Effects of brain natriuretic peptide on exercise hemodynamics and neurohormones in isolated diastolic heart failure

Peter B.M. Clarkson (Lead / Corresponding author), Nigel M. Wheeldon, Robert J. MacFadyen, Stuart D. Pringle, Thomas M. MacDonald

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    Abstract

    Background: Experimental models suggest that brain natriuretic peptide (BNP) can modify left ventricular diastolic performance. The aim of this study was to evaluate the effects of BNP on resting and exercise hemodynamics and neurohormones in patients with isolated diastolic heart failure. Methods and Results: Six patients with isolated diastolic heart failure were studied. After baseline hemodynamic measurements were obtained with use of thermistor- tipped pulmonary artery catheters, patients were randomized to receive infusion of BNP or placebo in a single-blind, crossover study. Hemodynamic and neurohormonal parameters were measured at rest after 30 minutes of infusion and during incremental supine bicycle exercise. BNP did not significantly affect resting hemodynamics but attenuated the rise in both pulmonary capillary wedge pressure (placebo, 23±2 mm Hg; BNP, 16±2 mm Hg; P<.01) and mean pulmonary artery pressure (palcebo, 34±3 mm Hg; P<.05) during exercise without affecting changes in heart rate, systemic blood pressure, or stroke volume. In response to BNP, there was significant suppression of plasma aldosterone concentration (placebo, 552±107 pmol/L; BNP, 381±56 pmol/L; P<.05). Conclusions BNP infusion causes beneficial hemodynamic and neurohormonal effects during exercise in patients with isolated diastolic heart failure.

    Original languageEnglish
    Pages (from-to)2037-2042
    Number of pages6
    JournalCirculation
    Volume93
    Issue number11
    DOIs
    Publication statusPublished - 1 Jun 1996

    Keywords

    • heart failure
    • hemodynamics
    • Peptides

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