Circulation, Vol 89, 1153-1159, Copyright © 1994 by American Heart Association
DR Singer, ND Markandu, MG Buckley, MA Miller, GA Sagnella, DR Lachno, FP Cappuccio, A Murday, MH Yacoub and GA MacGregor
BACKGROUND: The role of cardiac extrinsic innervation in the regulation of
sodium balance and blood pressure is controversial. METHODS AND RESULTS: We
performed a double-blind study of endocrine and blood pressure responses to
5 days of low- (LS, 10 mmol/d) and 5 days of high- (350 mmol/d) sodium
intake in 12 cardiac transplant recipients, 12 matched healthy subjects,
and 12 matched subjects with untreated essential hypertension. In
transplant recipients on low sodium, supine blood pressure was 137/94 +/-
8/4 (mean +/- SEM) mm Hg and plasma atrial natriuretic peptide (ANP) was
59.3 +/- 6.3 pg/mL; on high sodium, blood pressure was 148/97 +/- 5/3 mmHg
(P < .05 for systolic pressure versus LS), and ANP was 94.3 +/- 10.6
pg/mL (P < .01 versus LS), respectively. Plasma ANP for those on each
diet was significantly higher in the cardiac transplant recipients than in
healthy or hypertensive controls; relative changes in plasma ANP in
changing from low- to high-sodium diet were similar in each group. Urinary
sodium excretion by the fifth day of each diet was similar in each group.
Suppression of plasma renin activity and aldosterone by high-sodium diet
was blunted in cardiac transplant recipients compared with healthy subjects
(respectively, plasma renin activity: 1.41 +/- 0.30 versus 0.68 +/- 0.21
ng.mL-1 x h-1, P < .05; aldosterone: 391 +/- 35 versus 166 +/- 21
pmol/L, P < .05). CONCLUSIONS: These results suggest that extensive
denervation of the heart does not result in major abnormalities in
regulation of large changes in sodium intake and that intact cardiac
innervation is not required for plasma ANP responses to altered sodium
intake. Blood pressure after cardiac transplantation is sensitive to
reduced sodium intake.
ARTICLES
Blood pressure and endocrine responses to changes in dietary sodium intake in cardiac transplant recipients. Implications for the control of sodium balance
Blood Pressure Unit, St George's Hospital Medical School, London, UK.
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