Role of atrial natriuretic peptide and urinary cGMP in the natriuretic and diuretic response to central hypervolemia in normal human subjects

Leung, Wai Ming; Logan, Alexander G.; Campbell, Peter J.; Dębowski, Tomasz; Bull, Shelley B.; Wong, P. Y.; Blendis, Laurence M.; Skorecki, Karl

doi:10.1139/y87-325

Cited by 20 publications

(6 citation statements)

References 15 publications

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“…HR responses are similarly conflicting, with studies reporting increases (5,7,10,11,29,44) and decreases (14 -16, 22, 27, 33, 37, 38). Finally, MAP responses have also reported increases (5,33), decreases (25,32), or no change (10,16,31). These conflicting results are related to differences in methodology, in particular posture, the duration of immersion, and water temperature, as highlighted in a study by Park et al (33), all of which may elicit reflex changes.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular responses to water immersion in humans: impact on cerebral perfusion

Carter

Spence

Pugh

et al. 2014

American Journal of Physiology-Regulatory, Integrative and Comp

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Episodic increases in cerebrovascular perfusion and shear stress may have beneficial impacts on endothelial function that improve brain health. We hypothesized that water immersion to the level of the right atrium in humans would increase cerebral perfusion. We continuously measured, in 9 young (means ± SD, 24.6 ± 2.0 yr) healthy men, systemic hemodynamic variables along with blood flows in the common carotid and middle and posterior cerebral arteries during controlled filling and emptying of a water tank to the level of the right atrium. Mean arterial pressure (80 ± 9 vs. 91 ± 12 mmHg, P < 0.05), cardiac output (4.8 ± 0.7 vs. 5.1 ± 0.6 l/min, P < 0.05) and end-tidal carbon dioxide (PetCO2, 39.5 ± 2.0 vs. 44.4 ± 3.5 mmHg, P < 0.05) increased with water immersion, along with middle (59 ± 6 vs. 64 ± 6 cm/s, P < 0.05) and posterior cerebral artery blood flow velocities (41 ± 9 vs. 44 ± 10 cm/s, P < 0.05). These changes were reversed when the tank was emptied. Water immersion is associated with hemodynamic and PetCO2 changes, which increase cerebral blood velocities in humans. This study provides an evidence base for future studies to examine the potential additive effect of exercise in water on improving cerebrovascular health.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular responses to water immersion in humans: impact on cerebral perfusion

Carter

Spence

Pugh

et al. 2014

American Journal of Physiology-Regulatory, Integrative and Comp

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“…Therefore, cyclic GMP in many cases appears to be a sensitive marker for the action of ANP in humans. Leung et al [32] demonstrated that urinary cyclic GMP excretion rose significantly by the initial hour of immer sion and that this increase was sustained and, indeed, tended to increase during 3 h of immersion. Cessation of immersion was associated with a decline in cyclic GMP, although the levels continued to exceed that of the preimmersion hour.…”

Section: Urinary Cyclic Nucleotide Excretion During Immersionmentioning

confidence: 97%

“…Leung et al [32] demonstrated that water immersion in sodium-replete normal subjects was associated with a prompt doubling of ANP by 30 min of immersion with a 2-fold ANF = Atrial natriuretic factor; UnsV = urinary sodium excre tion; NR = not reported; FR = overnight fluid restricted. All studies investigated the subjects in the seated posture and in thermoneutral water (34.5 ± 0.5 °C).…”

Section: Effects O F Wi To the Neck On Plasma Anpmentioning

confidence: 99%

Effects of Water Immersion on Atrial Natriuretic Peptide Release in Humans

Epstein

Norsk²,

Loutzenhiser³

1989

Am J Nephrol

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Water immersion (WI) to the neck induces prompt increases in central blood volume, central venous pressure, and atrial distension. Since atrial distension is a major stimulus for atrial natriuretic peptide (ANP) release, WI constitutes a unique model to investigate the physiological importance of ANP in humans. All studies to date demonstrate that ANP increases during the 1st h of WI in hydrated subjects, rising 2.5- to 3-fold by the end of the 2nd or 3rd h. During recovery from WI, ANP returns promptly to prestudy levels. Although distension of the atria probably constitutes the major stimulus for ANP release during WI, other mechanisms may coexist. In normal hydrated subjects undergoing WI, the increases in ANP correlate with the magnitude of the natriuresis, suggesting that ANP constitutes an important determinant of renal sodium handling in humans. It is simplistic, however, to consider the Wl-induced augmentation of ANP to be the sole, or even the prepotent, mediator of the resultant natriuresis. Rather ANP should be considered as one of several hormonal, neural, and hemodynamic factors acting in concert in an integrated matrix to modulate volume homeostasis. Clearly, the results of several recent studies utilizing WI demonstrate that this maneuver constitutes an important investigative model to delineate further the role of ANP in subserving volume homeostasis in normal humans and in disorders of deranged volume regulation.

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“…Because ANF release is mediated at least in part by atrial stretch (19), HWI has been found to increase pANF in normal subjects (20) and in cirrhotic patients (21-23). This rise in pANF levels is associated with a rise in levels of urinary 5' cyclic guanosine monophosphate (cGMP), its second messenger (23)(24)(25)(26), in normal subjects (24) and in cirrhotic patients with ascites (25). However, the natriuretic response to HWI in cirrhotic patients with ascites has allowed us to categorize them into two groups: responders and nonresponders (23).…”

Section: Laurence M Blendis'mentioning

confidence: 99%

Refractory ascites in cirrhosis: Roles of volume expansion and plasma atrial natriuretic factor level elevation

et al. 1993

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Cirrhotic patients with ascites refractory to diuretics also have blunted response to marked elevations of plasma atrial natriuretic factor levels alone or to moderate intravascular volume expansion by head-out water immersion. However, these patients usually undergo natriuresis after peritoneovenous shunting. To dissect the factors responsible for this response, we studied the effects on separate days of moderate intravascular volume expansion and highly elevated plasma atrial natriuretic factor levels (head-out water immersion and atrial natriuretic factor infusion) or marked volume expansion and moderate plasma atrial natriuretic factor level elevation (head-out water immersion and albumin infusion) in 13 alcoholic cirrhotic patients with massive ascites. Three of these patients, who responded to initial head-out water immersion with a negative sodium balance, served as controls. Unresponsiveness to head-out water immersion was confirmed in the remaining 10 patients on both days on the basis of blunted natriuretic response (urinary sodium excretion < 0.8 mmol/hr after 2 hr). In contrast, these 10 refractory patients were able to achieve negative sodium balance with both combinations. Mean urinary sodium excretion increased from a baseline level of 0.13 +/- 0.10 mmol/hr to a peak level of 2.29 +/- 0.61 mmol/hr after head-out water immersion and atrial natriuretic factor infusion and from 0.10 +/- 0.3 mmol/hr to 1.61 +/- 0.62 mmol/hr after head-out water immersion and albumin infusion. Both maneuvers were associated with suppression of plasma renin activity and serum aldosterone levels. With head-out water immersion and atrial natriuretic factor infusion, we noted a significant increase in 5' cyclic GMP levels, a second messenger of atrial natriuretic factor, indicating possible activation of atrial natriuretic factor receptors at the inner medullary collecting ducts. In contrast, with head-out water immersion and albumin infusion no such increase in levels occurred, indicating that the increase in urinary sodium excretion was mainly due to increased delivery of sodium to the cortical distal nephron, as indicated by a disproportionate increase in urinary potassium excretion. In conclusion, massive (as opposed to moderate) volume expansion or greatly elevated levels of plasma atrial natriuretic factor associated with moderate volume expansion can improve blunted atrial natriuretic factor responsiveness in cirrhotic patients with refractory ascites. This appears to be achieved by way of a marked increase in distal delivery of filtrate in the kidney, with or without activation of distal atrial natriuretic factor receptors in the inner medullary collecting ducts.

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Role of atrial natriuretic peptide and urinary cGMP in the natriuretic and diuretic response to central hypervolemia in normal human subjects

Cited by 20 publications

References 15 publications

Cardiovascular responses to water immersion in humans: impact on cerebral perfusion

Cardiovascular responses to water immersion in humans: impact on cerebral perfusion

Effects of Water Immersion on Atrial Natriuretic Peptide Release in Humans

Refractory ascites in cirrhosis: Roles of volume expansion and plasma atrial natriuretic factor level elevation

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