Plasma Concentration of Atrial Natriuretic Factor in Congestive Heart Failure

Abstract

The presence of secretory granules in mammalian atria is well documented (1). Since their number decreases during high sodium intake and increases with low sodium intake and water deprivation (2), it was suggested that these atrial granules may play a role in salt and water balance. Further work has shown that the granules contain biologically active peptides referred to as atrial natriuretic factor or atrial natriuretic polypeptides which produce diuresis, natriuresis (3), vasorelaxation (4) and reduced aldosterone synthesis (5). Because of such physiological effects, markedly stimulated atrial natriuretic factor in the pathophysiology of congestive heart failure has been anticipated. Although there have been reports on raised plasma atrial natriuretic factor concentrations during paroxysmal atrial tachycardia (6,7,8) and in patients with severe congestive heart failure (9,10), the relationship between hemodynamic details and plasma concentration of atrial natriuretic factor has not been studied. In the present study, plasma atrial natriuretic factor concentrations was determined in healthy subjects and in patients with congestive heart failure and the correlations with the symptoms and the hemodynamic indices including pulmonary capillary wedge pressure, cardiac index and left ventricular ejection fraction were investigated.