Atrial Natriuretic Peptide Concentrations and Pulmonary Hemodynamics in Patients with Pulmonary Artery Hypertension

Adnot, Serge; Chabrier, P; Andrivet, Pierre; Viossat, Isabelle; Piquet, J.; Brun‐Buisson, Christian; Gutkowska, Y.; Braquet, P.

doi:10.1164/ajrccm/136.4.951

Cited by 83 publications

(50 citation statements)

References 19 publications

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“…The magnitude of the PAP response was dose dependent, with the drop of PAP being more profound after 5 ,ug than after 0.5 ,ug rat ANF (p<0.05). However, CO, heart rate, and SAP remained unchanged.…”

Section: Titer Ofadministered Mab In Rats In Ivomentioning

confidence: 88%

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Pulmonary vasodilatory action of endogenous atrial natriuretic factor in rats with hypoxic pulmonary hypertension. Effects of monoclonal atrial natriuretic factor antibody.

Raffestin

Levame

Eddahibi

et al. 1992

Circulation Research

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We administered ascitic fluid containing atrial natriuretic factor (ANF) monoclonal antibody to rats after 3 weeks of exposure to hypoxia while the rats were still hypoxic. In additional chronically hypoxic rats, we infused synthetic rat ANF. In conscious chronically instrumented rats, after a bolus dose of 5 ,ug i.v. ANF, pulmonary arterial pressure fell significantly from 26.5±2 to 21±2 mm Hg (p<0.01), reaching its nadir at 5 minutes without change of systemic arterial pressure, cardiac output, or heart rate. Pulmonary arterial pressure increased gradually from 26±4 to 34±4 mm Hg within 30 minutes (p<0.05) after acute administration of ANF monoclonal antibody and decreased transiently to return to baseline within 15 minutes after infusion of control ascitic fluid containing monoclonal antibody against an apolipoprotein. Cardiac output and heart rate remained unchanged after both ANF monoclonal antibody and control ascitic fluid. In normoxic rats, acute administration of ANF monoclonal antibody did not cause significant changes in pulmonary arterial pressure, cardiac output, or heart rate.Rats receiving weekly intravenous injections of ANF monoclonal antibody that were started before initiation of exposure to hypoxia experienced significantly aggravated pulmonary hypertension and right ventricular hypertrophy compared with rats receiving repeated infusions of control ascitic fluid. However, there was no significant difference in small pulmonary arterial wall thickness or percentage of muscularized arteries at the alveolar duct level. These results suggest that endogenous ANF attenuates hypoxic pulmonary hypertension by decreasing pulmonary vascular tone. (Circulation Research 1992;70:184-192) Several laboratories, including ours, have documented increased plasma levels of atrial natriuretic factor (ANF) in animals exposed to chronic hypoxia1-3 as well as humans exposed to high altitude4 or patients suffering from chronic obstructive lung disease.5 In a previous study, we found that gene expression for ANF is enhanced in both right and left ventricles of chronically hypoxic rats, suggesting that during chronic hypoxia, production of ANF by the ventricles may contribute to the high levels of circulating ANF.1 Several lines of evidence suggest that ANF may play a compensatory role in the pathophysiology of hypoxic pulmonary hypertension. ANF shown to be a potent vasorelaxant of the pulmonary circulation when its tone has been increased by hypoxia or various constrictor agonists. It relaxes precontracted isolated pulmonary vessels of guinea pigs, pigs, and humans.67 Administration of ANF blunts pulmonary vasoconstriction induced by acute hypoxia in conscious rats and in anesthetized rats, dogs, and pigs.8-1' Experiments using the isolated lung of chronically hypoxic rats have demonstrated significant vasorelaxant effects of ANF.12 Acute administration of synthetic ANF in patients with chronic obstructive lung disease and pulmonary hypertension causes pulmonary vasodilation, increase of cardiac output (CO) an...

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Section: Titer Ofadministered Mab In Rats In Ivomentioning

confidence: 88%

“…In additional chronically hypoxic rats, we infused synthetic rat ANF. In conscious chronically instrumented rats, after a bolus dose of 5 ,ug i.v. ANF, pulmonary arterial pressure fell significantly from 26.5±2 to 21±2 mm Hg (p<0.01), reaching its nadir at 5 minutes without change of systemic arterial pressure, cardiac output, or heart rate.…”

mentioning

confidence: 99%

Pulmonary vasodilatory action of endogenous atrial natriuretic factor in rats with hypoxic pulmonary hypertension. Effects of monoclonal atrial natriuretic factor antibody.

Raffestin

Levame

Eddahibi

et al. 1992

Circulation Research

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“…This retrospective analysis showed NT-proBNP to be an independent predictor of mortality. Plasma ANP is significantly increased in PH of varying aetiologies and, like BNP, correlates with haemodynamic variables [35][36][37][38]. ANP may better reflect short-term haemodynamic changes, owing to different patterns of synthesis, secretion and clearance than BNP [23].…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Biomarkers in pulmonary hypertension

Warwick

Thomas²,

Yates³

2008

European Respiratory Journal

137

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There have been significant recent advances in the understanding of the pathophysiology of pulmonary hypertension, and a growing number of therapeutic agents have become available to the treating physician. Traditional methods of diagnosing and monitoring this condition have comprised echocardiography and right heart catheterisation, in addition to functional measures, such as estimation of functional class and the 6-min walk test. An increasing number of biomarkers have been described that are elevated in pulmonary hypertension and which may assist the clinician in diagnosis and in the assessment of disease severity and response to treatment.The present article details the more important biomarkers, their potential applications and the evidence supporting their use.

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“…In patients with PH, a high level of plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) negatively correlates with parameters of RV function [126][127][128]. Following prostacyclin treatment, the decreases in both ANP and BNP parallel pulmonary vasodilatation and haemodynamic improvement [127,128].…”

Section: Natriuretic Peptidesmentioning

confidence: 99%

Haemodynamic evaluation of pulmonary hypertension

Chemla¹,

Castelain²,

Hervé³

et al. 2002

European Respiratory Journal

302

185

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Haemodynamic evaluation of pulmonary hypertension. D. Chemla, V. Castelain, P. Hervé, Y. Lecarpentier, S. Brimioulle. #ERS Journals Ltd 2002. ABSTRACT: Pulmonary hypertension is characterised by the chronic elevation of pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) leading to right ventricular enlargement and hypertrophy. Pulmonary hypertension may result from respiratory and cardiac diseases, the most severe forms occurring in thromboembolic and primary pulmonary hypertension.Pulmonary hypertension is most often defined as a mean PAP w25 mmHg at rest or w30 mmHg during exercise, the pressure being measured invasively with a pulmonary artery catheter. Doppler echocardiography allows serial, noninvasive follow-up of PAPs and right heart function. When the adaptive mechanisms of right ventricular dilatation and hypertrophy cannot compensate for the haemodynamic burden, right heart failure occurs and is associated with poor prognosis.The haemodynamic profile is the major determinant of prognosis. In both primary and secondary pulmonary hypertension, special attention must be paid to the assessment of pulmonary vascular resistance index (PVRI), right heart function and pulmonary vasodilatory reserve.Recent studies have stressed the prognostic values of exercise capacity (6-min walk test), right atrial pressure, stroke index and vasodilator challenge responses, as well as an interest in new imaging techniques and natriuretic peptide determinations. Overall, careful haemodynamic evaluation may optimise new diagnostic and therapeutic strategies in pulmonary hypertension.

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Atrial Natriuretic Peptide Concentrations and Pulmonary Hemodynamics in Patients with Pulmonary Artery Hypertension

Cited by 83 publications

References 19 publications

Pulmonary vasodilatory action of endogenous atrial natriuretic factor in rats with hypoxic pulmonary hypertension. Effects of monoclonal atrial natriuretic factor antibody.

Pulmonary vasodilatory action of endogenous atrial natriuretic factor in rats with hypoxic pulmonary hypertension. Effects of monoclonal atrial natriuretic factor antibody.

Biomarkers in pulmonary hypertension

Haemodynamic evaluation of pulmonary hypertension

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