What question did this study set out to answer?

To compare the peripheral vasodilatory effects and cyclic GMP spillover of C-type natriuretic peptide versus atrial natriuretic peptide in chronic heart failure patients and healthy controls.

September 1, 1994Circulation

Vasodilatory effects of C-type natriuretic peptide on forearm resistance vessels are distinct from those of atrial natriuretic peptide in chronic heart failure.

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Why the study?

Does intra-arterial infusion of C-type natriuretic peptide (CNP) cause different vasodilatory effects compared to atrial natriuretic peptide (ANP) in patients with chronic heart failure?

Key Points

To compare the peripheral vasodilatory effects and cyclic GMP spillover of C-type natriuretic peptide versus atrial natriuretic peptide in chronic heart failure patients and healthy controls.
Measured forearm blood flow via strain-gauge plethysmography in 11 patients with chronic heart failure and 11 age-matched healthy controls.
Administered randomized, graded intra-arterial infusions of CNP and ANP (8, 16, 32, and 48 pmol·min⁻¹·dL⁻¹ tissue volume) into the nondominant brachial artery while tracking systemic hemodynamics.
Absolute and percent forearm blood flow responses relative to baseline were significantly reduced after ANP infusion in heart failure patients compared with controls (P < .01), whereas vasodilatory responses to CNP were preserved.
Forearm cyclic GMP spillover at the highest dose was significantly lower in heart failure patients receiving ANP (P < .02), whereas cyclic GMP spillover following equimolar CNP was significantly higher (P < .02) despite lower overall vasodilatory potency.

Structured PICO

Does intra-arterial infusion of C-type natriuretic peptide (CNP) cause different vasodilatory effects compared to atrial natriuretic peptide (ANP) in patients with chronic heart failure?

Population

11 patients with chronic heart failure (CHF) and 11 age-matched healthy controls (n=22)

Intervention

Intra-arterial infusion of C-type natriuretic peptide (CNP) at graded doses (8, 16, 32, and 48 pmol.min-1.dL-1 tissue volume) into the nondominant brachial artery

Comparator

Intra-arterial infusion of atrial natriuretic peptide (ANP) at equimolar graded doses

Outcome

Forearm blood flow (FBF) measured by strain-gauge plethysmographysurrogate

In patients with chronic heart failure, peripheral vasorelaxation induced by C-type natriuretic peptide is preserved, in contrast to the attenuated response seen with atrial natriuretic peptide.

Discussion

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Implication

Preserved CNP responses in CHF may support pathway-specific investigation; leaves open therapeutic relevance pending prospective trials.

Cite This Study

Nakamura et al. (1994) studied this question.

synapsesocial.com/papers/6a7239e3f44fa9f079dfc804 https://doi.org/10.1161/01.cir.90.3.1210

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Vasodilatory effects of C-type natriuretic peptide on forearm resistance vessels are distinct from those of atrial natriuretic peptide in chronic heart failure.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Vasodilatory effects of C-type natriuretic peptide on forearm resistance vessels are distinct from those of atrial natriuretic peptide in chronic heart failure.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider