What is the clinical evidence from this study?

Study design: Other. Population: Acute myocardial infarction (n=8). Intervention: Synthetic Atrial Natriuretic Factor vs. Baseline. Primary outcome: Pulmonary capillary wedge pressure at 4 hours (p=<0.01).

January 1, 1993Japanese Heart JournalOpen Access

Effects of Long-term Infusion of Synthetic Atrial Natriuretic Factor on Hemodynamics and Water Input-output Balance in Patients with Acute Myocardial Infarction.

Q: What are the key findings of this study?

Synthetic atrial natriuretic factor infusion decreased pulmonary capillary wedge pressure by >50% (from 16 to 7 mmHg, p<0.01) without reflex tachycardia or volume depletion in acute MI patients.

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Key result

Synthetic atrial natriuretic factor infusion decreased pulmonary capillary wedge pressure by >50% (from 16 to 7 mmHg, p<0.01) without reflex tachycardia or volume depletion in acute MI patients.

Why the study?

Does 24-hour intravenous infusion of synthetic atrial natriuretic factor improve hemodynamic parameters in patients with acute myocardial infarction?

Population

8 patients with acute myocardial infarction. Excluded: cardiogenic shock, life-threatening arrhythmias, and…

Design

Case_series

Follow-up

24 hours

Authors

MNMotoyuki NakamuraKagoshima University NANaoshi ArakawaUniversity of Kentucky HYHiroaki YoshidaMiyagi University

Discussion

Member takes

Implication

ANF infusion appears feasible in AMI; leaves open clinical utility pending controlled trials.

Structured PICO

Does 24-hour intravenous infusion of synthetic atrial natriuretic factor improve hemodynamic parameters in patients with acute myocardial infarction?

Population

8 patients (mean age 55 years, 25% female) with acute myocardial infarction, free of cardiogenic shock or right ventricular infarction, monitored during a 24-hour synthetic ANF infusion.

Intervention

Synthetic atrial natriuretic factor (ANF-[99-126]) continuous intravenous infusion at 20-50 ng/kg/min for 24 hours.

Outcome

Hemodynamic parameters (pulmonary capillary wedge pressure, right atrial pressure, pulmonary arterial pressure, cardiac output, systemic blood pressure, heart rate) and water input-output balance over 24 hours.surrogate

Main Result

Absolute Event Rate: 7% vs 16%

p-value: p=<0.01

Prolonged 24-hour infusion of synthetic ANF in patients with acute myocardial infarction safely produces potent and sustained left ventricular unloading without reflex tachycardia or volume depletion.

Limitations

Lack of a placebo-control group
Inability to standardize previous medications and water-sodium intake
Potential influence of prior cardiac catheterization and contrast medium
Did not include a placebo-control group
Small number of patients with severe congestive heart failure
Previous medications and water-sodium intake could not be standardized

Cite This Study

Nakamura et al. (1993) studied Acute myocardial infarction (n=8). Synthetic Atrial Natriuretic Factor vs. Baseline was evaluated on Pulmonary capillary wedge pressure at 4 hours (p=<0.01). Synthetic atrial natriuretic factor infusion decreased pulmonary capillary wedge pressure by >50% (from 16 to 7 mmHg, p<0.01) without reflex tachycardia or volume depletion in acute MI patients.

synapsesocial.com/papers/6a6d330078a11c550e07da2f https://doi.org/10.1536/ihj.34.707

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Effects of Long-term Infusion of Synthetic Atrial Natriuretic Factor on Hemodynamics and Water Input-output Balance in Patients with Acute Myocardial Infarction.

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

Effects of Long-term Infusion of Synthetic Atrial Natriuretic Factor on Hemodynamics and Water Input-output Balance in Patients with Acute Myocardial Infarction.

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

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