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Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55902
The effects on myocardial function and
loading conditions of clinically relevant doses of the natriuretic
peptides (NP) have not been established. The actions of single doses
(100 ng · kg
1 · min
1
iv over 30 min) of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) were studied in
conscious normal dogs and in dogs with pacing-induced heart failure.
All three NP reduced end-diastolic pressure in normal dogs, and ANP and
BNP reduced end-diastolic volume. In heart failure ANP and BNP reduced
EDP, and ANP reduced EDV. Arterial elastance was unchanged in normal
dogs and in dogs with heart failure. ANP increased
end-systolic elastance (Ees) in normal dogs,
whereas BNP tended to increase Ees (P = 0.06). In dogs with heart failure, no inotropic effect was seen. In
normal dogs, all NP reduced the time constant of isovolumic relaxation
(
), and ANP and BNP reduced
in dogs with heart
failure. Increases in plasma cGMP in dogs with heart
failure were blunted. The NP reduced preload and enhanced systolic and
diastolic function in normal dogs. Effects of ANP and BNP on preload
and diastolic function were maintained in heart failure. Lack of
negative inotropic effects in heart failure supports the validity of
the NP as therapeutic agents.
hemodynamics; contractility; diastole; guanosine 3',5'-cyclic monophosphate
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