Plasma concentrations of atrial and brain natriuretic peptides and cyclic guanosine monophosphate in response to dobutamine infusion in patients withsurgically repaired tetralogy of fallot

Citation
Y. Hayabuchi et al., Plasma concentrations of atrial and brain natriuretic peptides and cyclic guanosine monophosphate in response to dobutamine infusion in patients withsurgically repaired tetralogy of fallot, PEDIAT CARD, 20(5), 1999, pp. 343-350
Citations number
25
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics
Journal title
PEDIATRIC CARDIOLOGY
ISSN journal
0172-0643 → ACNP
Volume
20
Issue
5
Year of publication
1999
Pages
343 - 350
Database
ISI
SICI code
0172-0643(199909/10)20:5<343:PCOAAB>2.0.ZU;2-R
Abstract
We examined the plasma concentrations of atrial and brain natriuretic pepti des (ANP and BNP) and cyclic guanosine monophosphate (cGMP) during dobutami ne infusion and their relationship with hemodynamic parameters in 14 patien ts with surgically repaired tetralogy of Fallot (TOF). Dobutamine was infus ed at an initial dose of 5 mu g/kg/min and increased by 5 mu g/kg/min up to 20 mu g/kg/min. The plasma ANP, BNP, and cGMP concentrations were determin ed before infusion, at the end of each stage, and 15 minutes after disconti nuing dobutamine infusion. The plasma concentrations of ANP, BNP, and cGMP were elevated in all patients before dobutamine infusion. The ANP, BNP, and cGMP concentrations decreased in 11 of the 14 patients during dobutamine i nfusion. In contrast, the plasma ANP and BNP concentrations increased in th e remaining 3 patients without a change in the cGMP concentration. The righ t ventricular pressure and volume were significantly elevated in these pati ents. The plasma cGMP concentration correlated with the ANP concentration ( r = 0.62, p < 0.01) but not the BNP concentration. The plasma ANP concentra tion during dobutamine infusion correlated with right ventricular systolic pressure (r = 0.71, p < 0.05), mean right atrial pressure (r = 0.29, p < 0. 05), and mean pulmonary capillary wedge pressure (r = 0.32, p < 0.05). The BNP concentration correlated with right ventricular volume (r = 0.61, p < 0 .05) and systolic pressure (r = 0.46, p < 0.05). In conclusion, rapid chang es in ANP, BNP, and cGMP concentrations during dobutamine infusion reflect the changes in atrial and ventricle pressure and volume overload. In surgic ally repaired TOF, the ANP concentration is affected by right ventricular s ystolic pressure, right atrial pressure, and pulmonary capillary pressure. Furthermore, the BNP concentration reflects right ventricular pressure and volume overload.