Functional explanation for increased atrial natriuretic peptide in systemic sclerosis

Elsadig Kazzam, Kenneth Caidahl, Thomas Hedner, Anders Waldenström

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

We related atrial natriuretic peptide (ANP) among 30 consecutive patients with systemic sclerosis (SScl) and 48 gender‐ and age‐matched controls to the measurements of left ventricular (LV) function as evaluated by echocardiography and external pulse curves to determine possible causative factors for an increased level of plasma ANP. The patients had a markedly elevated plasma ANP level (239.4± 59 vs. 178.2± 36 pmol/1, p < 0.0005), which was not related to LV systolic function, heart rate, or blood pressure. Patients had LV hypertrophy and plasma ANP correlated directly to interventricular septal thickness (r = 0.41, p < 0.005), LV posterior wall thickness (r = 0.32, p < 0.01), and wall thickness to cavity dimension (r = 0.44, p < 0.0005), LV mass index (r = 0.40, p < 0.005). LV early filling properties were impaired, with reduction of atrial emptying index (p < 0.0005) and increased contribution of atrial contraction to LV filling. Plasma ANP correlated to atrial emptying index (r = 0.41, p < 0.0005) and to apex‐car‐diographic a wave (r = 0.28, p <0.05). Plasma ANP was also related to left atrial dimension index (r = 0.27, p < 0.05), and was still related to atrial emptying index, but not to left atrial dimension, when considering the degree of LV hypertrophy in multivariate analysis. We conclude that ANP is elevated in patients with SScl. Reduced LV compliance, probably due to increased fibrosis, may cause changes in atrial pressure sufficient to stimulate ANP production without systolic dysfunction as a prerequisite.

Original languageEnglish
Pages (from-to)647-652
Number of pages6
JournalClinical Cardiology
Volume18
Issue number11
DOIs
Publication statusPublished - Nov 1995
Externally publishedYes

Keywords

  • apexcardiogram
  • atrial natriuretic peptide
  • diastolic function
  • echocardiography
  • left ventricle
  • systemic sclerosis
  • systolic function

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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