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European Journal of Heart Failure 1999 1(1):51-58; doi:10.1016/S1388-9842(98)00005-1
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© 1999 European Society of Cardiology

Relation of atrial natriuretic peptides to left ventricular systolic and diastolic function in heart failure

Anke A.M. Wijbengaa,*, Aggie H.M.M. Balka, Fokke A.M. Jonkmana, Frans Boomsmab, Maarten L. Simoonsa and Arie J. Man in 't Veldb

a Heart Center Bd 381, University Hospital Rotterdam Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
b Department of Internal Medicine I, University Hospital Rotterdam Rotterdam, The Netherlands

* Corresponding author. Tel.: +31 10 4633949; fax: +31 10 40849484; email: wybenga{at}card.azr.nl


  Abstract

Background: Plasma concentrations of atrial natriuretic peptides are correlated with atrial pressures, as are left ventricular ejection fraction and left ventricular filling abnormalities.

Aims: This study investigated the relation of atrial natriuretic peptides to both left ventricular systolic and diastolic function in heart failure.

Methods: Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were measured in 63 patients with chronic heart failure and left ventricular systolic dysfunction. According to Doppler transmitral flow measurements, 19 patients had a restrictive and 44 patients had a non-restrictive left ventricular filling pattern.

Results: Plasma concentrations of atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide were higher in patients with a restrictive filling pattern than in patients with a non-restrictive filling pattern (197 vs. 75 pmol/l, P < 0.0001 and 1.14 vs. 0.45 nmol/l, P < 0.0001). In univariate analysis, atrial natriuretic peptide and N-terminal pro-atrial natriuretic peptide correlated with deceleration time, E/A ratio and left ventricular ejection fraction. In multivariate analysis, both peptides appeared independently related to left ventricular ejection fraction and left ventricular filling pattern.

Conclusion: In patients with chronic heart failure, atrial natriuretic peptides provide information on left ventricular systolic as well as diastolic function.

Key Words: Heart failure • Atrial natriuretic peptide • N-terminal pro-atrial natriuretic peptide • Left ventricular ejection fraction • Left ventricular filling pattern


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