From the Departments of Medicine, Physiology, and Biophysics, James A.
Haley Veterans Hospital, and the University of South Florida Health Sciences
Center, Tampa.
Correspondence to David L. Vesely, MD, PhD, Director, Atrial Natriuretic Peptides Research Laboratories, J.A. Haley Veterans Hospital-151, 13000 Bruce B. Downs Blvd, Tampa, FL 33612.
Background—Vessel dilator, a
37–amino acid peptide hormone synthesized in the heart, enhances urine
flow 4- to 12-fold and sodium excretion 3- to 6-fold in healthy humans.
The present investigation was designed to determine whether vessel
dilator might have similar beneficial effects in persons with
congestive heart failure (CHF).
Methods and Results—Vessel dilator (100 ng/kg body weight
per minute) given intravenously for 60 minutes to NYHA
class III CHF subjects increased urine flow 2- to 13-fold, which was
still increased (P<0.001) 3 hours after its infusion
was stopped. Vessel dilator enhanced sodium excretion 3- to 4-fold in
CHF subjects (P<0.01), which was still significantly
(P<0.01) elevated 3 hours after infusion. Vessel
dilator decreased systemic vascular resistance 24%, pulmonary
vascular resistance 25%, pulmonary capillary wedge pressure
33%, and central venous pressure 27% while increasing cardiac output
34%, cardiac index 35%, and stroke volume index 24% without
significantly affecting heart rate or pulmonary artery pressure
in the CHF subjects. The control CHF patients did not have any changes
in the above parameters.
Conclusions—These results indicate that vessel dilator has
significant beneficial diuretic, natriuretic, and
hemodynamic properties in humans with congestive heart
failure.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Vessel Dilator Enhances Sodium and Water Excretion and Has Beneficial Hemodynamic Effects in Persons With Congestive Heart Failure
Key Words: natriuretic peptides • cardiac output • diuretics
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