The beneficial effects of atrial natriuretic peptide on arrhythmias and myocardial high-energy phosphates after reperfusion

Takata, Yasuyuki; Hirayama, Yoji; Kiyomi, Sadamichi; Ogawa, Takashi; Iga, Kentaro; Ishii, Toshiharu; Nagai, Yoshiko; Ibukiyama, Chiharu

doi:10.1016/0008-6363(96)00076-4

Cited by 37 publications

(21 citation statements)

References 21 publications

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“…[4][5][6] Thereafter, several trials were conducted to determine the benefi cial role of ANP/BNP infusion on AMI; however, the results were confl icting. In order to provide a more robust evaluation of the potential benefi ts of ANP/BNP infusion in AMI patients, we performed a systematic review and meta-analysis.…”

Section: Discussionmentioning

confidence: 99%

“…3) Previous experimental studies revealed that natriuretic peptide infusion could limit myocardial infarct size and prevent reperfusion arrhythmia in myocardial ischemia-reperfusion injured rats. [4][5][6] Thereafter, several trials were conducted to determine the benefi cial role of ANP/BNP infusion on AMI; however, the results were confl icting. In order to provide a more robust evaluation of the potential benefi ts of ANP/BNP infusion in AMI patients, we performed a systematic review and meta-analysis.…”

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confidence: 99%

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Natriuretic Peptides as an Adjunctive Treatment for Acute Myocardial Infarction

et al. 2014

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SummaryAnimal studies have reported a cardioprotective effect for atrial natriuretic peptide (ANP) or brain natriuretic peptide (BNP) administration in the setting of acute myocardial infarction (AMI). However, previous trials performed on AMI patients have reported differences in the cardiac function protection for ANP/BNP infusion, making it diffi cult to confi rm the benefi cial effect of natriuretic peptides. We performed a meta-analysis of all available trials to determine whether ANP/BNP infusion was effective in improving cardiac function. Methods: We searched various databases including PubMed, EMBASE, Web of Knowledge, the Cochrane Library, and CKNI for studies related to ANP/BNP infusion in AMI. The major outcome was left ventricular ejection fraction (LVEF). Results: Twenty trials (4 for ANP, 16 for BNP) with 1389 patients were included. There were no signifi cant differences in patient characteristics between the ANP/BNP infusion and control groups at baseline. Pooled analysis showed that patients in the ANP/BNP infusion group had signifi cantly higher LVEF than in the control during follow-up [Studies on ANP: weighted mean differences (WMD) 2.94%, 95% confi dence interval (CI): 1.39%-4.50%, P = 0.0002; Studies on BNP: WMD 4.45%, 95%CI: 2.25%-6.65%, (PPCI) or thrombolysis therapy could reestablish normal epicardial blood fl ow in most cases after onset of acute myocardial infarction (AMI), myocardial damage is still usually unavoidable and may result in heart failure caused by adverse left ventricular remodeling. Under these circumstances, effective adjunct therapies are necessary to improve the prognosis of AMI. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) have been approved to treat heart failure.1,2) They share similar biological actions such as suppressing the renin-angiotensin-aldosterone system and sympathetic system.3) Previous experimental studies revealed that natriuretic peptide infusion could limit myocardial infarct size and prevent reperfusion arrhythmia in myocardial ischemia-reperfusion injured rats. [4][5][6] Thereafter, several trials were conducted to determine the benefi cial role of ANP/BNP infusion on AMI; however, the results were confl icting. In order to provide a more robust evaluation of the potential benefi ts of ANP/BNP infusion in AMI patients, we performed a systematic review and meta-analysis. MethodsSearch strategy: We searched the databases such as PubMed, EMBASE, Web of Knowledge, the Cochrane Library, and China National Knowledge Infrastructure (CKNI) (all from their inception to March 2013). The search terms were as follows: natriuretic peptide, cardiac peptide, atrial natriuretic peptide, atrium natriuretic peptide, carperitide, brain natriuretic peptide, B-type natriuretic peptide, nesiritide, acute myocardial infarction, acute heart infarction, ST-segment elevated myocardial infarction, ST-segment elevation myocardial infarction, non-ST-segment elevated myocardial infarction, non-ST-segment elevation myocardial infarction, therapy, treatm...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Natriuretic Peptides as an Adjunctive Treatment for Acute Myocardial Infarction

et al. 2014

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“…15 Moreover, in an animal model for ischemia -reperfusion injury, hANP administration attenuated the incidence of arrhythmias by preventing the decrease in myocardium internal high-energy phosphate. 16 Takagi et al have reported that administration of hANP after LAD occlusion resulted in an increase of collateral blood flow and a decrease in the size of the infarct in an animal experiment. 17 In Japan, a large-scale clinical study has been undertaken to investigate the effectiveness of hANP administration after PCI in patients with AMI, and promising results are expected.…”

Section: Circulation Journal Vol70 November 2006mentioning

confidence: 99%

Efficacy of Low-Dose Continuous Infusion of .ALPHA.-Human Atrial Natriuretic Peptide (hANP) During Cardiac Surgery Possibility of Postoperative Left Ventricular Remodeling Effect

Sezai

Hata

Wakui

et al. 2006

Circ J

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uman atrial natriuretic peptide (hANP) is a bio-identical hormone that is secreted by the atrium extension and has a strong diuretic effect. 1 It is a peptide consisting of 28 amino acids 2 and its effects include vasodilation, suppression of the renin -angiotensin -aldosterone system (RAS), and dilation of coronary arteries, which have been utilized clinically as a novel treatment for heart failure. [3][4][5] Recently, an inhibitory effect of hANP on left ventricular (LV) remodeling after acute myocardial infarction (AMI) was reported for the first time, and the mechanism is considered to be based on its inhibition of the RAS. 6 During cardiac surgery using cardiopulmonary bypass (CPB), there may be abnormal elevation of both the RAS and catecholamines, resulting in decreased urine volume and fluid retention. Therefore, we considered that administration of hANP would be effective in such conditions, and have continued investigating the mechanism. We previously reported internationally for the first time on using a low-dose continuous infusion of hANP from the initiation of CPB and demonstrated that hANP could satisfactorily compensate for the imperfections of CPB by reducing fluid retention, suppressing the RAS, and exerting a potent diuretic effect. 7 In our previous study, 0.05 or 0.03 g·kg -1 · min -1 of hANP was used, whereas in this study, it was 0.02 g·kg -1 ·min -1 and the number of study patients was increased to evaluate the efficacy and postoperative effects of hANP. MethodsWe studied 150 patients undergoing scheduled coronary artery bypass grafting (CABG) who met the inclusion criteria: no underlying renal dysfunction detected during the preoperative examination, LV ejection fraction (LVEF) ≥50%, ischemia or infarction in the left anterior descending (LAD) coronary artery, and neither previous catheter therapy nor CABG. The allocation was random and we used saline solution as placebo. The protocol was approved by the Institutional Review Board of Nihon University Itabashi Hospital and all patients gave informed consent to participate in this study.The patients were randomized into 2 groups: those re- BackgroundThe aim of the present study was to evaluate the efficacy of -human atrial natriuretic peptide (hANP) in cardiac surgery under cardiopulmonary bypass (CPB). Methods and ResultsA prospective randomized study was conducted with 150 patients who underwent scheduled coronary artery bypass grafting to compare a group of patients receiving 0.02 g·kg -1 ·min -1 of hANP from the initiation of CPB with a group not receiving hANP. Hemodynamics, levels of atrial and brain natriuretic peptides (BNP), angiotensin-II and aldosterone, renin activity, and left ventricular (LV) function were examined. The hANP group showed significantly lower renin activity and lower levels of angiotensin-II and aldosterone during the early postoperative period, compared with the non-hANP group. The incidence of postoperative ventricular arrhythmia and the postoperative peak level of creatine kinase-MB were significantly lower...

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“…[11][12][13] Epidemiological investigations have revealed that the prevalence of congestive heart failure increases proportionally with age, with a particularly remarkable increase in the group of patients aged ≥60 years. [14][15][16] The present investigation included 16% of the patients classified as Killip Class I, which might reflect the inclusion of the patients with symptom-less heart failure for whom carperitide was used with the expectation of diuresis and/or cardio-renal protection, [17][18][19][20][21][22] in the real-world therapy of heart failure.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Multicenter Prospective Investigation on Efficacy and Safety of Carperitide for Acute Heart Failure in the 'Real World' of Therapy

Suwa

Seino

Nomachi

et al. 2005

Circ J

114

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The beneficial effects of atrial natriuretic peptide on arrhythmias and myocardial high-energy phosphates after reperfusion

Abstract: These data show that the infusion of ANP has cardioprotective effects on myocardial ischaemia and reperfusion in this model. These beneficial effects are probably due to direct effects through cGMP rather than haemodynamic changes.

Cited by 37 publications

References 21 publications

Natriuretic Peptides as an Adjunctive Treatment for Acute Myocardial Infarction

Natriuretic Peptides as an Adjunctive Treatment for Acute Myocardial Infarction

Efficacy of Low-Dose Continuous Infusion of .ALPHA.-Human Atrial Natriuretic Peptide (hANP) During Cardiac Surgery Possibility of Postoperative Left Ventricular Remodeling Effect

Multicenter Prospective Investigation on Efficacy and Safety of Carperitide for Acute Heart Failure in the 'Real World' of Therapy

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