Secretion patterns of brain natriuretic peptide and atrial natriuretic peptide in patients with or without pulmonary hypertension complicating atrial septal defect☆,☆☆,★,★★
Section snippets
Patients
The diagnosis of ASD was made by echocardiography and was confirmed by cardiac catheterization.7 All patients had uncomplicated secundum atrial septal defect. No patient had evidence of Eisenmenger syndrome. Of the 38 consecutive patients with ASD initially examined, 7 patients were excluded because of the presence of atrial fibrillation. The remaining 31 patients (12 men and 19 women, mean age 46 years, range 19 to 72 years) were divided into two groups on the basis of the presence of
Clinical and hemodynamic characteristics
Patients with ASD with pulmonary hypertension (group 2) showed significantly higher values for PAP, RVEDP, and PVR than did those without pulmonary hypertension (group 1) (Table I).Parameter Control ( n = 11) Group 1 ( n = 21) Group 2 ( n = 10) Age (yr) 50 ± 3 42 ± 4 53 ± 5 Sex (M/F) 9/2 8/13 4/6 NYHA I (n) n/a 7 3 II (n) n/a 14 6 III (n) n/a 0 1 Sys PAP (mm Hg) 24 ± 1 28 ± 1 53 ± 4*† Dia PAP (mm Hg) 6 ± 1 7 ± 1 16 ± 2*†
Discussion
In this study, we demonstrated that (1) plasma ANP levels were elevated in patients with ASD regardless of the presence of pulmonary hypertension, and (2) plasma BNP levels and the BNP/ANP ratio were markedly elevated in patients with ASD with pulmonary hypertension, although they were not significantly increased in patients with ASD without pulmonary hypertension. We also demonstrated that (3) plasma ANP levels were positively correlated with the degree of Qp and Qp/Qs; plasma BNP levels
Acknowledgements
We thank Yoko Saito for technical assistance.
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From the Department of Internal Medicine and Research Institute, National Cardiovascular Center.
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Supported in part by the Special Coordination Funds for Promoting Science and Technology (Encouragement System of COE) from the Science and Technology Agency of Japan.
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Reprint requests: Toshio Nishikimi, MD, Department of Internal Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565 Japan.
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