Vasoactive peptide release in relation to hemodynamic and metabolic changes during rapid ventricular pacing.
Pacing Clin Electrophysiol
; 22(7): 1064-70, 1999 Jul.
Article
en En
| MEDLINE
| ID: mdl-10456635
ABSTRACT
Plasma atrial natriuretic peptide (ANP) concentration increases during ventricular arrhythmias and rapid ventricular pacing but less is known about plasma brain natriuretic peptide (BNP) and endothelin (ET-1). In the present study concentrations of ANP, the amino terminal part of the proANP (NT-proANP), BNP, and ET-1 were measured in the coronary sinus and femoral artery before and at the end of rapid ventricular pacing in 15 patients with coronary arterial disease. The changes were compared with the changes in mean arterial blood pressure, pulmonary capillary wedge pressure (PCWP), transcardiac differences in pH, pCO2, lactate, and norepinephrine. There was an increase in PCWP and a transient decrease in blood pressure after initiation of pacing. Pacing caused a decrease in ST-segment, transcardiac difference of norepinephrine, lactate extraction, pCO2 difference, and an increase in pH difference. Concentration of ANP in the coronary sinus and femoral artery and its transcardiac difference increased during pacing (P < 0.001), whereas changes in NT-proANP were small and BNP and ET-1 levels remained unchanged. The change in transcardiac ANP difference correlated with the change in lactate (r = 0.53, P < 0.05) but not that of norepinephrine, PCWP, or blood pressure. The results show that the plasma concentration of ANP increases more than that of NT-proANP during rapid ventricular pacing. Ischemia-induced release of ANP and its diminished elimination may contribute to the increased plasma ANP level.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estimulación Cardíaca Artificial
/
Factor Natriurético Atrial
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Endotelina-1
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Péptido Natriurético Encefálico
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Metabolismo Energético
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Frecuencia Cardíaca
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Hemodinámica
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Angina de Pecho
Límite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Pacing Clin Electrophysiol
Año:
1999
Tipo del documento:
Article
País de afiliación:
Finlandia