Original ArticlesHemodynamic Effects of Human Atrial Natriuretic Peptide After Modified Fontan Procedure
Section snippets
Patients
Eight children underwent the Fontan procedure (connection of the right atrial appendage to the pulmonary artery), 1 for pulmonary atresia with an intact ventricular septum, 1 for pure pulmonary stenosis, 1 for a criss-crossed heart, 2 for a common atrioventricular canal, 1 for a single right ventricle, and 1 for a single left ventricle. The children ranged in age from 2 to 15 years (mean, 7.6 ± 1.1 years). Permission to conduct the study was granted by the Ethical Committee of the Tokyo Women’s
Plasma Atrial Natriuretic Peptide
The plasma ANP level was 29.1 ± 15.6 pg/mL before operation and increased significantly to 54.9 ± 16.3 pg/mL after operation (Fig. 1). The plasma BNP level increased slightly after operation, but the difference did not reach statistical significance. After the administration of HANP for 1 hour, the plasma ANP level increased to 617.5 ± 132.4 pg/mL.
Correlation Between Central Venous Pressure and Plasma Atrial Natriuretic Peptide Levels Before and After Operation
There was a statistically significant positive correlation between plasma ANP levels and CVP before and after operation (r = 0.720, p < 0.05) (Fig. 2
Comment
In the natriuretic peptide family, ANP and BNP are derived from the heart and are strongly associated with the pathophysiology of heart failure [4]. Atrial natriuretic peptide, with 28 amino acid residues, has multiple biologic actions. It is a diuretic, a natriuretic, a vasodilator of the systemic and pulmonary arteries, and an inhibitor of the secretion of aldosterone [2]. Brain natriuretic peptide, with 32 amino acid residues, plays an important role in regulating somatic fluid and blood
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Cited by (25)
QRS duration in Fontan circulation in adults: A predictor of aerobic capacity
2009, International Journal of CardiologyCitation Excerpt :In chronic heart failure of biventricular physiology NT-proBNP correlates with aerobic capacity [30]. In the present study functional status showed a close relation to aerobic capacity, however, there was a lacking correlation between NT-proBNP levels and reduced aerobic capacity which is consistent with other observations [26,31,32]. Until now the lacking correlation between aerobic capacity and neurohumoral activation in a Fontan circulation has not been fully elucidated.
Human Atrial Natriuretic Peptide Prevents the Increase in Pulmonary Artery Pressure Associated With Aortic Unclamping During Abdominal Aortic Aneurysmectomy
2008, Journal of Cardiothoracic and Vascular AnesthesiaEffect of cardiopulmonary bypass and surgical intervention on the natriuretic hormone system in children
2005, Journal of Thoracic and Cardiovascular SurgeryQuantitative assessment of systolic and diastolic ventricular function with tissue Doppler imaging after Fontan type of operation
2005, International Journal of CardiologyLow-dose continuous infusion of human atrial natriuretic peptide during and after cardiac surgery
2000, Annals of Thoracic SurgeryCitation Excerpt :Because there has been no report on the administration of hANP from the start of CPB, we should first establish the dose of hANP, timing for the initiation of administration, and infusion time. hANP is usually administered for heart failure through continuous infusion at a starting dose of 0.1 μg/kg/min or through single intravenous injection [5, 11]. In the present study, hANP was administered at doses as low as 0.03 to 0.05 μg/kg/min because it was used for patients undergoing elective operations rather than for heart failure, and also because we were concerned about its safe use for patients in a dehydrated condition at the start of the operation, because it has been reported that hANP may lower blood pressure in dehydrated patients.
Suppression of the secretion of atrial and brain natriuretic peptide after total cavopulmonary connection
2000, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :Recently, human ANP has been produced commercially by a genetic recombinant technique (Suntory; Osaka, Japan). Hiramatsu and associates9 examined the effects of human ANP on hemodynamic parameters after the Fontan procedure and concluded that human ANP could be a physiologic diuretic and a pulmonary vasodilator after this procedure. The administration of human ANP should offer the possibility of combining the hemodynamic benefits of TCPC with the endocrine benefits of the Fontan procedure.