Acute effects of ANP and BNP on hypoxic pulmonary vasoconstriction in humans.

Abstract

1 Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) have pulmonary vasorelaxant activity with plasma concentrations being elevated in patients with hypoxaemic pulmonary hypertension. However, their effects on acute hypoxic pulmonary vasoconstriction (HPV), the initiating stimulus for pulmonary hypertension have not to date been investigated. We have therefore studied the effects of ANP and BNP on acute HPV in humans. 2 Eight healthy volunteers were studied on three separate occasions. After reaching a resting haemodynamic state (to), an infusion of either ANP (10 pmol kg-1 min-'), BNP (10 pmol kg-1 min-1) or placebo (5% dextrose) was commenced. This was given alone for 30 min (t30) before subjects were rendered hypoxaemic (SaO2 75-80%) for a further 30 min (t60), with the initial infusion continuing to t60. Pulsed-wave Doppler analysis of pulmonary artery flow was used to measure mean pulmonary arterial pressure (MPAP) and hence total pulmonary vascular resistance (PVR) was calculated. Keywords natriuretic peptides hypoxaemia pulmonary circulation Introduction remains unknown but the beneficial effects of lung blood flow redistribution are more clear. Vasoconstriction in The vasoconstriction of the mammalian pulmonary areas of alveolar hypoxia leads to diversion of blood vasculature in response to hypoxia has intrigued physiol-flow away from hypoxic regions hence improving overall ogists since the phenomenon was first described by Von ventilation/perfusion matching [2]. This response can, Euler & Liljestrand [ 1]. The exact mechanism under-however, be detrimental if hypoxia is chronic and affects lying acute hypoxic pulmonary vasoconstriction (HPV) the whole lung, as is seen in hypoxaemic chronic

Preserved pulmonary vasodilative properties of aerosolized brain natriuretic peptide

“…Consequently, BNP is a vasodilator in various tissues [11]. The intravascular application of exogenous BNP has been shown to blunt acute hypoxic pulmonary vasoconstriction in rat lungs [12] and healthy volunteers [13]. In addition, M A N U S C R I P T…”

“…Although a direct BNP induced vasodilation has never been described in a quasi in vivo setting in non hypoxia mediated pulmonary vasoconstriction, this observation is in accordance to the previously reported data from acute and chronic hypoxia. For example, intravascular application of BNP partially antagonised acute hypoxia induced pulmonary vasoconstriction in an experimental study [21] and in healthy volunteers [13]. In addition, mice lacking the natriuretic peptide A receptor encoding gene have an increased susceptibility to hypoxia mediated pulmonary vascular remodelling [22].…”

Pulmonary hypertension in patients with stage 1-3 chronic kidney disease

“…It was reported that BNP was related to PASP in primary PH (Leuchte et al, 2004), and a supplementary dose of BNP reduces PASP levels (Cargill and Lipworth, 1995). BNP is a sensitive and specific predictor of LV systolic failure (Vasan et al, 2002), a very useful tool to confirm LV diastolic dysfunction (LVEF ≥ 45-50%) (Wei et al, 2005) and is in accordance with volume overload (Kunii et al, 2003) at the same time.…”

Chronic obstructive pulmonary disease and pulmonary hypertension: brain natriuretic peptide as a marker of pulmonary hypertension

“…BNP вызывают расслабление гладких мышц со судов, что приводит к снижению давления крови и постнагрузки желудочков [22][23][24].…”

“…В пред ставленном исследовании у больных ХОБЛ даже без признаков ЛГ концентрация BNP в плазме была вы ше по сравнению со значением этого показателя у лиц, не страдавших легочно сердечной патологи ей [31]. Представляют интерес результаты ранее про веденных исследований, которые показали роль гипоксии [22,25,32,33], уровня эндотелина 1 [26], С реактивного белка [34], интерлейкина 6 [35] в по вышении концентрации BNP в плазме крови.…”