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Stimulation of atrial natriuretic peptide and vasopressin during retrograde mitral valvuloplasty. Am Heart J 1990 Dec;120(6 Pt 1):1305-10

Date

12/01/1990

Pubmed ID

2147351

DOI

10.1016/0002-8703(90)90240-x

Scopus ID

2-s2.0-0025647792   1 Citation

Abstract

Acute mitral obstruction may lead to an increase in atrial natriuretic peptide (ANP) due to increased atrial pressure and a large increase in arginine vasopressin (AVP) due to simultaneous arterial and ventricular baroreceptor unloading. We measured ANP and AVP concentration after transseptal puncture and during percutaneous retrograde mitral balloon valvuloplasty (PRMV) in 11 patients (mean age 57 +/- 12 years; nine women) with mitral stenosis and congestive heart failure. Atrial septal puncture per se resulted in a significant increase in ANP and AVP without a significant change in aortic pressure. Subsequent PRMV led to a further increase in ANP, a transient decrease in aortic pressure from 89 +/- 7 to 45 +/- 4 mm Hg, and a large (fivefold) increase in AVP. ANP and AVP were no longer different from baseline values 18 to 24 after the procedure. This study suggests that transseptal puncture and acute mitral obstruction are major stimuli to ANP release and that combined unloading of arterial and left ventricular mechanoreceptors is a very potent vasopressinergic stimulus.

Author List

Lewin RF, Raff H, Findling JW, Dorros G

Authors

James W. Findling MD Staff Physician in the Multi-Specialty department at Medical College of Wisconsin
Hershel Raff PhD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Aldosterone
Arginine Vasopressin
Atrial Natriuretic Factor
Blood Pressure
Cardiac Output
Catheterization
Female
Heart Ventricles
Humans
Male
Middle Aged
Mitral Valve
Mitral Valve Stenosis
Renin
Rheumatic Heart Disease
Time Factors
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d