Circulation, Vol 90, 1210-1214, Copyright © 1994 by American Heart Association
M Nakamura, N Arakawa, H Yoshida, S Makita and K Hiramori
BACKGROUND: C-type natriuretic peptide (CNP) is a newly identified peptide
that is structurally related to atrial natriuretic peptide (ANP). Although
it has been suggested that CNP is released from the endothelium for the
regulation of local vascular tone, no data are available concerning the
vasodilatory response to CNP in humans. METHODS AND RESULTS: Strain-gauge
plethysmography was used to determine the vasodilatory effects of
intra-arterially infused CNP compared with the effects of ANP infusion in
11 patients with chronic heart failure (CHF) and 11 age-matched healthy
controls. Graded doses of CNP and ANP (8, 16, 32, and 48 pmol.min-1.dL-1
tissue volume) were administered randomly into the nondominant brachial
artery, and forearm blood flow (FBF) was measured. No significant changes
in systemic blood pressure and heart rate were found during the study. Both
the absolute and percent FBF responses to ANP relative to the baseline
value were significantly lower in CHF patients than in healthy controls (P
< .01), whereas the responses to CNP were similar. The calculated
forearm spillover of cyclic GMP (cGMP) was significantly lower in CHF
patients receiving the highest dose of ANP (P < .02), whereas changes in
cGMP spillover after the equimolar dose of CNP were significantly higher (P
< .02), despite the lesser potency of CNP. CONCLUSIONS: In patients with
CHF the peripheral vasodilatory effect of ANP is attenuated, but
CNP-induced peripheral vasorelaxation is preserved, with CNP being less
potent for equimolar doses.
ARTICLES
Vasodilatory effects of C-type natriuretic peptide on forearm resistance vessels are distinct from those of atrial natriuretic peptide in chronic heart failure
Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
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