Atrial natriuretic peptide during different pacing modes in a comparison with hemodynamic changes.

The study investigates the response of atrial natriuretic peptide (ANP) to different cardiac pacing modes in comparison with hemodynamic changes. Ten patients underwent Swan-Ganz catheterization during pacemaker implant. Atrioventricular and ventricular pacing were performed consecutively at three p...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 13; no. 4; pp. 432 - 443
Autores principales: Baratto MT, Berti S, Clerico A, Fommei E, Del Chicca MG, Contini C
Formato: Journal Article
Publicado: Wiley-Blackwell Apr1990
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr1990
      vid: 13
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Atrial natriuretic peptide during different pacing modes in a comparison with hemodynamic changes.
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        au:
          Baratto MT
          Berti S
          Clerico A
          Fommei E
          Del Chicca MG
          Contini C
      sug:
        subj:
          Atrial Natriuretic Factor Blood
          Cardiac Pacing, Artificial Methods
          Hemodynamics Physiology
          Aged
          Aged, 80 and Over
          Atrioventricular Node
          Blood Pressure Physiology
          Cardiac Output Physiology
          Female
          Heart Block Therapy
          Heart Rate Physiology
          Heart Ventricle
          Male
          Middle Age
          Pulmonary Artery Physiopathology
          Pulmonary Wedge Pressure Physiology
          Sick Sinus Syndrome Therapy
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: The study investigates the response of atrial natriuretic peptide (ANP) to different cardiac pacing modes in comparison with hemodynamic changes. Ten patients underwent Swan-Ganz catheterization during pacemaker implant. Atrioventricular and ventricular pacing were performed consecutively at three pacing rate levels (80, 100, and 110 ppm). Blood samples were taken from the pulmonary artery for ANP determination, bath basally and at the end of each pacing period. Concomitantly, mean pulmonary capillary wedge pressure (PCWP) and mean pulmonary artery pressure (PAP) were measured. Cardiac output (CO) was determined by thermodilution both basally and during the 110 ppm steps. During atrioventricular pacing, whereas no significant changes were observed for ANP, PCWP and PAP, CO increased significantly (P < 0.0005). At the beginning of ventricular pacing hemodynamic parameters and ANP levels were comparable with those of baseline conditions. During subsequent ventricular pacing PCWP and ANP increased significantly at the 110 ppm rate step (P < 0.05). PAP did not change significantly, whereas CO decreased in all cases (P < 0.01). A positive correlation was observed between ANP and PCWP during ventricular (P < 0.001), but not atrioventricular pacing. The results, while confirming the hemodynamic advantages of atrioventricular pacing, point to a major stimulation of ANP secretion during ventricular pacing. This fact, together with the observed drop in CO and the correlation between ANP and PCWP, suggest that the increase of ANP in ventricular pacing may be the expression of a compensatory mechanism to the hemodynamic disadvantages of atrioventricular asynchrony.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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