Kinetics of atrial and brain natriuretic peptides during hemodialysis are regulated in association with different cardiac functional changes.
Cardiac function
Echocardiography
Hemodialysis
Natriuretic peptide
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
19
10
2021
accepted:
03
12
2021
pubmed:
11
1
2022
medline:
1
6
2022
entrez:
10
1
2022
Statut:
ppublish
Résumé
The blood levels of atrial and brain natriuretic peptides (ANP and BNP) are both increased markedly in hemodialysis patients, but the kinetics of the two are not always parallel. The present study investigated the association of changes in ANP and BNP levels before and after dialysis with changes in cardiac function in hemodialysis patients. A total of 57 patients (mean age 64 years, 47 males and 10 females) on maintenance hemodialysis with sinus rhythm were enrolled. Blood samples were taken at the beginning and end of dialysis, and plasma levels of ANP and BNP were measured. Changes in cardiac function during dialysis were examined by echocardiography performed just before and after dialysis. Both plasma ANP and BNP concentrations decreased significantly after hemodialysis, but the rate of decrease in BNP [mean ± SD, 555 ± 503 to 519 ± 477 pg/mL (- 6.4%), P = 0.011] was much smaller than that in ANP [233 ± 123 to 132 ± 83 pg/mL (- 43.4%), P < 0.001]. As for the relation to the changes in echocardiographic parameters before and after dialysis, the decrease in inferior vena cava diameter had a close correlation with the decrease in ANP (r = 0.528, P < 0.001), but not BNP. In contrast, the decrease in left ventricular end-diastolic volume index was correlated only with the decrease in BNP (r = 0.297, P = 0.035). The peak velocity ratio of early diastolic to atrial filling decreased with preload reduction by dialysis, and its decrease was more strongly correlated with the decrease in BNP (r = 0.407, P = 0.002) than that in ANP (r = 0.273, P = 0.040). These results demonstrated that in hemodialysis patients, the decrease in plasma ANP by a single dialysis was essentially caused by blood volume reduction, while BNP decrease was mainly induced by the reduction of left ventricular overload. Our findings indicate that the kinetics of both peptides during dialysis are regulated by different cardiac and hemodynamic factors.
Identifiants
pubmed: 35001145
doi: 10.1007/s00380-021-02011-w
pii: 10.1007/s00380-021-02011-w
doi:
Substances chimiques
Natriuretic Peptide, Brain
114471-18-0
Atrial Natriuretic Factor
85637-73-6
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1146-1152Informations de copyright
© 2021. Springer Japan KK, part of Springer Nature.
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