Topic: Interesting information read on
+Anonymous A — 15 years ago #9,535
Paradoxical Relationship Between N-Terminal Proatrial Natriuretic Peptide and Filling Pressure in Adults With Cyanotic Congenital Heart Disease
William E. Hopkins, MD; ; Christian Hall, MD, PhD
From the Cardiology Unit, University of Vermont College of Medicine, Burlington (W.E.H.), and Institute for Surgical Research, University of Oslo, Norway (C.H.).
Correspondence to William E. Hopkins, MD, University of Vermont College of Medicine, Cardiology Unit, McClure 1, Burlington, VT 05401. E-mail william.hopkins@vtmednet.org
Background Many adults with cyanotic congenital heart disease are characterized by reduced ventricular filling pressures and decreased systemic oxygen transport. Data from animals suggest that hypoxia can induce synthesis and secretion of atrial natriuretic peptide.
Methods and Results We measured plasma N-terminal (1-98) proatrial natriuretic peptide (proANP) in 26 cyanotic adults and 28 noncyanotic control subjects. Resting arterial oxygen saturation was significantly lower and hemoglobin concentration and hematocrit significantly greater in cyanotic patients than in control subjects (82±6 versus 96±3%, 19.7±2.2 versus 14.7±2.1 g/dL, and 59.0±8.5% versus 44.3±5.2%, respectively, P<.0001 in all cases). Four cyanotic patients had evidence of iron deficiency. Plasma proANP levels were elevated in cyanotic patients compared with control subjects (1828±1147 versus 689±343 pmol/L, P<.0001). Comparison of resting arterial oxygen saturation and proANP levels demonstrated an inverse linear relationship between the two measures (r=-.70, P<.0001). There was a significant linear relationship between both hemoglobin concentration and hematocrit and proANP levels as well (r=.53, P=.0003 and r=.48, P=.002, respectively). Cyanotic patients had lower mean right atrial pressures than the control subjects (4±3 versus 7±2 mm Hg, P=.005), and there were inverse logarithmic relationships between proANP levels and systemic cardiac index (r=-.82, P=.0002), systemic oxygen transport (r=-.68, P=.005), and mixed venous oxygen saturation (r=-.79, P<.0001).
Conclusions Adults with cyanotic congenital heart disease are characterized by increased levels of plasma proANP. The increased atrial natriuretic peptide most likely results in extracellular and plasma volume depletion and reduced systemic oxygen transport. Measures designed to increase ventricular filling may improve quality of life of these patients.
William E. Hopkins, MD; ; Christian Hall, MD, PhD
From the Cardiology Unit, University of Vermont College of Medicine, Burlington (W.E.H.), and Institute for Surgical Research, University of Oslo, Norway (C.H.).
Correspondence to William E. Hopkins, MD, University of Vermont College of Medicine, Cardiology Unit, McClure 1, Burlington, VT 05401. E-mail william.hopkins@vtmednet.org
Background Many adults with cyanotic congenital heart disease are characterized by reduced ventricular filling pressures and decreased systemic oxygen transport. Data from animals suggest that hypoxia can induce synthesis and secretion of atrial natriuretic peptide.
Methods and Results We measured plasma N-terminal (1-98) proatrial natriuretic peptide (proANP) in 26 cyanotic adults and 28 noncyanotic control subjects. Resting arterial oxygen saturation was significantly lower and hemoglobin concentration and hematocrit significantly greater in cyanotic patients than in control subjects (82±6 versus 96±3%, 19.7±2.2 versus 14.7±2.1 g/dL, and 59.0±8.5% versus 44.3±5.2%, respectively, P<.0001 in all cases). Four cyanotic patients had evidence of iron deficiency. Plasma proANP levels were elevated in cyanotic patients compared with control subjects (1828±1147 versus 689±343 pmol/L, P<.0001). Comparison of resting arterial oxygen saturation and proANP levels demonstrated an inverse linear relationship between the two measures (r=-.70, P<.0001). There was a significant linear relationship between both hemoglobin concentration and hematocrit and proANP levels as well (r=.53, P=.0003 and r=.48, P=.002, respectively). Cyanotic patients had lower mean right atrial pressures than the control subjects (4±3 versus 7±2 mm Hg, P=.005), and there were inverse logarithmic relationships between proANP levels and systemic cardiac index (r=-.82, P=.0002), systemic oxygen transport (r=-.68, P=.005), and mixed venous oxygen saturation (r=-.79, P<.0001).
Conclusions Adults with cyanotic congenital heart disease are characterized by increased levels of plasma proANP. The increased atrial natriuretic peptide most likely results in extracellular and plasma volume depletion and reduced systemic oxygen transport. Measures designed to increase ventricular filling may improve quality of life of these patients.
·yo !3GqYIJ3Obs (OP) — 14.2 years ago, 10 months later[T] [B] #180,556
hi.
+Anonymous B — 14.2 years ago, 2 minutes later, 10 months after the original post[T] [B] #180,557
didnt read+Balfomoar !v.HDBoners — 14.2 years ago, 6 hours later, 10 months after the original post[T] [B] #180,564
find the boners
+Wozaz — 14.2 years ago, 3 hours later, 10 months after the original post[T] [B] #180,573
@OP
NO PEPTIDES THEN AAAAANNND CRANK THE VENTRICULSR FUCKING VOLUME TO LEVELS OF FUCK TO LIVE FOUREVEAR
NO PEPTIDES THEN AAAAANNND CRANK THE VENTRICULSR FUCKING VOLUME TO LEVELS OF FUCK TO LIVE FOUREVEAR
+Anonymous E — 14.2 years ago, 37 minutes later, 10 months after the original post[T] [B] #180,581
the posters below me ordered the butt stuff sir, not me
·FUCK !YAH.boners (OP) — 13.6 years ago, 6 months later, 1.4 year after the original post[T] [B] #208,133
bump
+Anonymous F — 13.6 years ago, 37 minutes later, 1.4 year after the original post[T] [B] #208,137
+Dead !Pool..v42s — 13.6 years ago, 3 hours later, 1.4 year after the original post[T] [B] #208,177
+Anti !M6R0eWkIpk — 13.6 years ago, 1 minute later, 1.4 year after the original post[T] [B] #208,179
Is this thread worth any CE hours?
·Thed Octor !eqV35U3yE. (OP) — 13.4 years ago, 2 months later, 1.6 year after the original post[T] [B] #246,109
Upgrade to dwarf fortress
+Bill Cosby — 13.4 years ago, 4 hours later, 1.6 year after the original post[T] [B] #246,186
@OPDear OP 1.6 year ago,
I apologize for the lateness of this reply, but due to my schedule on The Bill Cosby Show and off, I’m behind on my mail. Thank you for sharing your thoughts with me. They were read with appreciation. Thank you for your comments about Paradoxical Relationship Between N-Terminal Proatrial Natriuretic Peptide and Filling Pressure in Adults With Cyanotic Congenital Heart Disease. They were read with interest.
I hope you continue to watch and enjoy the show.
Sincerely, Bill Cosby
·Anonymous A (OP) — 11 years ago, 2.4 years later, 4 years after the original post[T] [B] #464,656
Bump. Interested in starting a discussion on this important topic with the cardiologist community of Tinychan.
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