Cardiovascular Function during Brain Natriuretic Peptide Infusion in Man

Lazzeri, Chiara; G, La Villa; Bisi, G; Boddi,; Messeri, Gianni; Strazzulla, G; Franchi, F

doi:10.1159/000176909

Cited by 15 publications

(8 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, changes in preload as well as in inotropism might compensate for the reduction in afterload induced by vasodilation, 40 resulting in the maintenance of CO and arterial pressure. Indeed, such a phenomenon has been observed by our group in healthy subjects 26 and patients with essential hypertension 27 receiving low-dose BNP. In fact, BNP significantly reduced LV EDVI and stroke volume, whereas CO did not decline, due to compensatory increases in HR and in LV emptying, as indicated by increments in ejection fraction and reductions in ESVI.…”

Section: Discussionsupporting

confidence: 56%

“…25 We recently showed that intravenous infusion of low-dose BNP markedly affects cardiac function in the absence of any appreciable changes in CO and peripheral vascular resistance. 26,27 These considerations prompted us to evaluate cardiac volumes, filling and emptying dynamics, and systemic hemodynamic parameters during CNP infusion. In addition, we assessed the renal effects of CNP by evaluating RPF, GFR, and intrarenal sodium handling.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Low-Dose C-Type Natriuretic Peptide Does Not Affect Cardiac and Renal Function in Humans

et al. 1998

Self Cite

View full text Add to dashboard Cite

Abstract-In experimental animals, C-type natriuretic peptide (CNP) has vasodilating, hypotensive, and natriuretic activities.The role of circulating CNP in the overall regulation of cardiac and renal function in humans is less defined, in both health and disease. We measured cardiac volumes, diastolic and systolic functions, systemic (Doppler echocardiography) and renal hemodynamics, intrarenal sodium handling (lithium clearance method), plasma and urinary cGMP, plasma renin concentration, and plasma aldosterone level in six healthy volunteers (mean age, 33Ϯ3 years) receiving CNP (2 and 4 pmol/kg per minute for 1 hour each) in a single-blind, placebo-controlled, random-order, crossover study. During CNP infusion, plasma CNP increased from 1.17Ϯ0.23 to 41.52Ϯ4.61 pmol/L (ie, 4-to 10-fold higher levels than those observed in disease states) without affecting plasma and urinary cGMP, cardiac volumes, dynamics of left and right heart filling, cardiac output, arterial pressure, renal hemodynamics, intrarenal sodium handling, sodium excretion, or plasma levels of renin and aldosterone. The finding that increments in plasma CNP within the pathophysiological range have no effects on systemic hemodynamics, renal function, or the renin-angiotensin system do not support the hypothesis that CNP may act as a circulating hormone in humans. (Hypertension. 1998;31:802-808.)Key Words: echocardiography Ⅲ hemodynamics Ⅲ systole Ⅲ diastole Ⅲ natriuretic peptides T he natriuretic peptide system consists of at least three structurally homologous peptides: ANP, BNP, and CNP. ANP and BNP are cardiac hormones that contribute to the overall regulation of cardiovascular homeostasis and fluid volume due to their natriuretic, vasodilating, and renin-aldosterone-inhibiting actions.1,2 CNP, first isolated in porcine brain, 3 is a 22-amino acid peptide that shares a high homology with ANP and BNP within the ring structure but lacks the carboxyl-terminal extension. 3Outside the central nervous system, CNP is mainly produced by the vascular endothelium, [4][5][6] in which it is thought to act as a local paracrine factor for the control of vascular tone. Endothelial production of CNP is remarkably augmented by various cytokines and growth factors such as transforming growth factor-␤ and tumor necrosis factor-␣, suggesting that CNP may be of pathophysiological relevance in various vascular disorders.7 Like the other natriuretic peptides, CNP is detectable in plasma of healthy subjects, although at much lower concentrations than ANP and BNP. 4,8 -13 Plasma CNP levels are increased in patients with chronic renal failure, 9,10 septic shock, 11 and cor pulmonale, 12 raising the possibility that CNP may be a circulating hormone involved in the regulation of cardiovascular function. CNP exerts its biological effects by selectively activating the NPR-B, 14,15 leading to an increase in cGMP in target cells. In experimental animals, the administration of CNP induces vasodilation of both arteries and veins 16 ; reduces cardiac filling pressures, 17 CO,18,1...

show abstract

Section: Discussionsupporting

confidence: 56%

mentioning

confidence: 99%

Low-Dose C-Type Natriuretic Peptide Does Not Affect Cardiac and Renal Function in Humans

et al. 1998

Self Cite

View full text Add to dashboard Cite

show abstract

“…Previous studies using similar doses and long continuous infusion of ANP and BNP showed increase of HR (up to 20%) and decrease of MAP (up to 6%), as well as being diuretic [37][38][39][40]. In the pilot study using very high pharmacological doses, we also saw an effect on STA but not on radial artery.…”

Section: Discussionsupporting

confidence: 64%

Effect of natriuretic peptides on cerebral artery blood flow in healthy volunteers

et al. 2015

View full text Add to dashboard Cite

“…The observed decrease in plasma BNP in response to posture‐induced changes in central volume could even be a compensating mechanism to prevent orthostatic hypotension. Infusion of low doses of BNP into normal subjects does not reduce peripheral vascular resistance or CO, while it decreases stroke volume [20,22]. This suggests that BNP does not primarily affect the arterial vascular bed, but rather reduces preload, possibly by lowering venous return.…”

Section: Central Hemodynamic Effects Of Bnpmentioning

confidence: 99%

“…Normal plasma levels of BNP vary from 4 to 35 pg/mL (or 1.2-10 pmol/L) [17][18][19][20][21][22][23][24][25][26][27] (for review see [28]). These levels rise with age and are higher in females than in males [17].…”

Section: Introductionmentioning

confidence: 99%

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Houben¹,

Zander²,

Leeuw³

2005

Fundamemntal Clinical Pharma

View full text Add to dashboard Cite

During the last decade brain natriuretic peptide (BNP) has received increasing attention as a potential marker of cardiovascular disease. BNP may act as a compensating mechanism in cardiovascular diseases in order to reduce preload. However, the increase in endogenous BNP is often not sufficient to compensate for volume overload in diseases like established hypertension and heart failure. The reported hemodynamic and renal effects of BNP in man differ largely between studies, because of differences in design and doses of BNP employed. In the pharmacological range, BNP has clear blood pressure and afterload lowering effects, and in the kidney blood flow and filtration is increased with concomitant natriuresis and diuresis. While in the physiological range BNP does not affect blood pressure and reduces preload only, and induces natriuresis/diuresis without changes in renal blood flow and filtration. There is increasing evidence from vascular studies that BNP preferentially acts on the venous system resulting in preload reduction, in contrast to atrial natriuretic peptide which acts preferentially on the arterial system to reduce afterload. This review summarizes our current understanding of BNP, and discuss its regulation and mechanisms of action on the vasculature and the kidneys.

show abstract

Cardiovascular Function during Brain Natriuretic Peptide Infusion in Man

Cited by 15 publications

References 14 publications

Low-Dose C-Type Natriuretic Peptide Does Not Affect Cardiac and Renal Function in Humans

Low-Dose C-Type Natriuretic Peptide Does Not Affect Cardiac and Renal Function in Humans

Effect of natriuretic peptides on cerebral artery blood flow in healthy volunteers

Vascular and renal actions of brain natriuretic peptide in man: physiology and pharmacology

Contact Info

Product

Resources

About