the Swedish Medical Research Council (project 08642).
PY - 1994/12
Y1 - 1994/12
N2 - To determine the relation between left ventricular filling properties and plasma atrial natriuretic peptide in systemic sclerosis, we evaluated 30 consecutive patients and 48 age- and sex-matched controls. The venous plasma atrial natriuretic peptide was measured by radio-immunoassay. Left ventricular involvement was evaluated by echocardiography and mitral regurgitation was evaluated by Doppler. The patient group had markedly elevated plasma atrial natriuretic peptide as compared to the matched controls (239.4 ± 59 vs. 178.2 ± 36 pmol/l, P < 0.0005). We found signs of impaired left ventricular filling properties among the patients, with an increase of the Doppler A-wave velocity and A E ratio. A relative reduction of early filling was found in spite of some degree of mitral regurgitation in two-thirds of the patients. The plasma atrial natriuretic peptide concentration was related to the A-wave velocity (r = 0.44, P < 0.0005), the A E ratio (r = 0.40, P < 0.005), and also to the degree of mitral regurgitation (r = 0.43, P < 0.005). The relationship to the A-wave velocity remained when considering possible confounding factors. We conclude that the previously observed fibrotic process in systemic sclerosis does not prevent production and liberation of plasma atrial natriuretic peptide in relation to factors distending the left atrium, such as altered left ventricular filling properties and the presence of mitral regurgitation. However, the moderate relationships between atrial natriuretic peptide and haemodynamic variables indicate that the peptide might also be an independent indicator of cardiac involvement in systemic sclerosis.
AB - To determine the relation between left ventricular filling properties and plasma atrial natriuretic peptide in systemic sclerosis, we evaluated 30 consecutive patients and 48 age- and sex-matched controls. The venous plasma atrial natriuretic peptide was measured by radio-immunoassay. Left ventricular involvement was evaluated by echocardiography and mitral regurgitation was evaluated by Doppler. The patient group had markedly elevated plasma atrial natriuretic peptide as compared to the matched controls (239.4 ± 59 vs. 178.2 ± 36 pmol/l, P < 0.0005). We found signs of impaired left ventricular filling properties among the patients, with an increase of the Doppler A-wave velocity and A E ratio. A relative reduction of early filling was found in spite of some degree of mitral regurgitation in two-thirds of the patients. The plasma atrial natriuretic peptide concentration was related to the A-wave velocity (r = 0.44, P < 0.0005), the A E ratio (r = 0.40, P < 0.005), and also to the degree of mitral regurgitation (r = 0.43, P < 0.005). The relationship to the A-wave velocity remained when considering possible confounding factors. We conclude that the previously observed fibrotic process in systemic sclerosis does not prevent production and liberation of plasma atrial natriuretic peptide in relation to factors distending the left atrium, such as altered left ventricular filling properties and the presence of mitral regurgitation. However, the moderate relationships between atrial natriuretic peptide and haemodynamic variables indicate that the peptide might also be an independent indicator of cardiac involvement in systemic sclerosis.
KW - Atrial natriuretic peptide
KW - Diastolic function
KW - Echocardiography
KW - Left ventricle
KW - Mitral regurgitation
KW - Systemic sclerosis
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U2 - 10.1016/0167-5273(94)90182-1
DO - 10.1016/0167-5273(94)90182-1
M3 - Article
C2 - 7721483
AN - SCOPUS:0028063625
SN - 0167-5273
VL - 47
SP - 151
EP - 156
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 2
ER -