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Sample records for atrial natriuretic factor

  1. Atrial natriuretic factor and postnatal diuresis in respiratory distress syndrome.

    OpenAIRE

    Rozycki, H J; Baumgart, S.

    1991-01-01

    To find out if atrial natriuretic factor plays a part in the control of urine output during the initiation alone or throughout postnatal diuresis in neonates with respiratory distress syndrome, atrial natriuretic factor concentrations and clinical and renal variables were measured prospectively three times during the first three days of life in 13 premature infants. Atrial natriuretic factor concentrations rose significantly between the first and second sample times as did the urine output an...

  2. Changes in plasma atrial natriuretic factor in patients with idiopathic atrial fibrillation

    International Nuclear Information System (INIS)

    To observe the changes in plasma atrial natriuretic factor (AFN) in patients with idiopathic atrial fibrillation and investigate its mechanism, plasma ANF, platelet count and hematocrit were detected in 21 cases with transient idiopathic atrial fibrillation (group A, A1 representing attack, while A2 termination), 28 with persistent idiopathic atrial fibrillation (group B), 27 suffered from rheumatic heart disease with mitral stenosis and persistent atrial fibrillation (group C), 32 with transient supraventricular tachycardia (group D) and 20 normal controls (group E). It was found that the level of ANF was significantly higher in patients with attacking transient idiopathic atrial fibrillation than that in group A2, D and E (P 0.05), while there was significant difference in hematocrit in group A1 compared with group A2, D, E (P < 0.01). It suggested that ANF and hematocrit play an important role in the attack of idiopathic atrial fibrillation

  3. Interaction of lead acetate with atrial natriuretic factor in rats

    International Nuclear Information System (INIS)

    Lead exposure alters cardiovascular function and has been implicated in the etiology of hypertension. Therefore it was of interest to study the short term effect of lead treatment on atrial natriuretic factor (ANF). Male Sprague Dawley rats were randomly divided into 5 groups containing 4 animals each and injected intraperitoneally with normal saline (control), 0.01, 0.1, 0.5 or 1.0 mg/kg of body weight with lead acetate solution twice a day for 7 days, and then maintained for a period of 30 days. During this period water consumption and urine volume were measured daily. At the end of the 30 day period, immunoreactive levels of ANF in hypothalamus, atria and plasma were measured by radioimmunoassay. Lead treatment did not alter water consumption, but significantly decreased urine output. At all doses, lead produced a decrease in hypothalamic content of ANF and slightly increased atrial levels. The content of ANF in plasma was decreased. The changes in ANF content indicate that lead interacts with the hormonal regulation of the cardiovascular system and these observations may relate to the cardiovascular toxicity of this heavy metal

  4. Atrial natriuretic factor binding sites in experimental congestive heart failure

    International Nuclear Information System (INIS)

    A quantitative in vitro autoradiographic study was performed on the aorta, renal glomeruli, and adrenal cortex of cardiomyopathic hamsters in various stages of heart failure and correlated, in some instances, with in vivo autoradiography. The results indicate virtually no correlation between the degree of congestive heart failure and the density of 125I-labeled atrial natriuretic factor [(Ser99, Tyr126)ANF] binding sites (Bmax) in the tissues examined. Whereas the Bmax was increased in the thoracic aorta in moderate and severe heart failure, there were no significant changes in the zona glomerulosa. The renal glomeruli Bmax was lower in mild and moderate heart failure compared with control and severe heart failure. The proportion of ANF B- and C-receptors was also evaluated in sections of the aorta, adrenal, and kidney of control and cardiomyopathic hamsters with severe heart failure. (Arg102, Cys121)ANF [des-(Gln113, Ser114, Gly115, Leu116, Gly117) NH2] (C-ANF) at 10(-6) M displaced approximately 505 of (Ser99, Tyr126)125I-ANF bound in the aorta and renal glomeruli and approximately 20% in the adrenal zona glomerulosa in both series of animals. These results suggest that ANF may exert a buffering effect on the vasoconstriction of heart failure and to a certain extent may inhibit aldosterone secretion. The impairment of renal sodium excretion does not appear to be related to glomerular ANF binding sites at any stage of the disease

  5. Atrial natriuretic factor in maternal and fetal sheep

    International Nuclear Information System (INIS)

    To determine atrial natriuretic factor (ANF) concentrations in the circulation and body fluids of adult pregnant sheep and their fetuses, pregnant ewes were anesthetized with pentobarbital sodium, and the fetuses were exteriorized for sampling. ANF concentration, as measured by radioimmunoassay, was 47 +/- 6 (SE) pg/ml in maternal plasma, which was significantly higher than the 15 +/- 3 pg/ml in maternal urine. In the fetus, plasma ANF concentration was 265 +/- 49 pg/ml, 5.6 times that in maternal plasma. No umbilical arterial and venous difference in ANF concentration was observed. Fetal urine ANF concentration was significantly lower than that in fetal plasma, and was similar to that measured in amniotic and allantoic fluid. In chronically catheterized maternal and fetal sheep, fetal plasma ANF was again 5.1 times that in maternal plasma, and these levels were not different from those measured in acutely anesthetized animals. These results demonstrate that immunoreactive ANF is present in the fetal circulation at levels higher than those found in the mother. The low concentration of ANF in fetal urine suggests that ANF is probably metabolized and/or reabsorbed by the fetal kidney

  6. Comparison of different standards used in radioimmunoassay for atrial natriuretic factor (ANF)

    DEFF Research Database (Denmark)

    Rasmussen, Peter Have; Nielsen, M. Damkjær; Giese, J.

    1991-01-01

    consequence, estimates of the ANF content in human plasma samples with different standard preparations as the reference showed a considerable variability. With the international standard as the gold reference (plasma ANF concentration 100%) the apparent plasma ANF concentrations measured with the other......Six different standards for determination of atrial natriuretic factor (ANF) in human plasma samples have been compared using our radio-immunoassay for ANF: International standard 85/669, National Biological Standard Boards, UK; Bachem standard, Torrance, USA; Bachem standard, Bubendorf......, Switzerland; Bissendorf standard, Wedemark, Germany; Peninsula standard, Belmont, USA; UCB-Bioproducts standard, Brussels, Belgium, Standard curves obtained with different preparations were in parallel but showed considerable quantitative differences. Standard curves referring to the Bissendorf standard and...

  7. Elevated plasma atrial natriuretic factor and vasopressin in high-altitude pulmonary edema.

    Science.gov (United States)

    Cosby, R L; Sophocles, A M; Durr, J A; Perrinjaquet, C L; Yee, B; Schrier, R W

    1988-11-15

    A diagnosis of acute high-altitude pulmonary edema was made in five male skiers (age, 35.0 +/- 1.8 years) by history and physical examination and was confirmed by a characteristic chest radiogram showing alveolar infiltrates associated with a normal cardiac silhouette. Five healthy age- and sex-matched subjects with similar physical activity at the same altitude served as controls. Plasma sodium was 135.0 +/- 1.5 mmol/L in the acutely ill patients compared with 144.0 +/- 3.3 mmol/L in the controls (P less than 0.025). Mean plasma atrial natriuretic factor immunoreactivity averaged 17.6 +/- 5.6 pmol/L in patients with high-altitude pulmonary edema compared with 6.8 +/- 0.7 pmol/L in the controls at the same altitude (P less than 0.05). Elevated atrial natriuretic factor levels normalized to 7.5 +/- 1.9 pmol/L (P less than 0.05) during recovery in Denver (altitude, 1600 meters) 24 hours later. Plasma arginine vasopressin levels were 1.8 +/- 0.37 pmol/L in patients with high-altitude pulmonary edema at diagnosis compared with 0.92 +/- 0.28 pmol/L in controls (P = 0.07). The inappropriately elevated arginine vasopressin levels decreased to 1.29 +/- 0.37 pmol/L during recovery (P less than 0.025), but the lowered plasma sodium concentration had not normalized by discharge within 24-hours of transfer to Denver and averaged 135.8 +/- 1.2 mmol/L. The pathophysiologic implications of these findings are discussed. PMID:2973274

  8. Atrial natriuretic factor: radioimmunoassay and effects on adrenal and pituitary glands

    International Nuclear Information System (INIS)

    A simple and sensitive radioimmunoassay was developed for measurement of immunoreactive atrial natriuretic factor (IR-ANF) in rat and human plasma and in rat atria. The two atria contain about 20 μg ANF per rat. The right atrium contained 2.5 times more ANF than did the left. Ether anesthesia and morphine markedly increased IR-ANF in rat plasma. The concentration of IR-ANF in plasma of clinically normal human subjects was 65.3 +/- 2.5 pg/ml. Paroxysmal tachycardia and rapid atrial pacing significantly increased IR-ANF in human plasma. Two- to seven-fold higher concentrations were found in coronary sinus blood than in the peripheral circulation. In the plasma of rats and humans, circulating ANF is probably a small-molecular-weight peptide. ANF acts on the adrenal and the pituitary. ANF inhibits aldosterone secretion from rat zona glomerulosa and steroid secretion by bovine adrenal zona glomerulosa and fasciculata. ANF stimulated the basal secretion of arginine vasopressin (AVP) in vitro and inhibited KCl-stimulated release of AVP

  9. Binding and aggregation of pro-atrial natriuretic factor by calcium.

    Science.gov (United States)

    Thibault, G; Doubell, A F

    1992-04-01

    Analysis of atrial secretory granule content by sodium dodecyl sulfate-gel electrophoresis followed by a 45Ca2+ overlay assay indicates that a 17,000 protein binds 45Ca2+. This protein, which can be immunostained by atrial natriuretic factor (ANF) antiserum, corresponds to proANF. Ca2+ binding is proportional to the amount of proANF and pH dependent. Generation of ANF-(1-98) by thrombin digestion of proANF does not affect Ca2+ binding. Blocking the carboxyl groups of proANF and the use of NH2-terminal fragments bearing those carboxyl groups demonstrated that the Ca(2+)-interaction site is probably located within the highly acidic portion (11-30) of the propeptide. Ca2+ binding to proANF induces its aggregation that can be verified by sedimentation. ProANF aggregation is Ca2+ dependent, being optimal at 10 mM, partially pH dependent, and greatly increased by high concentrations of proANF. However, because of its relatively low-binding affinity, Ca2+ can be substituted by other divalent cations such as Sr2+, Ba2+, or Mg2+. The high level of Ca2+ in atrial secretory granules and the aggregation of proANF in the presence of Ca2+ suggest a possible involvement of these physicochemical properties in the condensed state of the matrix of secretory granules. Indeed, detergent solubilization of the membrane of the secretory granules in presence of Ca2+ resulted only in a partial dissolution of the dense core matrix. We therefore postulate that, in the Golgi complex, proANF and Ca2+ associate to form a condensed aggregate that helps package secretory material into secretory vesicles. PMID:1533094

  10. Immunocytochemical localization of atrial natriuretic factor in the heart and salivary glands.

    Science.gov (United States)

    Cantin, M; Gutkowska, J; Thibault, G; Milne, R W; Ledoux, S; MinLi, S; Chapeau, C; Garcia, R; Hamet, P; Genest, J

    1984-01-01

    Antibodies produced in the mouse by repeated intraperitoneal injections of partly purified atrial natriuretic factor (low molecular weight peptide (LMWP) and high molecular weight peptide (HMWP)) have been used to localize these factors by immunohistochemistry (immunofluorescence and immunoperoxidase method) and by immunocytochemistry (protein A-gold technique) in the heart of rats and of a variety of animal species including man and in the rat salivary glands. Immunofluorescence and the immunoperoxidase method gave identical results; in the rat, atrial cardiocytes gave a positive reaction at both nuclear poles while ventricular cardiocytes were consistently negative. The cardiocytes of the right atrial appendage were more intensely reactive than those localized in the left appendage. A decreasing gradient of intensity was observed from the subpericardial to the subendocardial cardiocytes. The cardiocytes of the interatrial septum were only lightly granulated. Sodium deficiency and thirst (deprivation of drinking water for 5 days) produced, as already shown at the ultrastructural level, a marked increase in the reactivity of all cardiocytes from both atria with the same gradient of intensity as in control animals. Cross-reactivity of intragranular peptides with the rat antibodies allowed visualization of specific granules in a variety of animal species (mouse, guinea pig, rabbit, rat, dog) and in human atrial appendages. No reaction could be elicited in the frog atrium and ventricle although, in this species, specific granules have been shown to be present by electron microscopy in all cardiac chambers. With the protein A-gold technique, at the ultrastructural level, single labeling (use of one antibody on one face of a fine section) or double labeling (use of two antibodies on the two faces of a fine section) showed that the two peptides are localized simultaneously in all three types (A, B and D) of specific granules. In the rat salivary glands

  11. Atrial natriuretic peptide and feeding activity patterns in rats

    Directory of Open Access Journals (Sweden)

    Oliveira M.H.A.

    1997-01-01

    Full Text Available This review presents historical data about atrial natriuretic peptide (ANP from its discovery as an atrial natriuretic factor (ANF to its role as an atrial natriuretic hormone (ANH. As a hormone, ANP can interact with the hypothalamic-pituitary-adrenal axis (HPA-A and is related to feeding activity patterns in the rat. Food restriction proved to be an interesting model to investigate this relationship. The role of ANP must be understood within a context of peripheral and central interactions involving different peptides and pathways

  12. Removal of atrial natriuretic factor by perfused rabbit lungs in situ

    International Nuclear Information System (INIS)

    Because atrial natriuretic factor (ANF) can be released from the right atrium into pulmonary blood, the authors studied the possibility of uptake of the peptide by rabbit lung, perfused in situ, at 20 ml/min with Krebs-albumin medium. Single pass removal (multiple indicator dilution with 14C-dextran as reference) of trace amounts (40 pmoles) of 125I-ANF was 66 +/- 4% (n=12). This was reduced to 8 +/- 4% by co-injection of 10 μM ANF but was unchanged by co-injection of CPAP (340 nM), an inhibitor of angiotensin-converting enzyme (ACE). When 125I-ANF was re-circulated through lung, uptake reached maximum at 14 min (64 +/- 5%; n=7). Efflux of 125I-ANF from preloaded lungs was monoexponential with t/sub 1/2/ = 17.7 min. Recovery of 125I-ANF uptake after block by unlabelled ANF was studied. For this purpose, lungs were loaded with 0.1 μM unlabelled ANF by recirculating for 20 minutes, after which medium was changed to Krebs-albumin and removal of bolus injections of 125I-ANF was measured every 5 min. Removal of 125I-ANF, initially 0%, returned to control levels after 20 min. Thus, 125I-ANF is removed from the pulmonary circulation by a saturable and reversible process which probably does not involve binding to the ACE present on endothelial cells

  13. Removal of atrial natriuretic factor by perfused rabbit lungs in situ

    Energy Technology Data Exchange (ETDEWEB)

    Turrin, M.; Maack, T.; Gillis, C.N.

    1986-03-05

    Because atrial natriuretic factor (ANF) can be released from the right atrium into pulmonary blood, the authors studied the possibility of uptake of the peptide by rabbit lung, perfused in situ, at 20 ml/min with Krebs-albumin medium. Single pass removal (multiple indicator dilution with /sup 14/C-dextran as reference) of trace amounts (40 pmoles) of /sup 125/I-ANF was 66 +/- 4% (n=12). This was reduced to 8 +/- 4% by co-injection of 10 ..mu..M ANF but was unchanged by co-injection of CPAP (340 nM), an inhibitor of angiotensin-converting enzyme (ACE). When /sup 125/I-ANF was re-circulated through lung, uptake reached maximum at 14 min (64 +/- 5%; n=7). Efflux of /sup 125/I-ANF from preloaded lungs was monoexponential with t/sub 1/2/ = 17.7 min. Recovery of /sup 125/I-ANF uptake after block by unlabelled ANF was studied. For this purpose, lungs were loaded with 0.1 ..mu..M unlabelled ANF by recirculating for 20 minutes, after which medium was changed to Krebs-albumin and removal of bolus injections of /sup 125/I-ANF was measured every 5 min. Removal of /sup 125/I-ANF, initially 0%, returned to control levels after 20 min. Thus, /sup 125/I-ANF is removed from the pulmonary circulation by a saturable and reversible process which probably does not involve binding to the ACE present on endothelial cells.

  14. Clearance function of type C receptors of atrial natriuretic factor in rats

    International Nuclear Information System (INIS)

    The overwhelming majority of atrial natriuretic factor (ANF) receptors in kidney and vascular tissues do not mediate any of the known functional effects of the hormone. To test whether these receptors (C-ANF receptors) function as clearance receptors for circulating ANF-(1-28), we determined the effects of C-ANF-(4-23) [des[Gln18Ser19Gly20Leu21Gly22]rANF-(3-23)-NH2], a specific ligand of C-ANF receptors, on the pharmacokinetics and hydrolysis of 125I-labeled ANF-(1-28) in anesthetized rats. Radioactivity in plasma was characterized by trichloroacetic acid solubility and high-pressure liquid chromatography. C-ANF-(4-23) (1 and 10 micrograms.min-1.kg body wt-1) led to marked dose-dependent increases in initial plasma concentration of administered 125I-ANF-(1-28) and decreases in its volume of distribution at steady state (Vss), metabolic clearance rate (MCR), and appearance of hydrolytic products ([125I]monoiodotyrosine and free 125I) in plasma (Pm). At the highest dose, C-ANF-(4-23) decreased Vss from 97 +/- 12 to 36 +/- 2 ml/100 g body wt, MCR from 50 +/- 4 to 12 +/- 1 ml.min-1.100 g body wt-1, and Pm from 54 +/- 8 to 11 +/- 2% of initial plasma 125I-ANF-(1-28). The data demonstrate that C-ANF receptors are mainly responsible for the very large volume of distribution and fast MCR of ANF in the rat. In this manner, C-ANF receptors are likely to play an important role in the homeostasis of circulating ANF

  15. Brain binding sites for atrial natriuretic factor (ANF): alterations in prehypertensive Dahl salt-sensitive (S/JR) rats

    International Nuclear Information System (INIS)

    The binding of radioiodinated atrial natriuretic factor (125I-ANF-28) to discrete areas of brain in 7 week old, inbred Dahl salt-sensitive (S/JR) and salt-resistant (R/JR) rats was studied utilizing quantitative film autoradiography. At this age, S/JR rats exhibit systolic blood pressures that are prehypertensive and tend to be slightly higher than systolic blood pressures of age-matched R/JR rats. Scatchard analysis of 125I-ANF-28 binding in forebrain revealed that S/JR rats have a significantly increased number of binding sites for 125I-ANF-28 in the subfornical organ as compared to R/JR controls. In contrast, values for 125I-ANF-28 binding capacity in the choroid plexus and area postrema were similar for both strains, and binding affinity constants for 125I-ANF-28 binding revealed no strain differences in any brain area examined. The elevation in the number of binding sites for atrial natriuretic factor may serve as a compensatory mechanism acting in part to lower fluid volume and sodium levels prior to the precipitous increase in blood pressure which occurs in S/JR rats by 10 weeks of age

  16. Atrial natriuretic factor receptor guanylate cyclase, ANF-RGC, transduces two independent signals, ANF and Ca2+

    Directory of Open Access Journals (Sweden)

    Teresa eDuda

    2014-03-01

    Full Text Available Atrial natriuretic factor receptor guanylate cyclase, ANF-RGC, was the first discovered member of the mammalian membrane guanylate cyclase family. The hallmark feature of the family is that a single protein contains both the site for recognition of the regulatory signal and the ability to transduce it into the production of the second messenger, cyclic GMP. For over two decades, the family has been classified into two subfamilies, the hormone receptor subfamily with ANF-RGC being its paramount member, and the Ca2+ modulated subfamily, which includes the rod outer segment guanylate cyclases, ROS-GC1 and 2, and the olfactory neuroepithelial guanylate cyclase, ONE-GC. ANF-RGC is the receptor and the signal transducer of the most hypotensive hormones, atrial natriuretic factor (ANF and B-type natriuretic peptide (BNP. After binding these hormones at the extracellular domain it, at its intracellular domain, signals activation of the C-terminal catalytic module and accelerates the production of cyclic GMP. Cyclic GMP then serves the second messenger role in biological responses of ANF and BNP such as natriuresis, diuresis, vasorelaxation and anti-proliferation. Very recently another modus operandi for ANF-RGC was revealed. Its crux is that ANF-RGC activity is also regulated by Ca2+. The Ca2+ sensor neurocalcin  mediates this signaling mechanism. Strikingly, the Ca2+ and ANF signaling mechanisms employ separate structural motifs of ANF-RGC in modulating its core catalytic domain in accelerating the production of cyclic GMP. In this review the biochemistry and physiology of these mechanisms with emphasis on cardiovascular regulation will be discussed.

  17. Clinical significance of plasma atrial natriuretic factor and endothelin detection in hyperthyroidism and hypothyroidism

    International Nuclear Information System (INIS)

    Plasma at rial natriuretic factor (ANF) and endothelin (ET) were detected by RIA in 58 cases of hyperthyroidism and 47 cases of hypothyroidism. Before the ANF and ET concentration of untreatment hyperthyroid patients was much higher than that of treatment hyperthyroid patients, hypothyroid patients before and after treatment and the normal group (P3 and FT4. Compared with the normal group, ANF concentration in treatment hyperthyroid patients, hypothyroid patients before and after treatment was no significantly different (P>0.05), but that in hypothyroid patients before treatment was significantly decreased compared with hypothyroid patients after treatment (P0.05), but that in hypothyroid patients before treatment was significantly decreased compared with others (P<0.01 and P<0.05). Detection of ANF and ET level may be have a role in supplementary diagnosis and curative effect observation of hyperthyroidism and hypothyroidism. (authors)

  18. Atrial natriuretic peptides in plasma

    DEFF Research Database (Denmark)

    Goetze, Jens P; Holst Hansen, Lasse; Terzic, Dijana;

    2015-01-01

    Measurement of cardiac natriuretic peptides in plasma has gained a diagnostic role in the assessment of heart failure. Plasma measurement is though hampered by the marked instability of the hormones, which has led to the development of analyses that target N-terminal fragments from the prohormone....... These fragments are stable in plasma and represent surrogate markers of the actual natriuretic hormone. Post-translational processing of the precursors, however, is revealing itself to be a complex event with new information still being reported on proteolysis, covalent modifications, and amino acid...

  19. Atrial Natriuretic Peptide and Renal Dopaminergic System: A Positive Friendly Relationship?

    Directory of Open Access Journals (Sweden)

    Marcelo Roberto Choi

    2014-01-01

    Full Text Available Sodium metabolism by the kidney is accomplished by an intricate interaction between signals from extrarenal and intrarenal sources and between antinatriuretic and natriuretic factors. Renal dopamine plays a central role in this interactive network. The natriuretic hormones, such as the atrial natriuretic peptide, mediate some of their effects by affecting the renal dopaminergic system. Renal dopaminergic tonus can be modulated at different steps of dopamine metabolism (synthesis, uptake, release, catabolism, and receptor sensitization which can be regulated by the atrial natriuretic peptide. At tubular level, dopamine and atrial natriuretic peptide act together in a concerted manner to promote sodium excretion, especially through the overinhibition of Na+, K+-ATPase activity. In this way, different pathological scenarios where renal sodium excretion is dysregulated, as in nephrotic syndrome or hypertension, are associated with impaired action of renal dopamine and/or atrial natriuretic peptide, or as a result of impaired interaction between these two natriuretic systems. The aim of this review is to update and comment on the most recent evidences demonstrating how the renal dopaminergic system interacts with atrial natriuretic peptide to control renal physiology and blood pressure through different regulatory pathways.

  20. Atrial natriuretic factor R1 receptor from bovine adrenal zona glomerulosa: Purification, characterization, and modulation by amiloride

    International Nuclear Information System (INIS)

    The atrial natriuretic factor (ANF) R1 receptor from bovine adrenal zona glomerulosa was solubilized with Triton X-100 and purified 13,000-fold, to apparent homogeneity, by sequential affinity chromatography on ANF-agarose and steric exclusion high-performance liquid chromatography. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and silver staining of the purified receptor preparation in the absence or presence of dithiothreitol revealed a single protein band of Mr 130,000. Affinity cross-linking of 125I-ANF to the purified receptor resulted in the labeling of the Mr 130,000 band. The purified receptor bound ANF with a specific activity of 6.8 nmol/mg of protein, corresponding to a stoichiometry of 0.9 mol of ANF bound/mol of Mr 130,000 polypeptide. Starting with 500 g of adrenal zona glomerulosa tissue, the authors obtained more than 500 pmol of purified receptor with an overall yield of 9%. The purified receptor showed a typical ANF-R1 pharmacological specificity similar to that of the membrane-bound receptor. The homogeneous Mr 130,000 receptor protein displayed high guanylate cyclase activity [1.4 μmol of cyclic GMP formed min-1 (mg of protein)-1] which was not stimulated by ANF. This finding supports the notion that the ANF binding and the guanylate cyclase activities are intrinsic components of the same polypeptide. Finally, the purified ANF-R1 receptor retained its sensitivity to modulation by amiloride, suggesting the presence of an allosteric binding site for amiloride on the receptor protein

  1. Raised plasma concentrations of atrial natriuretic peptide are independent of left atrial dimensions in patients with chronic atrial fibrillation.

    OpenAIRE

    Berglund, H; Boukter, S; Theodorsson, E; Vallin, H; Edhag, O

    1990-01-01

    The aim of the present study was to determine whether left atrial size--a likely indicator of atrial stretching--correlates with the plasma concentration of atrial natriuretic peptide and whether this relation is different in patients in sinus rhythm and in those with atrial fibrillation. Arterial plasma concentrations of immunoreactive atrial natriuretic peptide (ir-ANP), adrenaline, noradrenaline, aldosterone, and vasopressin were measured in 13 patients in sinus rhythm without apparent hea...

  2. Atrial secretion of B-type natriuretic peptide

    DEFF Research Database (Denmark)

    Goetze, Jens Peter; Friis-Hansen, Lennart; Rehfeld, Jens F; Nilsson, Brian; Svendsen, Jesper Hastrup

    2006-01-01

    In the normal heart, the endocrine capacity resides in the atria. Atrial myocytes express and secrete natriuretic hormones that regulate fluid homeostasis and blood pressure. But in ventricular disease, atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) gene expression is also...... understanding of the endocrine atria during ventricular dysfunction is still scarce. Although ventricular disease and increased circulating concentrations are associated, it does not entail that the ventricle is the sole or even the main source in all types of heart disease. Clearly, the endocrine atria are...

  3. Are endogenous cardenolides controlled by atrial natriuretic peptide.

    Science.gov (United States)

    Brar, Kanwarjeet S; Gao, Yonglin; El-Mallakh, Rif S

    2016-07-01

    Endogenous cardenolides are digoxin-like substances and ouabain-like substances that have been implicated in the pathogenesis of hypertension and mood disorders in clinical and pre-clinical studies. Regulatory signals for endogenous cardenolides are still unknown. These endogenous compounds are believed to be produced by the adrenal gland in the periphery and the hypothalamus in the central nervous system, and constitute part of an hormonal axis that may regulate the catalytic activity of the α subunit of Na(+)/K(+)-ATPase. A review of literature suggests that there is great overlap in physiological environments that are associated with either elevations or reductions in the levels of atrial natriuretic peptide (ANP) and endogenous cardenolides. This suggests that these two factors may share a common regulatory signal or perhaps that ANP may be involved in the regulation of endogenous cardenolides. PMID:27241248

  4. Guanylyl cyclase / atrial natriuretic peptide receptor-A: role in the pathophysiology of cardiovascular regulation.

    Science.gov (United States)

    Pandey, Kailash N

    2011-08-01

    Atrial natriuretic factor (ANF), also known as atrial natriuretic peptide (ANP), is an endogenous and potent hypotensive hormone that elicits natriuretic, diuretic, vasorelaxant, and anti-proliferative effects, which are important in the control of blood pressure and cardiovascular events. One principal locus involved in the regulatory action of ANP and brain natriuretic peptide (BNP) is guanylyl cyclase / natriuretic peptide receptor-A (GC-A/NPRA). Studies on ANP, BNP, and their receptor, GC-A/NPRA, have greatly increased our knowledge of the control of hypertension and cardiovascular disorders. Cellular, biochemical, and molecular studies have helped to delineate the receptor function and signaling mechanisms of NPRA. Gene-targeted and transgenic mouse models have advanced our understanding of the importance of ANP, BNP, and GC-A/NPRA in disease states at the molecular level. Importantly, ANP and BNP are used as critical markers of cardiac events; however, their therapeutic potentials for the diagnosis and treatment of hypertension, heart failure, and stroke have just begun to be realized. We are now just at the initial stage of molecular therapeutics and pharmacogenomic advancement of the natriuretic peptides. More investigations should be undertaken and ongoing ones be extended in this important field. PMID:21815745

  5. DMPD: The atrial natriuretic peptide regulates the production of inflammatorymediators in macrophages. [Dynamic Macrophage Pathway CSML Database

    Lifescience Database Archive (English)

    Full Text Available 11890659 The atrial natriuretic peptide regulates the production of inflammatorymed...tml) (.csml) Show The atrial natriuretic peptide regulates the production of inflammatorymediators in macrop...hages. PubmedID 11890659 Title The atrial natriuretic peptide regulates the production

  6. Purification and subunit composition of atrial natriuretic peptide receptor.

    OpenAIRE

    Schenk, D B; Phelps, M N; Porter, J G; Fuller, F; Cordell, B; Lewicki, J A

    1987-01-01

    A receptor for atrial natriuretic peptide (ANP) was purified 2700-fold, to apparent homogeneity, from cultured bovine aortic smooth muscle cells by affinity chromatography. The native ANP receptor has a molecular weight of 125,000 as determined by both metrizamide gradient centrifugation and nonreducing NaDodSO4/polyacrylamide gel electrophoresis. With 125I-labeled ANP as ligand, the purified receptor bound a maximum of 5.70 nmol of ligand per mg of protein and the dissociation constant was 4...

  7. Plasma concentration of atrial natriuretic peptide in normal pregnant women and in pregnant women with preeclampsia

    DEFF Research Database (Denmark)

    Mikkelsen, A L; Schütten, G; Asping, U;

    1991-01-01

    Plasma concentration of atrial natriuretic peptide (ANP) was determined in pregnant women with preeclampsia, in normal pregnant and in nonpregnant women by a specific radioimmunoassay. Results did not show important differences between nonpregnant controls and normal pregnant women, but a...

  8. Purification and subunit composition of atrial natriuretic peptide receptor

    International Nuclear Information System (INIS)

    A receptor for atrial natriuretic peptide (ANP) was purified 2700-fold, to apparent homogeneity, from cultured bovine aortic smooth muscle cells by affinity chromatography. The native ANP receptor has a molecular weight of 125,000 as determined by both metrizamide gradient centrifugation and nonreducing NaDodSO4/polyacrylamide gel electrophoresis. With 125I-labeled ANP as ligand, the purified receptor bound a maximum of 5.70 nmol of ligand per mg of protein and the dissociation constant was 4.0 X 10(-10)M. Upon treatment with 10 mM dithiothreitol, the purified receptor migrated as a single band at Mr 60,500 in NaDodSO4/polyacrylamide gel electrophoresis. These findings show that the holoreceptor for ANP in vascular tissue is composed of two subunits of identical apparent molecular weight, presumably linked by a disulfide bridge(s)

  9. Thiorphan, an inhibitor of endopeptidase 24.11, potentiates the natriuretic activity of atrial natriuretic peptide

    International Nuclear Information System (INIS)

    To evaluate the role of endopeptidase 24.11 in metabolism of atrial natriuretic peptide (ANP) in vivo, we examined the effect of thiorphan, an inhibitor of this enzyme, on plasma ANP concentrations and the cardiovascular and renal actions of ANP(99-126). Thiorphan alone produced a modest increase in urinary sodium excretion in anesthetized rats; however, urine flow, arterial pressure, and basal plasma ANP concentrations were unchanged. When administered during an infusion of ANP(99-126) (330 ng/kg/min i.v.), thiorphan increased the plasma concentration of ANP and enhanced the diuretic and natriuretic activity of this hormone. The effects on urine flow and urinary sodium excretion were most pronounced immediately after the inhibitor was administered and later diminished in magnitude. Thiorphan did not alter the depressor activity of exogenous ANP(99-126). These data suggest that endopeptidase 24.11 participates in metabolism of ANP(99-126) and that thiorphan potentiates the renal actions of this hormone by inhibiting its degradation

  10. Analysis of brain natriuretic peptide in 30 patients with atrial fibrillation

    International Nuclear Information System (INIS)

    To investigate the relationship between atrial fibrillation and brain natriuretic peptide (BNP), plasma levels of BNP in 30 patients with atrial fibrillation and 30 health controls were assayed and compared. The results showed that plasma levels of BNP in patients with atrial fibrillation were significantly higher than those of health controls (P<0.05). When the patients with atrial fibrillation were restored sinus rhythm, the concentration of BNP decreased significantly (P<0.05). BNP was a sensitive marker of cardiac dysfunction, and BNP was positively correlated with atrial fibrillation. (authors)

  11. Influence of atrial fibrillation on plasma von Willebrand factor, soluble E-selectin, and N-terminal pro B-type natriuretic peptide levels in systolic heart failure

    DEFF Research Database (Denmark)

    Freestone, B.; Gustasson, F.; Chong, A.Y.; Corell, P.; Kistorp, C.; Hildebrandt, P.; Lip, G.Y.H.

    2008-01-01

    Association class were similar. There were significant differences in NT-proBNP (p < 0.0001) and plasma vWF (p = 0.003) between patients and control subjects. On Tukey post hoe analysis, AF-HF patients had significantly increased NT-proBNP (p < 0.001) and vWF (p = 0.0183) but not E-selectin (p = 0.071) levels...... patients with systolic HF. Methods: We measured levels of plasma von Willebrand factor (vWF) and E-selectin (as indexes of endothelial damage/dysfunction and endothelial activation, respectively; both enzyme-linked immunosorbent assay) in patients with AF and HF (AF-HF), who were compared to patients with...... sinus rhythm and HF (SR-HF), as well as in age-matched, healthy, control subjects. We also assessed the relationship of vWF and E-selectin to plasma N-terminal pro B-type natriuretic peptide (NTpro-BNP), a marker for HF severity and prognosis. Results: One hundred ninety patients (73% men; mean age, 69...

  12. Atrial natriuretic peptide regulates Ca channel in early developmental cardiomyocytes.

    Directory of Open Access Journals (Sweden)

    Lin Miao

    Full Text Available BACKGROUND: Cardiomyocytes derived from murine embryonic stem (ES cells possess various membrane currents and signaling cascades link to that of embryonic hearts. The role of atrial natriuretic peptide (ANP in regulation of membrane potentials and Ca(2+ currents has not been investigated in developmental cardiomyocytes. METHODOLOGY/PRINCIPAL FINDINGS: We investigated the role of ANP in regulating L-type Ca(2+ channel current (I(CaL in different developmental stages of cardiomyocytes derived from ES cells. ANP decreased the frequency of action potentials (APs in early developmental stage (EDS cardiomyocytes, embryonic bodies (EB as well as whole embryo hearts. ANP exerted an inhibitory effect on basal I(CaL in about 70% EDS cardiomyocytes tested but only in about 30% late developmental stage (LDS cells. However, after stimulation of I(CaL by isoproterenol (ISO in LDS cells, ANP inhibited the response in about 70% cells. The depression of I(CaL induced by ANP was not affected by either Nomega, Nitro-L-Arginine methyl ester (L-NAME, a nitric oxide synthetase (NOS inhibitor, or KT5823, a cGMP-dependent protein kinase (PKG selective inhibitor, in either EDS and LDS cells; whereas depression of I(CaL by ANP was entirely abolished by erythro-9-(2-Hydroxy-3-nonyl adenine (EHNA, a selective inhibitor of type 2 phosphodiesterase(PDE2 in most cells tested. CONCLUSION/SIGNIFICANCES: Taken together, these results indicate that ANP induced depression of action potentials and I(CaL is due to activation of particulate guanylyl cyclase (GC, cGMP production and cGMP-activation of PDE2 mediated depression of adenosine 3', 5'-cyclic monophophate (cAMP-cAMP-dependent protein kinase (PKA in early cardiomyogenesis.

  13. Atrial natriuretic peptide mediates oxytocin secretion induced by osmotic stimulus.

    Science.gov (United States)

    Chriguer, Rosengela S; Antunes-Rodrigues, José; Franci, Celso R

    2003-02-15

    Atrial natriuretic peptide (ANP), first discovered in the heart, has been also detected in various brain regions involved in the control of cardiovascular function and water and sodium balance. The anteroventral region of the third ventricle (AV3V) and the subfornical organ (SFO) have ANP-immunoreactive projections towards the paraventricular (PVN) and supraoptic (SON) nuclei of the hypothalamus. Extracellular fluid (ECF) hyperosmolality stimulates the secretion of oxytocin (OT) which induces ANP release by the atrium. On the other hand, passive immunoneutralization of ANP reduces OT secretion in response to ECF hypertonicity. Previous studies have shown the co-localization of ANP and OT in PVN and SON neurons and in the periventricular region, as well as the presence of ANPergic and oxytocinergic neurons in the median eminence. The aim of the present study was to investigate the OT and ANP content in the SON and PVN of the hypothalamus and in the posterior pituitary (PP) after an osmotic stimulus that induces OT secretion. The results showed that intracerebroventricular microinjection of normal rabbit serum (NRS) or of ANP antiserum followed or not by an intraperitoneal injection of isotonic saline did not alter OT secretion or OT content in the PVN, SON, and PP; passive ANP immunoneutralization reduced the basal content of ANP in the PVN, SON, and PP of animals in a situation of isotonicity; the ANP antiserum inhibited the increase of OT secretion and content of OT and ANP in the PVN, SON and PP induced by the osmotic stimulus. Thus, the increase in plasma OT and oxytocinergic neurons of the hypothalamus-posterior pituitary system in response to hypertonicity depends on the action of endogenous ANP, i.e., ECF hypertonicity must activate ANPergic neurons which directly or indirectly stimulate OT release. PMID:12576148

  14. Endothelin-stimulated secretion of natriuretic peptides by rat atrial myocytes is mediated by endothelin A receptors.

    Science.gov (United States)

    Thibault, G; Doubell, A F; Garcia, R; Larivière, R; Schiffrin, E L

    1994-03-01

    Endothelin (ET), a potent vasoconstrictor peptide, is known to enhance the secretion of atrial natriuretic factor (ANF) by the heart. In the present study, we investigated the potency of ET isopeptides to stimulate ANF and brain natriuretic peptide (BNP) secretion in primary cultures of neonatal atrial myocytes, and we characterized the receptor mediating these effects. All ET isopeptides caused a twofold increase of ANF and BNP secretion with the following order of potency: ET-1 approximately ET-2 > sarafotoxin 6b > ET-3. Secretion of the natriuretic peptides was blocked by BQ-123, an ETA-receptor antagonist, but was not affected by either IRL-1620 or [Ala1,3,11,15]ET-1, two ETB-receptor agonists. ET receptors were localized by autoradiography on the surface of atrial myocytes, indicating that contaminating cells were not responsible for 125I-ET-1 binding. Competition binding analyses were then used to assess the ET-receptor subtype on atrial myocyte membrane preparations. A high-affinity (100 pmol/L) binding site with high density (approximately 1500 fmol/mg) was found to preferentially bind the ET isopeptides in the following order: ET-1 > or = ET-2 > or = sarafotoxin 6b > ET-3. Binding was totally displaced by BQ-123 but not by IRL-1620. The ET binding site therefore had the characteristics of an ETA-like receptor. Analysis by cross-linking and sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that it possessed a molecular mass of approximately 50 kD. Northern blot analysis of both ETA- and ETB-receptor mRNAs allowed only the detection of the former, indicating that the ETB receptor may be expressed in very small amounts. These results demonstrate that ANF and BNP secretion by atrial myocytes is enhanced by ET via binding to an ETA-like receptor. PMID:8118954

  15. Splanchnic removal of human alpha-atrial natriuretic peptide in humans: enhancement after food intake

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Bendtsen, Flemming; Gerbes, A L

    1990-01-01

    In order to assess the effect of food ingestion on splanchnic disposal of human alpha-atrial natriuretic peptide (ANF), hepatic-intestinal removal of ANF was determined before and after a test meal. Hepatic venous and arterial plasma samples were obtained from six subjects, most of whom had only...

  16. Mid-regional pro-atrial natriuretic peptide and blood pressure in adolescents

    DEFF Research Database (Denmark)

    Goharian, Tina S; Gimsing, Anders N; Goetze, Jens P;

    2015-01-01

    Little is known about blood pressure in relation to circulating natriuretic peptide concentrations and gender in generally healthy adolescents. We studied 15-year-old females and males (n = 335) from the Danish site of the European Youth Heart Study (EYHS). Blood pressure was measured using...... a standardized protocol, sexual maturity was assessed according to Tanner stage, and as a surrogate for atrial natriuretic peptide, we measured mid-regional pro-atrial natriuretic peptide (MR-proANP) in plasma. Compared with boys, girls had lower systolic blood pressure (SBP) (mean ± SD: 109.6 ± 9.9 mmHg vs 116.......9 ± 11.4 mmHg, p adolescents were further subdivided according to Tanner stage, there were no differences in blood pressure...

  17. Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger; Boomsma, Frans; Damm, Peter; Mathiesen, Elisabeth R

    2011-01-01

    The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting that...

  18. Atrial Natriuretic Peptide (ANP) in early pregnancy is associated with development of preeclampsia in type 1 diabetes

    DEFF Research Database (Denmark)

    Nielsen, Lene Ringholm; Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger; Boomsma, Frans; Damm, Peter; Mathiesen, Elisabeth R

    2011-01-01

    The vasoactive markers of cardiac overload Atrial Natriuretic Peptide (ANP) and Brain Natriuretic Peptide (BNP) are elevated in preeclampsia. This study documents higher ANP concentrations as early as at 9 weeks in type 1 diabetic women subsequently developing preeclampsia suggesting that...... preeclampsia is associated with cardiovascular changes in early pregnancy....

  19. Effect of atrial natriuretic factor and 8-bromo cyclic guanosine 3':5'-monophosphate on [3H]acetylcholine outflow from myenteric-plexus longitudinal muscle of the guinea pig

    International Nuclear Information System (INIS)

    We report that atrial natriuretic factor (ANF) inhibits electrically induced cholinergic twitches of longitudinal muscle in whole intestinal segments and myenteric-plexus longitudinal muscle (MPLM) strips from the guinea pig ileum. To elucidate the possible presynaptic mechanism of ANF's action, we studied spontaneous and stimulation-evoked radiolabeled acetylcholine (ACh) outflow from MPLM after incubation with [3H]choline. We developed a method of mounting and treating MPLM preparations, which allowed us, at the same time, to record isometric contractions and to determine [3H]ACh outflow upon electrical stimulation by a train of three pulses. ANF (5 x 10-8M), norepinephrine (2 x 10-7) M and 8-bromoguanosine 3':5'-cyclic monophosphate (10-3 M) in nearly equieffective concentrations caused a similar inhibition of cholinergic twitches. However, ANF had no effect on [3H]ACh outflow, whereas norepinephrine was found to suppress [3H]ACh outflow and 8-bromoguanosine 3':5'-cGMP to enhanced [3H]ACh outflow. ANF (5 x 10-8 M) caused a 7.0-fold increase of cGMP over control values, predominantly in muscle layers, whereas Escherichia coli heat-stable toxin (12.5 U/ml) elicited a 35-fold increment of cGMP in the extramuscular layer. Thus, ANF is able to elevate cGMP in intestinal smooth muscle and to inhibit cholinergic contractions of MPLM. This inhibition is mimicked by exogenous cGMP and by endogenously generated cyclic nucleotides. We suggest that the depressive action of ANF on cholinergic contractions of MPLM is mediated via its postsynaptic impact implicating elevation of cGMP in smooth muscle

  20. Evaluation of Serum Levels of N-terminal Pro Brain Natriuretic Peptide and Atrial Natriuretic Peptide in Neonates with Respiratory Distress

    OpenAIRE

    Noor Mohammad Noori; Sima Savadkoohi; Alireza Teimouri; Fatemeh Alizadeh

    2016-01-01

    Background: Acute respiratory distress (ARD) is a critical respiratory failure due to lung injury of neonates leading to the clinical appearance of poor lung compliance. The aimed of the study was to evaluate the diagnostic values in differentiating respiratory from heart diseases with using of N-terminal pro brain natriuretic peptide (NT-pro BNP) and Atrial natriuretic peptide(ANP) in neonates. Material and Methods: Ninety  neonates  randomly collected from those who hospitalized in the neon...

  1. Atrial natriuretic peptide and water and electrolyte transport in the human jejunum.

    OpenAIRE

    Brunner, J.; Lübcke, R; Barbezat, G O; Yandle, T G; Espiner, E A

    1991-01-01

    The effects of atrial natriuretic peptide were investigated on water and electrolyte transport in the human jejunum. Six healthy male volunteers (aged 21-33 years) were studied using a triple lumen perfusion technique. A plasma like electrolyte solution containing polyethylene glycol (5 milligrams) as a non-absorbable marker was perfused into the jejunum at 10 ml/min, and net water and electrolyte transport and transepithelial potential difference were measured. Subjects were studied single b...

  2. Attenuated atrial natriuretic peptide-mediated lipolysis in subcutaneous adipocytes of obese type 2 diabetic men

    OpenAIRE

    Verboven, Kenneth; Hansen, Dominique; Moro, Cedric; Op 't Eijnde, Bert; Hoebers, N.; Knol, J; Bouckaert, W.; Dams, A.; Blaak, E.E.; Jocken, J. W. E.

    2016-01-01

    Aims/hypothesis Catecholamines and atrial natriuretic peptide (ANP) are major regulators of adipocyte lipolysis. Although obesity is characterized by catecholamine resistance in subcutaneous adipose tissue (SCAT), data on ANP lipolytic response and sensitivity in different adipose tissue depots of metabolically distinct humans are scarce.Methods Ex vivo catecholamine- and ANP-induced lipolysis was investigated in adipocytes derived from SCAT and visceral (VAT) depot of lean (n=13) and obese m...

  3. Stability of plasma concentrations of N and C terminal atrial natriuretic peptides at room temperature.

    OpenAIRE

    Cleland, J G; Ward, S; Dutka, D.; Habib, F; Impallomeni, M; Morton, I J

    1996-01-01

    BACKGROUND: Plasma concentrations of atrial natriuretic peptide (ANP) are increased in patients with ventricular dysfunction and could have a diagnostic role in heart failure. ANP may be unstable after collection, however, limiting any practical diagnostic role. METHODS: Blood samples were obtained from 18 patients with various conditions. Aliquots were either processed optimally or kept as blood or plasma at room temperature for 6-72 h before processing. RESULTS: Concentrations of C-terminal...

  4. Atrial natriuretic peptide regulates lipid mobilization and oxygen consumption in human adipocytes by activating AMPK

    International Nuclear Information System (INIS)

    Highlights: → Treatment of differentiated human adipocytes with atrial natriuretic peptide (ANP) increased lipolysis and oxygen consumption by activating AMP-activated protein kinase (AMPK). → ANP stimulated lipid mobilization by selective activation of the alpha2 subunit of AMPK and increased energy utilization through activation of both the alpha1 and alpha2 subunits of AMPK. → ANP enhanced adipocyte mitochondrial oxidative capacity as evidenced by induction of oxidative mitochondrial genes and increase in oxygen consumption. → Exposure of human adipocytes to fatty acids and (TNFα) induced insulin resistance and decreased expression of mitochondrial genes which was restored to normal by ANP. -- Abstract: Atrial natriuretic peptide (ANP) has been shown to regulate lipid and carbohydrate metabolism providing a possible link between cardiovascular function and metabolism by mediating the switch from carbohydrate to lipid mobilization and oxidation. ANP exerts a potent lipolytic effect via cGMP-dependent protein kinase (cGK)-I mediated-stimulation of AMP-activated protein kinase (AMPK). Activation of the ANP/cGK signaling cascade also promotes muscle mitochondrial biogenesis and fat oxidation. Here we demonstrate that ANP regulates lipid metabolism and oxygen utilization in differentiated human adipocytes by activating the alpha2 subunit of AMPK. ANP treatment increased lipolysis by seven fold and oxygen consumption by two fold, both of which were attenuated by inhibition of AMPK activity. ANP-induced lipolysis was shown to be mediated by the alpha2 subunit of AMPK as introduction of dominant-negative alpha2 subunit of AMPK attenuated ANP effects on lipolysis. ANP-induced activation of AMPK enhanced mitochondrial oxidative capacity as evidenced by a two fold increase in oxygen consumption and induction of mitochondrial genes, including carnitine palmitoyltransferase 1A (CPT1a) by 1.4-fold, cytochrome C (CytC) by 1.3-fold, and peroxisome proliferator

  5. Atrial natriuretic peptide regulates lipid mobilization and oxygen consumption in human adipocytes by activating AMPK

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Sandra C. [Translational Sciences - Translational Medicine, Novartis Institutes for Biomedical Research, Inc., 220 Massachusetts Avenue, Cambridge, MA 02139 (United States); Chau, Mary D.L.; Yang, Qing [Cardiovascular and Metabolism Disease Area, Novartis Institutes for Biomedical Research, Inc., 100 Technology Square, Cambridge, MA 02139 (United States); Gauthier, Marie-Soleil [Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA 02140 (United States); Clairmont, Kevin B.; Wu, Zhidan; Gromada, Jesper [Cardiovascular and Metabolism Disease Area, Novartis Institutes for Biomedical Research, Inc., 100 Technology Square, Cambridge, MA 02139 (United States); Dole, William P., E-mail: bill.dole@novartis.com [Translational Sciences - Translational Medicine, Novartis Institutes for Biomedical Research, Inc., 220 Massachusetts Avenue, Cambridge, MA 02139 (United States)

    2011-07-08

    Highlights: {yields} Treatment of differentiated human adipocytes with atrial natriuretic peptide (ANP) increased lipolysis and oxygen consumption by activating AMP-activated protein kinase (AMPK). {yields} ANP stimulated lipid mobilization by selective activation of the alpha2 subunit of AMPK and increased energy utilization through activation of both the alpha1 and alpha2 subunits of AMPK. {yields} ANP enhanced adipocyte mitochondrial oxidative capacity as evidenced by induction of oxidative mitochondrial genes and increase in oxygen consumption. {yields} Exposure of human adipocytes to fatty acids and (TNF{alpha}) induced insulin resistance and decreased expression of mitochondrial genes which was restored to normal by ANP. -- Abstract: Atrial natriuretic peptide (ANP) has been shown to regulate lipid and carbohydrate metabolism providing a possible link between cardiovascular function and metabolism by mediating the switch from carbohydrate to lipid mobilization and oxidation. ANP exerts a potent lipolytic effect via cGMP-dependent protein kinase (cGK)-I mediated-stimulation of AMP-activated protein kinase (AMPK). Activation of the ANP/cGK signaling cascade also promotes muscle mitochondrial biogenesis and fat oxidation. Here we demonstrate that ANP regulates lipid metabolism and oxygen utilization in differentiated human adipocytes by activating the alpha2 subunit of AMPK. ANP treatment increased lipolysis by seven fold and oxygen consumption by two fold, both of which were attenuated by inhibition of AMPK activity. ANP-induced lipolysis was shown to be mediated by the alpha2 subunit of AMPK as introduction of dominant-negative alpha2 subunit of AMPK attenuated ANP effects on lipolysis. ANP-induced activation of AMPK enhanced mitochondrial oxidative capacity as evidenced by a two fold increase in oxygen consumption and induction of mitochondrial genes, including carnitine palmitoyltransferase 1A (CPT1a) by 1.4-fold, cytochrome C (CytC) by 1.3-fold, and

  6. Localization of atrial natriuretic peptide mRNA and immunoreactivity in the rat heart and human atrial appendage

    Energy Technology Data Exchange (ETDEWEB)

    Hamid, Q.; Wharton, J.; Terenghi, G.; Hassall, C.J.S.; Aimi, J.; Taylor, K.M.; Nakazato, H.; Dixon, J.E.; Burnstock, G.; Polak, J.M.

    1987-10-01

    The localization of mRNA encoding preproatrial natriuretic peptide was investigated in tissue sections and cultures of rat heart and in sections of human right atrial appendage using the technique of in situ hybridization with /sup 32/P- and /sup 35/S-labeled RNA probes. Rat atrial natriuretic peptide (ANP) transcripts were demonstrated in numerous atrial myocytes and, to a lesser extent, in ventricular myocytes in both tissue sections and newborn rat heart cultures. These findings are consistent with those obtained by RNA blot analysis of rat heart total RNA, indicating that a single prepro-ANP transcript of approx. 900 nucleotides was present in the ventricles as well as the atria. Using a /sup 35/S-labeled RNA probe for human ANP mRNA, ANP transcripts were also localized to the majority of myocytes in the human right atrial appendage. Only background levels of autoradiographic labeling were obtained when RNA probes identical to the coding sequence of rat or human ANP mRNA were used. A close correlation was found between the distribution of ANP immunoreactivity and prepro-ANP mRNA in these preparations. These results provide unequivocal evidence for the expression of the ANP gene in the rat ventricles, as well as the atria, because myocytes in these tissues have been established as the sites of both ANP localization and precursor biosynthesis. The combined use of cardiac cultures and in situ hybridization may be of value in future studies investigating the regulation of ANP synthesis in cardiac myocytes.

  7. Attenuated response to atrial natriuretic peptide in rats with myocardial infarction.

    Science.gov (United States)

    Kohzuki, M; Hodsman, G P; Johnston, C I

    1989-02-01

    The natriuretic, diuretic, and hypotensive effects of atrial natriuretic peptide (ANP) were examined in rats 4 wk after myocardial infarction induced by left coronary artery ligation. Synthetic rat ANP (fragment 1-28) was infused intravenously in doses of 0.1, 0.3, and 1.0 micrograms.kg-1.min-1 for 30 min. There was a significant decrease in systolic blood pressure in controls and rats with infarction, although only in control rats was there a significant decrease in diastolic blood pressure. Changes in systolic and diastolic blood pressure were attenuated in rats with infarction compared with controls (P less than 0.01). The diuretic and natriuretic effects of ANP were observed in both groups of rats, but the effects were significantly less in rats with infarction (P less than 0.01). The ANP infusion did not induce significant changes in heart rate or hematocrit in controls or rats with infarction. The results indicate that rats with chronic left heart failure are less sensitive to the natriuretic, diuretic, and hypotensive effects of ANP when compared with controls. The attenuated renal response to ANP may contribute to the impaired sodium and water excretion in chronic heart failure, although other mechanisms are involved. PMID:2521777

  8. 心房颤动患者心耳组织肝细胞生长因子、脑钠肽与纤维化的相关研究%Hepatocyte growth factor, B-type natriuretic peptide and atrial fibrosis in patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    庄端蓉; 陈颖敏; 茆臻贞; 李宏松; 徐瑾; 何奔

    2013-01-01

    目的 检测肝细胞生长因子(HGF)、脑钠肽(BNP)在心房颤动(简称房颤)患者心房组织中的表达,探讨心房纤维化的分子机制.方法 将术中获取右心耳的26例风湿性心脏病(简称风心病)患者分为2组,其中窦性心律(简称窦律)组10例,房颤组16例,另选先天性心脏病患者6例(均为窦律)作为对照组;于术中获取右心耳组织,采用苦味酸天狼猩红染色法对心房组织胶原沉积量及分布情况进行分析,以β-肌动蛋白(β-actin)为内参照基因,采用实时荧光定量聚合酶链式反应技术测定心房组织中HGF、BNP的mRNA含量,用免疫组织化学方法评价HGF、BNP的蛋白表达情况.结果 与对照组和窦律组比较,慢性房颤组心房组织胶原容积分数明显增加(P<0.01),而风心病窦律组和对照组无明显差异.与对照组和窦律组比较,房颤组HGF、BNP的mRNA和蛋白表达显著降低(P<0.05),而风心病窦律组和对照组无明显差异.结论 房颤患者心房组织中HGF、BNP表达显著降低可能是导致心房纤维化的分子机制之一,与房颤的发生和维持有关.%Objective To investigate the expressions of hepatocyte growth factor(HGF) and B-type natriuretic peptide (BNP) in patients with atrial fibrillation(AF),and discuss their possible molecular mechanisms in atrial fibrosis.Methods Twenty-six patients with rheumatic heart disease(RHD) were enrolled.Ten patients had no history of AF and 16 had AF.Atrial tissue was obtained from the right atrial appendage during heart surgery.Other 6 patients with congenital heart disease who had no history of AF were taken as the control group; Sirius red staining for quantitative analysis of collagen accumulation.The mRNA expression of HGF and BNP was measured by real-time fluorescence quota polymerase chain reaction.The protein expression of HGF and BNP was detected by immunhistochemical method.Results The volume fraction of collagen were significantly increased in

  9. Renal effects of urodilatin and atrial natriuretic peptide in volume expanded conscious dogs

    DEFF Research Database (Denmark)

    Bestle, M H; Bie, P

    1993-01-01

    The renal effects of urodilatin and atrial natriuretic peptide (ANP) were examined in conscious dogs during acute volume expansion maintained through independent infusions of water and NaCl. Peptide was infused in a step-up fashion, in 40-min periods at rates of 2.5, 12.5 and 50.0 ng kg-1 min-1....... The results demonstrate that in identical, relatively high doses, the changes in sodium excretion, diuresis, heart rate (HR) and arterial pressures elicited by urodilatin are more pronounced than those of ANP.(ABSTRACT TRUNCATED AT 250 WORDS)...

  10. ANP (Atrial Natriuretic Peptide presence in the heart of a tunicate, Ciona intestinalis.

    Directory of Open Access Journals (Sweden)

    Aldo Gerbino

    2010-06-01

    Full Text Available Atrial natriuretic peptide was found in the heart of vertebrates, we studied the ANP presence in the heart of Ciona intestinalis. This is animal is very important because of the its evolutionary position between invertebrates and vertebrates. ANP presence was only revealed in myoepithelial cells of the myocardium. Results suggest the hypothesis that ANP is present not only in the vertebrates but also in the invertebrates and in Ciona heart ANP might play a similar role like in the heart of vertebrates.

  11. Raised Plasma Aldosterone and Natriuretic Peptides in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Dixen, Ulrik; Ravn, Lasse Steen; Soeby-Rasmussen, Christian;

    2006-01-01

    , present AF at follow-up, total duration of AF disease, ongoing medication, and the LVEF as explanatory variables showed that only ongoing treatment with diuretics was significantly associated (likelihood ratio test, p = 0.0057) with a raised log-transformed plasma aldosterone, although present AF at...... log-transformed plasma Nt-proANP. Likewise, present AF at follow-up (p = 0.0008) as well as age (p < 0.0001) were associated with high log-transformed plasma Nt-proBNP. CONCLUSIONS: In patients with earlier AF, AF at long-term follow-up visit was independently associated with raised levels of Nt...... follow-up was related to a high aldosterone level (p = 0.09). For the natriuretic peptides, present AF at follow-up (p < 0.0001), age (p < 0.0001), female gender (p = 0.0047), ischemic heart disease (p = 0.0154), and ongoing treatment with sotalol (p = 0.0003) were all independently associated with high...

  12. A liver metalloendopeptidase which degrades the circulating hypotensive peptide hormones bradykinin and atrial natriuretic peptide

    Directory of Open Access Journals (Sweden)

    Carvalho K.M.

    1999-01-01

    Full Text Available A new metalloendopeptidase was purified to apparent homogeneity from a homogenate of normal human liver using successive steps of chromatography on DEAE-cellulose, hydroxyapatite and Sephacryl S-200. The purified enzyme hydrolyzed the Pro7-Phe8 bond of bradykinin and the Ser25-Tyr26 bond of atrial natriuretic peptide. No cleavage was produced in other peptide hormones such as vasopressin, oxytocin or Met- and Leu-enkephalin. This enzyme activity was inhibited by 1 mM divalent cation chelators such as EDTA, EGTA and o-phenanthroline and was insensitive to 1 µM phosphoramidon and captopril, specific inhibitors of neutral endopeptidase (EC 3.4.24.11 and angiotensin-converting enzyme (EC 3.4.15.1, respectively. With Mr 85 kDa, the enzyme exhibits optimal activity at pH 7.5. The high affinity of this endopeptidase for bradykinin (Km = 10 µM and for atrial natriuretic peptide (Km = 5 µM suggests that it may play a physiological role in the inactivation of these circulating hypotensive peptide hormones.

  13. Correlation between B type natriuretic peptide and metabolic risk factors

    OpenAIRE

    Zhu, Wen-hua; Chen, Li-Ying; Dai, Hong-Lei; CHEN, JIAN-HUA; Yan CHEN; Fang, Li-Zheng

    2016-01-01

    Introduction It has been shown that B type natriuretic peptide (BNP) level can indicate cardiovascular disease. However, the association between BNP and metabolic risk factors is unknown. The aim of this study was to investigate the correlation between N-terminal pro-B type natriuretic peptide (NT-proBNP) and metabolic risk factors. Material and methods A total of 11,508 subjects were selected from those who underwent health examinations in our hospital. NT-proBNP, waist circumference, blood ...

  14. Inhibition of atrial natriuretic peptide-induced cyclic GMP accumulation in the bovine endothelial cells with anti-atrial natriuretic peptide receptor antiserum

    International Nuclear Information System (INIS)

    Using an antiserum raised against the purified atrial natriuretic peptide (ANP) receptor that has a disulfide-linked homodimeric structure and represents one subtype of the multiple ANP receptors, we showed that the receptor is coupled to the guanylate cyclase activation; formerly, this type of ANP receptor is not considered to be coupled to the cyclase. The specificity of the antiserum was determined by immunoblot analysis and immunoprecipitation. The anti-receptor antiserum did not compete with 125I-ANP for binding to the receptor but it lowered the affinity of the receptor. When added to bovine endothelial cell cultures, the antiserum blocked the cyclic GMP response of the cells triggered by ANP. These results indicate that the subtype of the ANP receptor recognized by the antiserum is responsible for the activation of particulate guanylate cyclase as well as the double function type receptor that has been assumed to contain both the receptor domain and the catalytic domain for cGMP synthesis on the same molecule. The presence of dissociative complexes of ANP receptor and particulate guanylate cyclase was also demonstrated by radiation inactivation analysis

  15. Natriuretic peptides modulate ATP-sensitive K+ channels in rat ventricular cardiomyocytes

    OpenAIRE

    Burley, Dwaine S.; Charles D Cox; Zhang, Jin; Wann, Kenneth T.; Baxter, Gary F.

    2014-01-01

    B-type natriuretic peptide (BNP) and C-type natriuretic peptide (CNP), and (Cys-18)-atrial natriuretic factor (4–23) amide (C-ANF), are cytoprotective under conditions of ischemia–reperfusion, limiting infarct size. ATP-sensitive K+ channel (KATP) opening is also cardioprotective, and although the KATP activation is implicated in the regulation of cardiac natriuretic peptide release, no studies have directly examined the effects of natriuretic peptides on cardiac KATP activity. Normoxic cardi...

  16. Highly sensitive radioimmunoassay of atrial natriuretic peptide (ANP) in human plasma and urine

    International Nuclear Information System (INIS)

    A highly sensitive radioimmunoassay has been established for measurement of human plasma and urine concentrations of atrial natriuretic peptide (ANP) and requires no extraction or concentration process. An antiserum was prepared from rabbits immunized with α-human ANP (α-hANP) coupled with bovine-thyroglobulin. The sensitivity of this method was 0.2 pg/tube of synthetic α-hANP utilized as authentic standard. Recovery of α-hANP spiked to plasma and urine was 97.7 +/- 15.4% and 97.1 +/- 9.5% (mean +/- SD), respectively. Plasma and urinary ANP concentrations versus assay data showed satisfactory linearity. In 124 health subjects, the plasma ANP concentration was 31.7 +/- 12.0 pg/ml. Two different molecular forms of ANP in plasma and a single form in urine were found by gel permeation chromatography

  17. Relationship between the actions of atrial natriuretic peptide (ANP, guanylin and uroguanylin on the isolated kidney

    Directory of Open Access Journals (Sweden)

    M.S. Santos-Neto

    1999-08-01

    Full Text Available Guanylin and uroguanylin are peptides that bind to and activate guanylate cyclase C and control salt and water transport in many epithelia in vertebrates, mimicking the action of several heat-stable bacteria enterotoxins. In the kidney, both of them have well-documented natriuretic and kaliuretic effects. Since atrial natriuretic peptide (ANP also has a natriuretic effect mediated by cGMP, experiments were designed in the isolated perfused rat kidney to identify possible synergisms between ANP, guanylin and uroguanylin. Inulin was added to the perfusate and glomerular filtration rate (GFR was determined at 10-min intervals. Sodium was also determined. Electrolyte dynamics were measured by the clearance formula. Guanylin (0.5 µg/ml, N = 12 or uroguanylin (0.5 µg/ml, N = 9 was added to the system after 30 min of perfusion with ANP (0.1 ng/ml. The data were compared at 30-min intervals to a control (N = 12 perfused with modified Krebs-Hanseleit solution and to experiments using guanylin and uroguanylin at the same dose (0.5 µg/ml. After previous introduction of ANP in the system, guanylin promoted a reduction in fractional sodium transport (%TNa+, P<0.05 (from 78.46 ± 0.86 to 64.62 ± 1.92, 120 min. In contrast, ANP blocked uroguanylin-induced increase in urine flow (from 0.21 ± 0.01 to 0.15 ± 0.007 ml g-1 min-1, 120 min, P<0.05 and the reduction in fractional sodium transport (from 72.04 ± 0.86 to 85.19 ± 1.48, %TNa+, at 120 min of perfusion, P<0.05. Thus, the synergism between ANP + guanylin and the antagonism between ANP + uroguanylin indicate the existence of different subtypes of receptors mediating the renal actions of guanylins.

  18. Inhibition of atrial natriuretic peptide-induced natriuresis by plasma hydrolysates containing pepsanurin.

    Science.gov (United States)

    Borić, M P; Croxatto, H R; Albertini, R; Roblero, J S

    1992-02-01

    The specificity of antidiuretic actions of pepsanurin, a peptidic fraction obtained by pepsin hydrolysis of plasma, was studied in anesthetized rats and in isolated perfused rat kidneys. Pepsanurin was obtained from fresh dialyzed human plasma digested with pepsin (2,400 units/ml, 18 hours at 37 degrees C, pH 2.5), deproteinized (10 minutes at 80 degrees C), and centrifuged. In the rat, intraperitoneal injections of pepsanurin (0.5 ml/100 g body wt) significantly inhibited the effects of an intravenous bolus of atrial natriuretic peptide (ANP) (0.5 micrograms) on water, sodium, and potassium excretion without altering systemic blood pressure. In addition, pepsanurin abolished the peak in glomerular filtration rate and reduced the ANP-induced rise in fractional sodium excretion. Pepsanurin also inhibited the natriuretic effects of amiloride (10 micrograms/100 g body wt i.v.) without changing glomerular filtration rate, but it did not inhibit the potassium-retaining effect of amiloride. In contrast, pepsanurin had no effect on basal urinary excretion, and it did not affect the diuretic response induced by furosemide (doses of 25, 50, or 100 micrograms i.v.). Control peptidic hydrolysates prepared from human plasma preincubated 48 hours at 37 degrees C (PIPH), bovine albumin (BSAH), or human albumin did not inhibit ANP, amiloride, or furosemide. In perfused kidneys, pepsanurin significantly and reversibly reduced sodium and water excretion. Furthermore, pepsanurin, but not PIPH or BSAH, blocked the natriuretic and diuretic effects of ANP. These results support the existence of a specific plasma substrate able to release a peptide or peptides that counteract distal tubule diuresis and natriuresis by an intrarenal mechanism. PMID:1531208

  19. Atrial natriuretic peptide infusion in chronic heart failure in the rat.

    Science.gov (United States)

    Kohzuki, M; Hodsman, G P; Harrison, R W; Western, P S; Johnston, C I

    1989-01-01

    The natriuretic, diuretic, and hypotensive responses to infused atrial natriuretic peptide (ANP) were measured in rats 4 weeks after myocardial infarction induced by coronary artery ligation. Rat [1-28]-ANP was infused intravenously in doses of 0.1, 0.3, and 1.0 microgram/kg/min for 30 min each under pentobarbital anesthesia. There was a marked natriuresis, diuresis, and fall in blood pressure in rats with infarction but each response was significantly attenuated when compared with sham-operated controls (ANOVA: p less than 0.01, p less than 0.05, and p less than 0.01, respectively). Urinary cyclic guanosine monophosphate (cGMP) excretion in rats with infarction was higher than that of controls but rose to the same absolute level in both groups in response to ANP infusion (0.3 microgram/kg/min). Reduced ANP responsiveness may result from impaired postreceptor mechanisms or from physiological antagonism by angiotensin II. Reduced ANP responsiveness may partly explain impaired salt handling in heart failure. PMID:2473348

  20. Atrial natriuretic peptide decreases blood volume in intact and anephric rats

    International Nuclear Information System (INIS)

    Atrial natriuretic peptide (ANP) reportedly lowers atrial pressure and increases hematocrit, suggesting venodilation and/or decreased blood volume (BV). To examine these possibilities, rat ANP (99-126) was administered to Inactinanesthetized rats (313 +/- 9 g, +/- SE) at 0.5 μg/kg/min for 30 minutes. Urine flow increased by 0.05 ml/min (p 51Cr-RBC) decreased by 3.4 ml/kg (p < 0.001). Mean circulatory filling pressure, measured by inflating an intracardiac balloon to briefly stop the circulation, did not change. Distribution of BV between the thoracic and spanchnic organs (whole-animal freezing in liquid nitrogen) was not measurably altered. The results suggest that the decrease in CVP was related more to decreased BV than to venodilation. To investigate possible mechanisms for the decreased BV, the same dose of ANP was administered to anephric rats. MAP decreased by 8 mmHg (p < 0.001); hematocrit increased by 2.4 units (p < 0.001) and BV decreased by 1.7 ml/kg (p < 0.05). The results indicate that short-term administration of ANP decreases blood volume by causing intravascular fluid to shift into the interstitium as well as by inducing diuresis

  1. Influence of storage conditions on in vitro stability of atrial natriuretic peptide and of anesthesia on plasma atrial natriuretic peptide concentration in cats.

    Science.gov (United States)

    Heishima, Yasuhiro; Hori, Yasutomo; Chikazawa, Seishiro; Kanai, Kazutaka; Hoshi, Fumio; Itoh, Naoyuki

    2016-08-01

    OBJECTIVE To investigate the in vitro stability of atrial natriuretic peptide (ANP) in plasma samples under various storage conditions and the influence of anesthesia on plasma ANP concentration in cats. ANIMALS 1 cat with congestive heart failure and 5 healthy adult mixed-breed cats. PROCEDURES A plasma sample from the cat with heart failure was serially diluted, and dilutional parallelism of ANP concentration was evaluated. Plasma samples containing aprotinin or serum samples from the 5 healthy cats were kept at room temperature (27°C) for ≤ 12 hours. Plasma samples from the same healthy cats were stored at -70°, -20°, or 4°C for ≤ 14 days. Plasma samples were obtained from the healthy cats before and during isoflurane anesthesia. Plasma ANP concentrations were measured at a commercial laboratory by use of a human ANP chemiluminescence assay. RESULTS Intra- and interassay coefficients of variation were 1.5% and 2.5%, respectively, and dilutional parallelism was established. Although ANP concentration decreased by 82.4 ± 13.6% (mean ± SD) after sample storage for 12 hours at room temperature, this decrease was prevented by aprotinin. Plasma ANP concentrations were stable for 7 days at -20°C and for 14 days at -70°C. However, concentrations decreased markedly to 57.6 ± 6.9% at -20°C and to 18.0 ± 3.0% at 4°C after 14 days. Plasma ANP concentration decreased significantly in cats during anesthesia and was correlated with blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that aprotinin should be added routinely in preparation of plasma samples from cats for measurement of ANP concentration, and those samples, if stored, should be frozen immediately at ≤ -20°C. General anesthesia or systemic blood pressure may affect plasma ANP concentration in cats. PMID:27463548

  2. Electron microscopic analysis of the specific granule content of human atria. An investigation of the role of atrial pressure and atrial rhythm in the release of atrial natriuretic peptide.

    Science.gov (United States)

    Doubell, A F; Greeff, M P; Rossouw, D J; Weich, H F

    1990-08-18

    Knowledge about the stimulus for the release of atrial natriuretic peptide (ANP) from human atria is incomplete. Atrial stretch is known to be a stimulus and atrial tachyarrhythmias are thought to be another. The effects of atrial size (by two-dimensional echocardiography) and atrial fibrillation on the atrial specific granule content of human atria were studied to gain insight into the secretory mechanisms of ANP. An electron microscopic analysis of the atrial granule content was used to study 12 patients--5 with mitral stenosis and sinus rhythm, 3 with mitral stenosis and atrial fibrillation and 4 controls. Granules were counted using a free count and montage method. This is the first report of such a morphometric analysis in humans. Granule counts were significantly raised in the patients with mitral stenosis compared with controls (P less than 0.014). This observation probably reflects a high turnover state induced by elevated atrial pressures. Further support for this conclusion is provided by the demonstration of a positive correlation between granule counts and left atrial size (r = 0.86; P less than 0.01). The tendency for higher counts in patients with atrial fibrillation may be related to the rhythm disturbance itself, but clinical and echocardiographic data suggest more severe atrial pressure overload in this group. PMID:2143315

  3. Effectiveness of Human Atrial Natriuretic Peptide Supplementation in Pulmonary Edema Patients Using the Pulse Contour Cardiac Output System

    OpenAIRE

    Sakamoto, Yuichiro; Mashiko, Kunihiro; Saito, Nobuyuki; Matsumoto, Hisashi; Hara, Yoshiaki; Kutsukata, Noriyoshi; Yokota, Hiroyuki

    2010-01-01

    Purpose Atrial natriuretic peptide (ANP) has a variety of pharmacologic effects, including natriuresis, diuresis, vasodilatation, and suppression of the renin-angiotensin system. A recent study showed that ANP infusion improved hypoxemia and pulmonary hypertension in a lung injury model. On the other hand, the pulse contour cardiac output (PiCCO™) system (Pulsion Medical Systems, Munich, Germany) allows monitoring of the intravascular volume status and may be used to guide volume therapy in s...

  4. Characterisation of Anti-Apoptotic Signalling Pathways in Hepatocytes activated by alpha-Lipoic Acid and Atrial Natriuretic Peptide

    OpenAIRE

    Kulhanek-Heinze, Stefanie

    2004-01-01

    Both, the R-enantiomer of the antioxidant alpha-lipoic acid (R-LA) and the hormone atrial natriuretic peptide (ANP) are known to exert potent hepatoprotective action. The present work characterises alpha-lipoic acid- and ANP-mediated signal transduction pathways involved in the regulation of apoptotic cell death in two different models: primary hepatocytes and ischemic isolated perfused rat livers. alpha-lipoic acid was shown to protect isolated hepatocytes from TNF-alpha-/ActinomycinD-in...

  5. Atrial natriuretic peptide and oxytocin induce natriuresis by release of cGMP

    Science.gov (United States)

    Soares, T. J.; Coimbra, T. M.; Martins, A. R.; Pereira, A. G. F.; Carnio, E. C.; Branco, L. G. S.; Albuquerque-Araujo, W. I. C.; de Nucci, G.; Favaretto, A. L. V.; Gutkowska, J.; McCann, S. M.; Antunes-Rodrigues, J.

    1999-01-01

    Our hypothesis is that oxytocin (OT) causes natriuresis by activation of renal NO synthase that releases NO followed by cGMP that mediates the natriuresis. To test this hypothesis, an inhibitor of NO synthase, l-nitroarginine methyl ester (NAME), was injected into male rats. Blockade of NO release by NAME had no effect on natriuresis induced by atrial natriuretic peptide (ANP). This natriuresis presumably is caused by cGMP because ANP also activates guanylyl cyclase, which synthesizes cGMP from GTP. The 18-fold increase in sodium (Na+) excretion induced by OT (1 μg) was accompanied by an increase in urinary cGMP and preceded by 20 min a 20-fold increase in NO3− excretion. NAME almost completely inhibited OT-induced natriuresis and increased NO3− excretion; however, when the dose of OT was increased 10-fold, a dose that markedly increases plasma ANP concentrations, NAME only partly inhibited the natriuresis. We conclude that the natriuretic action of OT is caused by a dual action: generation of NO leading to increased cGMP and at higher doses release of ANP that also releases cGMP. OT-induced natriuresis is caused mainly by decreased tubular Na+ reabsorption mediated by cGMP. In contrast to ANP that releases cGMP in the renal vessels and the tubules, OT acts on its receptors on NOergic cells demonstrated in the macula densa and proximal tubules to release cGMP that closes Na+ channels. Both ANP- and OT-induced kaliuresis also appear to be mediated by cGMP. We conclude that cGMP mediates natriuresis and kaliuresis induced by both ANP and OT. PMID:9874809

  6. Atrial natriuretic peptide signal pathway upregulated in stomach of streptozotocin-induced diabetic mice

    Directory of Open Access Journals (Sweden)

    Zhang-Xun Qiu, Bing Mei, Yi-Song Wu, Xu Huang, Zuo-Yu Wang, Yan-Fei Han, Hong-Li Lu, Young-Chul Kim, Wen-Xie Xu

    2010-01-01

    Full Text Available AIM: To investigate atrial natriuretic peptide (ANP secretion from gastric mucosa and the relationship between the ANP/natriuretic peptide receptor type A (NPR-A pathway and diabetic gastroparesis.METHODS: Male imprinting control region (ICR mice (4 wk old were divided into two groups: control mice, and streptozotocin-induced diabetic mice. Eight weeks after injection, spontaneous gastric contraction was recorded by using physiography in control and streptozotocin-induced diabetic mice. The ANP-positive cells in gastric mucosa and among dispersed gastric epithelial cells were detected by using immunohistochemistry and flow cytometry, respectively. ANP and natriuretic peptide receptor type A (NPR-A gene expression in gastric tissue was observed by using the reverse transcriptase polymerase chain reaction.RESULTS: The frequency of spontaneous gastric contraction was reduced from 12.9 ± 0.8 cycles/min in the control group to 8.4 ± 0.6 cycles/min in the diabetic mice (n = 8, P < 0.05. However, the amplitude of contraction was not significantly affected in the diabetic group. The depletion of interstitial cells of Cajal in the gastric muscle layer was observed in the diabetic mice. ANP-positive cells were distributed in the gastric mucosal layer and the density index of ANP-positive cells was increased from 20.9 ± 2.2 cells/field in control mice to 51.8 ± 2.9 cells/field in diabetic mice (n = 8, P < 0.05. The percentage of ANP-positive cells among the dispersed gastric epithelial cells was increased from 10.0% ± 0.9% in the control mice to 41.2% ± 1.0% in the diabetic mice (n = 3, P < 0.05. ANP and NPR-A genes were both expressed in mouse stomach, and the expression was significantly increased in the diabetic mice.CONCLUSION: These results suggest that the ANP/NPR-A signaling pathway is upregulated in streptozotocin-induced diabetic mice, and contributes to the development of diabetic gastroparesis.

  7. Effect of sinus rhythm restoration on plasma brain natriuretic peptide (BNP) levels in patients with atrial fibrillation

    International Nuclear Information System (INIS)

    Objective: To study the changes of plasma brain natriuretic peptide (BNP) levels before and after sinus rhythm restoration in patients with paroxysmal or persistent atrial fibrillation (AF) but normal left ventricle function and to explore the role of BNP in AF. Methods: Plasma BNP levels were measured with RIA in 68 patients and 34 controls. Results: Twenty four hours after successful cardioversion, plasma BNP levels decreased significantly in all the patients. The 30 patients with paroxysmal atrial fibrillation were all restored to sinus rhythm and levels of plasma BNP dropped from 96±42pg/ml to 28 ±21pg/ml. Of the 38 patients with persistent atrial fibrillation, 28 of them were restored to sinus rhythm, in whom levels of plasma BNP dropped from 73±38pg/ml to 38±25pg/ml. Conclusion: The presence of AF should be taken into consideration when interpreting plasma BNP levels in patients with heart disease. (authors)

  8. Effects of atrial natriuretic peptide on glomerular filtration rate in essential hypertension: A radionuclide study

    International Nuclear Information System (INIS)

    A number of studies show that atrial natriuretic peptide (ANP) raises renal sodium excretion with a concomitant increase in glomerular filtration rate (GFR) in both experimental animals and normal humans. Studies using indirect evaluation of GFR have provided less consistent results in hypertensive patients. We studied the effects of intravenously administered (iv) α-human ANP on GFR in patients with hypertension by a radionuclide technique using technetium 99m diethylenetriaminepenta-acetic acid. In six patients (ANP group), GFR was determined under control conditions, during iv ANP (initial bolus of 0.5 μg/kg followed by a 21-min maintenance infusion at 0.05 μg.kg-1.min-1) and during a recovery phase. In six other patients (control group), GFR was determined under control conditions, during saline iv infusion and during recovery. The two groups did not differ with respect to age, sex, basal blood pressure, heart rate or GFR. In the ANP group, the infusion of the peptide induced a significant decrease of mean blood pressure (from 133±5 to 120±5 mmHg, P<0.01), no change in heart rate and a significant increase in GFR (from 104±4 to 125±5 ml/min, P<0.01). During recovery, blood pressure, heart rate and GFR were not different from the values recorded under control conditions. No changes in blood pressure, heart rate or GFR (from 106±5 to 108±5 ml/min, n.s.) were detected during saline infusion in the control group. Our results demonstrated that in patients with essential hypertension, ANP induces an augmentation in GFR in spite of a decrease in blood pressure; this suggests a unique role for atrial peptide-related drugs in the treatment of human hypertension. (orig.)

  9. The effect of calcium antagonists on atrial natriuretic peptide (ANP) release from the rat heart during rapid cardiac pacing.

    Science.gov (United States)

    Doubell, A F

    1989-05-01

    The diuresis associated with rapid atrial rhythms is a well recognized clinical entity (Wood, 1963). Atrial natriuretic peptide (ANP) levels are elevated during rapid atrial rhythms (Hirata et al., 1987), including during rapid atrial pacing (Rankin et al., 1986; Schiebinger and Linden 1986; Walsh et al., 1987), and may contribute to the associated diuresis. Calcium channel antagonists are often used to treat atrial tachycardias but the effect this may have on ANP secretion and subsequent compensatory responses, such as a diuresis, is unknown. Reported here are experiments demonstrating that the increase in ANP secretion that accompanies rapid atrial pacing of the isolated perfused rat heart is abolished by calcium channel antagonists. This effect is not limited to a single class of calcium channel antagonists and could be demonstrated with Verapamil and Nifedipine. Although extrapolation to the in vivo situation should always be done with care, the results reported here contribute towards clarifying the effect of the calcium channel antagonists on the ANP response to rapid heart rates. PMID:2528639

  10. Regulation of endothelial cell shape and monolayer permeability by atrial natriuretic peptide

    International Nuclear Information System (INIS)

    Atrial natriuretic peptide (ANP), considered to be an important regulator of intravascular fluid volume, binds specifically to receptors on endothelial cells. In this study, the role of ANP-specific binding was investigated by examining the effect of ANP on the morphology and macromolecular permeability of monolayer cultures of bovine aortic endothelial cells. ANP alone had no observable effect on the monolayers. However, incubation of monolayers with ANP antagonized thrombin- or glucose oxidase-induced cell shape changes and intercellular gap formation. ANP pretreatment also opposed the effect of thrombin and glucose oxidase on actin filament distribution as observed by rhodamine-phalloidin staining and digital image analysis of F0actin staining. In addition, ANP reversed cell shape changes and cytoskeletal alterations induced by thrombin treatment but did not reverse alternations induced by glucose oxidase treatment. ANP significantly reduced increases in monolayer permeability to albumin resulting from thrombin or glucose oxidases treatment. Thrombin caused a 2-fold increase in monolayer permeability to 125I-labeled albumin, which was abolished by 10-8-10-6M ANP pretreatment. Glucose oxidase caused similar increases in permeability and was inhibited by ANP at slightly shorter time periods

  11. PI 3-kinase pathway is responsible for antiapoptotic effects of atrial natriuretic peptidein rat liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Uwe Grutzner; Melanie Keller; Michael Bach; Alexandra K Kiemer; Herbert Meissner; Manfred Bilzer; Stefan Zahler; Alexander L Gerbes; Angelika M Vollmar

    2006-01-01

    AIM: To investigate the in vivo effect of atrial natriuretic peptide (ANP) and its signaling pathway during orthotopic rat liver transplantation.METHODS: Rats were infused with NaCl, ANP (5 μg/kg), wortmannin (WM, 16 μg/kg), or a combination of both for 20 min. Livers were stored in UW solution (4°C) for 24 h, transplanted and reperfused. Apoptosis was examined by caspase-3 activity and TUNEL staining.Phosphorylation of Akt and Bad was visualized by Western blotting and phospho-Akt-localization by confocai microscopy.RESULTS: ANP-pretreatment decreased caspase-3activity and TUNEL-positive cells after cold ischemia,indicating antiapoptotic effects of ANP in vivo. The antiapoptotic signaling of ANP was most likely caused by phosphorylation of Akt and Bad, since pretreatment with PI 3-kinase inhibitor WM abrogated the ANP-induced reduction of caspase-3 activity. Interestingly, analysis of liver tissue by confocal microscopy showed translocation of phosphorylated Akt to the plasma membrane of hepatocytes evoked by ANP.CONCLUSION: ANP activates the PI-3-kinase pathway in the liver in vivo leading to phosphorylation of Bad,an event triggering antiapoptotic signaling cascade in ischemic liver.

  12. Role of a molecular variant of rat atrial natriuretic Peptide gene in vascular remodeling.

    Science.gov (United States)

    De Paolis, Paola; Nobili, Valerio; Lombardi, Alessia; Tarasi, David; Barbato, Daniela; Marchitti, Simona; Ganten, Ursula; Brunetti, Ercole; Volpe, Massimo; Rubattu, Speranza

    2007-01-01

    Previous studies in a hypertensive animal model of stroke and in humans showed that mutations of the atrial natriuretic peptide (ANP) gene are associated with increased risk of stroke. To elucidate the vascular disease mechanisms that result from structural modifications of the ANP gene, we investigated a coding mutation of the ANP gene in stroke-prone spontaneously hypertensive rats (SHRsp). This mutation leads to a Gly/Ser transposition in the prosegment of ANP. We found that presence of this mutation is associated with increased immunostaining of ANP in the wall of SHRsp cerebral vessels. The mutation causes a major inhibitory effect on endothelial cell proliferation, as assessed by thymidine incorporation, and on angiogenesis, as determined by an endothelial cell tube formation assay, in human umbilical vein endothelial cells (HUVEC) exposed to ANP/SHRsp. These in vitro findings show that the SHRsp-derived form of ANP has an inhibitory effect on vascular remodeling and they provide further support for a role of the ANP gene in the pathogenesis of cerebrovascular disease in the animal model. PMID:17522368

  13. Permeability and contractile responses of collecting lymphatic vessels elicited by atrial and brain natriuretic peptides.

    Science.gov (United States)

    Scallan, Joshua P; Davis, Michael J; Huxley, Virginia H

    2013-10-15

    Atrial and brain natriuretic peptides (ANP and BNP, respectively) are cardiac hormones released into the bloodstream in response to hypervolaemia or fluid shifts to the central circulation. The actions of both peptides include natriuresis and diuresis, a decrease in systemic blood pressure, and inhibition of the renin-angiotensin-aldosterone system. Further, ANP and BNP elicit increases in blood microvessel permeability sufficient to cause protein and fluid extravasation into the interstitium to reduce the vascular volume. Given the importance of the lymphatic vasculature in maintaining fluid balance, we tested the hypothesis that ANP or BNP (100 nM) would likewise elevate lymphatic permeability (Ps) to serum albumin. Using a microfluorometric technique adapted to in vivo lymphatic vessels, we determined that rat mesenteric collecting lymphatic Ps to rat serum albumin increased by 2.0 ± 0.4-fold (P = 0.01, n = 7) and 2.7 ± 0.8-fold (P = 0.07, n = 7) with ANP and BNP, respectively. In addition to measuring Ps responses, we observed changes in spontaneous contraction amplitude and frequency from the albumin flux tracings in vivo. Notably, ANP abolished spontaneous contraction amplitude (P = 0.005) and frequency (P = 0.006), while BNP augmented both parameters by ∼2-fold (P lymphatic permeability opposes the absorptive function of the lymphatic capillaries, and aids in the retention of protein and fluid in the interstitial space to counteract volume expansion. PMID:23897233

  14. Atrial natriuretic peptide receptor heterogeneity and effects on cyclic GMP accumulation

    International Nuclear Information System (INIS)

    The effects of atrial natriuretic peptide (ANP), oxytocin (OT) and vasopressin (AVP) on guanylate cyclase activity and cyclic GMP accumulation were examined, since these hormones appear to be intimately associated with blood pressure and intravascular volume homeostasis. ANP was found to increase cyclic GMP accumulation in ten cell culture systems, which were derived from blood vessels, adrenal cortex, kidney, lung, testes and mammary gland. ANP receptors were characterized in intact cultured cells using 125I-ANP8-33. Specific 125I-ANP binding was saturable and of high affinity. Scratchard analysis of the binding data for all cell types exhibited a straight line, indicating that these cells possessed a single class of binding sites. Despite the presence of linear Scatchard plots, these studies demonstrated that cultured cells possess two functionally and physically distinct ANP-binding sites. Most of the ANP-binding sites in cultured cells have a molecular size of 66,000 daltons under reducing conditions. The identification of cultured cell types in which hormones (ANP and oxytocin) regulate guanylate cyclase activity and increase cyclic GMP synthesis will provide valuable systems to determine the mechanisms of hormone-receptor coupling to guanylate cyclase and the cellular processes regulated by cyclic GMP

  15. The role of atrial natriuretic peptide (ANP) in cold-induced diuresis (CID)

    Energy Technology Data Exchange (ETDEWEB)

    Agnew, J.W.; Freund, B.J.; DuBose, D.A.; McKay, J.M.; Hashiro, G.M. (Army Research Inst. of Environmental Medicine, Natick, MA (United States) Tripler Army Medical Center, Honolulu, HI (United States))

    1991-03-11

    The hormonal control of cold-induced diuresis (CID) remains unresolved. This study investigated the role of ANP, plasma vasopressin (AVP), and aldosterone (ALDO) on CID. Four semi-nude men participated in a 210 min exposure to 15C and 29C air, on separate days. These subjects drank 300 mL of water and had an intravenous saline drip throughout both exposures to replace blood and insensible fluid losses. CID was observed in 15C but not in the 29C experiment, as indicated by a greater urine output. In 15C, atrial natriuretic peptide (ANP) increased after 90 min by 41% and remained elevated for 2 h relative to 29C. No differences were observed in AVP between 15C and 29C. In the 15C versus the 29C experiment, ALDO was approximately 37% lower at the pre, 15 and 90 min time periods. Mean arterial blood pressure was generally greater but only significant at 60 min during the 15C versus the 29C experiment. Urinary NA{sup +} excretion was elevated in 15C relative to 29C while no difference in K{sup +} excretion was observed. Although pressure effects may contribute, the observed natriuresis in the absence of a kaliuresis in the cold suggests a physiological role of ANP in CID.

  16. Atrial natriuretic peptide secretion during development of the rat supraoptic nucleus

    Directory of Open Access Journals (Sweden)

    E Farina Lipari

    2009-06-01

    Full Text Available Since a relationship between atrial natriuretic peptide and oxytocin was recently demonstrated in the heart (Gutkowska et al., 1997, the aim of this study was to determine whether a relationship between the two peptides is present also in the rat hypothalamus. For this purpose, we measured ANPontogeny in the rat hypothalamus immunohistochemically and compared it with oxytocin-ontogeny which we previously studied. The results showed that the ANP-peptide and mRNA-ANP start at the 18th day of the fetal life. Our earlier data for oxytocin in the rat hypothalamus showed that only mRNA-oxytocin appeared the 18th day of foetal life (Farina Lipari et al., 2001; thus, at the 18th day of foetal life, mRNA-ANP, ANP-peptide and mRNA-oxytocin are present.We conclude that in the hypothalamus, differently from that in the heart, ANP might play a role on the synthesis of the oxytocin since ANP and its mRNA appear earlier than oxytocin.

  17. Atrial natriuretic peptide receptor heterogeneity and effects on cyclic GMP accumulation

    Energy Technology Data Exchange (ETDEWEB)

    Leitman, D.C.

    1988-01-01

    The effects of atrial natriuretic peptide (ANP), oxytocin (OT) and vasopressin (AVP) on guanylate cyclase activity and cyclic GMP accumulation were examined, since these hormones appear to be intimately associated with blood pressure and intravascular volume homeostasis. ANP was found to increase cyclic GMP accumulation in ten cell culture systems, which were derived from blood vessels, adrenal cortex, kidney, lung, testes and mammary gland. ANP receptors were characterized in intact cultured cells using {sup 125}I-ANP{sub 8-33}. Specific {sup 125}I-ANP binding was saturable and of high affinity. Scratchard analysis of the binding data for all cell types exhibited a straight line, indicating that these cells possessed a single class of binding sites. Despite the presence of linear Scatchard plots, these studies demonstrated that cultured cells possess two functionally and physically distinct ANP-binding sites. Most of the ANP-binding sites in cultured cells have a molecular size of 66,000 daltons under reducing conditions. The identification of cultured cell types in which hormones (ANP and oxytocin) regulate guanylate cyclase activity and increase cyclic GMP synthesis will provide valuable systems to determine the mechanisms of hormone-receptor coupling to guanylate cyclase and the cellular processes regulated by cyclic GMP.

  18. Relative Atrial Natriuretic Peptide Deficiency and Inadequate Renin and Angiotensin II Suppression in Obese Hypertensive Men

    DEFF Research Database (Denmark)

    Asferg, Camilla L; Nielsen, Søren J; Andersen, Ulrik B;

    2013-01-01

    Obesity is a strong risk factor for hypertension, but the mechanisms by which obesity leads to hypertension are incompletely understood. On this background, we assessed dietary sodium intake, serum levels of natriuretic peptides (NPs), and the activity of the renin-angiotensin system in 63 obese...... hypertensive men (obeseHT: body mass index, ≥30.0 kg/m(2); 24-hour ambulatory blood pressure, ≥130/80 mm Hg), in 40 obese normotensive men (obeseNT: body mass index, ≥30.0 kg/m(2); 24-hour ambulatory blood pressure,...

  19. Increased Activity of cGMP-Specific Phosphodiesterase (PDE5) Contributes to Resistance to Atrial Natriuretic Peptide Natriuresis in the Pregnant Rat

    OpenAIRE

    Ni, Xi-Ping; SAFAI, MASSY; Rishi, Rahul; Baylis, Chris; Humphreys, Michael H.

    2004-01-01

    Increased cGMP-specific phosphodiesterase (PDE5) activity in renal inner medullary collecting duct (IMCD) cells contributes to resistance to atrial natriuretic peptide (ANP) and the excessive sodium retention seen in experimental nephrotic syndrome and liver cirrhosis. Normal pregnancy is also accompanied by sodium retention and plasma volume expansion, and pregnant rats are resistant to the natriuretic action of ANP. The authors investigated a possible role of increased renal PDE5 activity i...

  20. The therapeutic potential of synthetic human atrial natriuretic peptide in nephrotic syndrome: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kanzaki M

    2012-06-01

    Full Text Available Motoko Kanzaki,1 Jun Wada,1 Yoko Kikumoto,1 Shigeru Akagi,1 Kazushi Nakao,3 Hitoshi Sugiyama,2 Hirofumi Makino11Department of Medicine and Clinical Science, 2Department of Chronic Kidney Disease and Peritoneal Dialysis, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan; 3Internal Medicine, Hiroshima City Hospital, Hiroshima, JapanBackground: In nephrotic syndrome, the combination of furosemide and albumin infusion is a standard regimen to treat systemic edema. The efficacy of synthetic human atrial natriuretic peptide (hANP for nephrotic syndrome to ameliorate the systemic edema and retain renal functions has not been fully demonstrated.Trial design: We conducted a prospective, randomized, controlled, open-label clinical trial. Patients were randomly assigned by a stratified biased coin design.Methods: A total of 12 patients with nephrotic syndrome between the ages of 20 to 79 years were enrolled and randomly assigned to either the conventional (CON group treated with furosemide and albumin, and hANP group, in which carperitide was administered in addition to the conventional therapies. The primary end points were: (1 the differences in serum creatinine levels, and (2 the reduction of total dosage of furosemide and albumin by the treatments of hANP. Secondary end points were body weight, systolic blood pressure, heart rate, serum protein, albumin, and urinary protein excretion.Results: A total of 13 patients were enrolled, and one patient was excluded due to severe pneumonia. In both hANP (n = 7 and CON (n = 5 groups, body weight was reduced after 2-week treatments. Serum creatinine levels at follow-up significantly increased compared with baseline. The increase in serum creatinine levels (Δ serum creatinine was smaller in the hANP group compared with the CON group (P = 0.31. The serum uric acid, serum urea nitrogen, and urinary protein excretion were reduced in the hANP group, and increased

  1. Characterization of atrial natriuretic peptide receptors in brain microvessel endothelial cells

    Science.gov (United States)

    Whitson, P. A.; Huls, M. H.; Sams, C. F.

    1991-01-01

    Atrial natriuretic peptide (ANP) binding and ANP-induced increases in cyclic guanosine monophosphate (cGMP) levels have been observed in brain microvessels (Chabrier et al., 1987; Steardo and Nathanson, 1987), suggesting that this fluid-regulating hormone may play a role in the fluid homeostasis of the brain. This study was initiated to characterize the ANP receptors in primary cultures of brain microvessel endothelial cells (BMECs). The apparent equilibrium dissociation constant, Kd, for ANP increased from 0.25 nM to 2.5 nM, and the number of ANP binding sites as determined by Scatchard analysis increased from 7,100 to 170,000 sites/cell between 2 and 10 days of culture following monolayer formation. Time- and concentration-dependent studies on the stimulation of cGMP levels by ANP indicated that guanylate cyclase-linked ANP receptors were present in BMECs. The relative abilities of ANP, brain natriuretic peptide (BNP), and a truncated analog of ANP containing amino acids 5-27 (ANP 5-27) to modulate the accumulation of cGMP was found to be ANP greater than BNP much greater than ANP 5-27. Affinity cross-linking with disuccinimidyl suberate and radiolabeled ANP followed by gel electrophoresis under reducing conditions demonstrated a single band corresponding to the 60-70 kD receptor, indicating the presence of the nonguanylate cyclase-linked ANP receptor. Radiolabeled ANP binding was examined in the presence of various concentrations of either ANP, BNP, or ANP 5-27 and suggested that a large proportion of the ANP receptors present in blood-brain barrier endothelial cells bind all of these ligands similarly. These data indicate both guanylate cyclase linked and nonguanylate cyclase linked receptors are present on BMECs and that a higher proportion of the nonguanylate cyclase linked receptors is expressed. This in vitro culture system may provide a valuable tool for the examination of ANP receptor expression and function in blood-brain barrier endothelial cells.

  2. Imidazoline receptors in the heart: a novel target and a novel mechanism of action that involves atrial natriuretic peptides

    Directory of Open Access Journals (Sweden)

    Mukaddam-Daher S.

    2004-01-01

    Full Text Available Chronic stimulation of sympathetic nervous activity contributes to the development and maintenance of hypertension, leading to left ventricular hypertrophy (LVH, arrhythmias and cardiac death. Moxonidine, an imidazoline antihypertensive compound that preferentially activates imidazoline receptors in brainstem rostroventrolateral medulla, suppresses sympathetic activation and reverses LVH. We have identified imidazoline receptors in the heart atria and ventricles, and shown that atrial I1-receptors are up-regulated in spontaneously hypertensive rats (SHR, and ventricular I1-receptors are up-regulated in hamster and human heart failure. Furthermore, cardiac I1-receptor binding decreased after chronic in vivo exposure to moxonidine. These studies implied that cardiac I1-receptors are involved in cardiovascular regulation. The presence of I1-receptors in the heart, the primary site of production of natriuretic peptides, atrial natriuretic peptide (ANP and brain natriuretic peptide (BNP, cardiac hormones implicated in blood pressure control and cardioprotection, led us to propose that ANP may be involved in the actions of moxonidine. In fact, acute iv administration of moxonidine (50 to 150 µg/rat dose-dependently decreased blood pressure, stimulated diuresis and natriuresis and increased plasma ANP and its second messenger, cGMP. Chronic SHR treatment with moxonidine (0, 60 and 120 µg kg-1 h-1, sc for 4 weeks dose-dependently decreased blood pressure, resulted in reversal of LVH and decreased ventricular interleukin 1ß concentration after 4 weeks of treatment. These effects were associated with a further increase in already elevated ANP and BNP synthesis and release (after 1 week, and normalization by 4 weeks. In conclusion, cardiac imidazoline receptors and natriuretic peptides may be involved in the acute and chronic effects of moxonidine.

  3. Mechanism of activation of particulate guanylate cyclase by atrial natriuretic peptide as deduced from radiation inactivation analysis

    International Nuclear Information System (INIS)

    The interaction between the receptor (Rc) for atrial natriuretic peptide (ANP) and the effector enzyme particulate guanylate cyclase (GC) has been studied by radiation inactivation. Irradiation of bovine lung membranes produced an increase in GC activity at low radiation doses followed by a dose-dependent reduction at higher doses. This deviation from linearity in the inactivation curve disappeared when lung membranes were pretreated with ANP. Essentially identical results were also obtained with adrenal membranes. Based on these radiation inactivation data, the following dissociative mechanism of activation of particulate guanylate cyclase by ANP has been proposed: Rc.GC(inactive) + ANP----Rc.ANP + GC(active)

  4. Treatment of hypertension with perindopril reduces plasma atrial natriuretic peptide levels, left ventricular mass, and improves echocardiographic parameters of diastolic function

    Science.gov (United States)

    Yalcin, F.; Aksoy, F. G.; Muderrisoglu, H.; Sabah, I.; Garcia, M. J.; Thomas, J. D.

    2000-01-01

    BACKGROUND: Hypertension is a major independent risk factor for cardiac deaths, and diastolic dysfunction is a usual finding during the course of this disease. HYPOTHESIS: This study was designed to investigate the effects of chronic therapy with perindopril on left ventricular (LV) mass, left atrial size, diastolic function, and plasma level of atrial natriuretic peptide (ANP) in patients with hypertension. METHODS: Twenty four patients who had not been previously taking any antihypertensive medication and without prior history of angina pectoris, myocardial infarction, congestive heart failure, dysrhythmias, valvular heart disease, or systemic illnesses received 4-8 mg/day of perindopril orally. Echocardiographic studies were acquired at baseline and 6 months after the initiation of therapy. RESULTS: Systolic and diastolic blood pressure decreased from 174 +/- 19.7 and 107.5 +/- 7.8 mmHg to 134 +/- 10.6 and 82 +/- 6.7 mmHg, respectively (p < 0.001). Left ventricular mass decreased from 252.4 +/- 8.3 to 205.7 +/- 7.08 g and left atrial volume from 20.4 +/- 5.1 to 17.6 +/- 5.2 ml, respectively (p < 0.001). Transmitral Doppler early and atrial filling velocity ratio (E/A) increased from 0.69 +/- 0.06 to 0.92 +/- 0.05 m/s and plasma ANP level decreased from 71.9 +/- 11.7 to 35.3 +/- 7.8 pg/ml (p < 0.001). Reduction of LV mass correlated positively with a reduction in ANP levels (r = 0.66, p < 0.0005). CONCLUSIONS: Perindopril caused a significant reduction of LV mass, left atrial volume, and plasma ANP levels, as well as improvement in Doppler parameters of LV filling in this group of patients with hypertension.

  5. Treatment of hypertension with perindopril reduces plasma atrial natriuretic peptide levels, left ventricular mass, and improves echocardiographic parameters of diastolic function

    Science.gov (United States)

    Yalcin, F.; Aksoy, F. G.; Muderrisoglu, H.; Sabah, I.; Garcia, M. J.; Thomas, J. D.

    2000-01-01

    BACKGROUND: Hypertension is a major independent risk factor for cardiac deaths, and diastolic dysfunction is a usual finding during the course of this disease. HYPOTHESIS: This study was designed to investigate the effects of chronic therapy with perindopril on left ventricular (LV) mass, left atrial size, diastolic function, and plasma level of atrial natriuretic peptide (ANP) in patients with hypertension. METHODS: Twenty four patients who had not been previously taking any antihypertensive medication and without prior history of angina pectoris, myocardial infarction, congestive heart failure, dysrhythmias, valvular heart disease, or systemic illnesses received 4-8 mg/day of perindopril orally. Echocardiographic studies were acquired at baseline and 6 months after the initiation of therapy. RESULTS: Systolic and diastolic blood pressure decreased from 174 +/- 19.7 and 107.5 +/- 7.8 mmHg to 134 +/- 10.6 and 82 +/- 6.7 mmHg, respectively (p Perindopril caused a significant reduction of LV mass, left atrial volume, and plasma ANP levels, as well as improvement in Doppler parameters of LV filling in this group of patients with hypertension.

  6. The second messenger system(s) mediating the secretion of atrial natriuretic peptide (ANP) from the isolated rat heart during rapid cardiac pacing.

    Science.gov (United States)

    Doubell, A F

    1989-01-01

    This study demonstrates that rapid cardiac pacing elevates Atrial Natriuretic Peptide (ANP) levels, independently from atrial stretch. The second messenger system mediating this response was examined. The phosphoinositide system, generally regarded to be important in mediating ANP release, was shown to play only a modulating role during rapid cardiac pacing. The main mediator would appear to be calcium, and a non-calmodulin dependent, calcium mediated system controlling ANP release during rapid cardiac pacing is suggested. PMID:2532285

  7. Risk Factors for Atrial Fibrillation

    OpenAIRE

    Krijthe, Bouwe

    2013-01-01

    textabstractAtrial fibrillation is a common cardiac arrhythmia that is characterized by rapid disorganized atrial electrical activity resulting in absence of atrial contractions. It is diagnosed on the basis of typical findings on an electrocardiogram (ECG). The characteristic ECG findings are absence of P-waves, and an irregular heart rate. Symptoms of atrial fibrillation include palpitations, dyspnea, reduced exercise capacity, chest pain and dizziness, but it often goes without symptoms. A...

  8. Risk factors predictive of atrial fibrillation after lung cancer surgery.

    Science.gov (United States)

    Iwata, Takekazu; Nagato, Kaoru; Nakajima, Takahiro; Suzuki, Hidemi; Yoshida, Shigetoshi; Yoshino, Ichiro

    2016-08-01

    Postoperative atrial fibrillation (POAF), the most frequent arrhythmia after pulmonary resection, is a cause of both morbidity and mortality. Being able to predict the risk of POAF before surgery would help us evaluate the surgical risk and plan prophylaxis. We investigated the reported preoperative risk factors associated with the incidence of POAF and found that the recommended predictive factors were quite variable. Therefore, we evaluated the previously reported preoperative risk factors for POAF using our institutional data. We discuss our findings in this short review. Male gender, resected lung volume, brain natriuretic peptide (BNP), and left ventricular early transmitral velocity/mitral annular early diastolic velocity (E/e') calculated by echocardiography were suggested as independent predictors for POAF, but the predictive values of each individual parameter were not high. The lack of definitive predictors for POAF warrants further investigations by gathering the reported knowledge, to establish an effective preoperative examination strategy. PMID:26471506

  9. Sex differences in the beneficial cardiac effects of chronic treatment with atrial natriuretic Peptide in spontaneously hypertensive rats.

    Directory of Open Access Journals (Sweden)

    Mariana Romero

    Full Text Available INTRODUCTION: The aim of this study was to investigate both the effects of chronic treatment with atrial natriuretic peptide (ANP on systolic blood pressure (SBP, cardiac nitric oxide (NO system, oxidative stress, hypertrophy, fibrosis and apoptosis in spontaneously hypertensive rats (SHR, and sex-related differences in the response to the treatment. METHODS: 10 week-old male and female SHR were infused with ANP (100 ng/hr/rat or saline (NaCl 0.9% for 14 days (subcutaneous osmotic pumps. SBP was recorded and nitrites and nitrates excretion (NOx were determined. After treatment, NO synthase (NOS activity, eNOS expression, thiobarbituric acid-reactive substances (TBARS and glutathione concentration were determined in left ventricle, as well as the activity of glutathione peroxidase (GPx, catalase (CAT and superoxide dismutase (SOD. Morphological studies in left ventricle were performed in slices stained with hematoxylin-eosin or Sirius red to identify collagen as a fibrosis indicator; immunohistochemistry was employed for identification of transforming growth factor beta; and apoptosis was evaluated by Tunel assay. RESULTS: Female SHR showed lower SBP, higher NO-system activity and less oxidative stress, fibrosis and hypertrophy in left ventricle, as well as higher cardiac NOS activity, eNOS protein content and NOx excretion than male SHR. Although ANP treatment lowered blood pressure and increased NOS activity and eNOS expression in both sexes, cardiac NOS response to ANP was more marked in females. In left ventricle, ANP reduced TBARS and increased glutathione concentration and activity of CAT and SOD enzymes in both sexes, as well as GPx activity in males. ANP decreased fibrosis and apoptosis in hearts from male and female SHR but females showed less end-organ damage in heart. Chronic ANP treatment would ameliorate hypertension and end-organ damage in heart by reducing oxidative stress, increasing NO-system activity, and diminishing fibrosis

  10. Cocaine-associated increase of atrial natriuretic peptides: an early predictor of cardiac complications in cocaine users?

    Science.gov (United States)

    Casartelli, Alessandro; Dacome, Lisa; Tessari, Michela; Pascali, Jennifer; Bortolotti, Federica; Trevisan, Maria Teresa; Bosco, Oliviero; Cristofori, Patrizia; Tagliaro, Franco

    2014-01-01

    Objective Cocaine is known to produce life-threatening cardiovascular complications, and the investigation of the causes of death may be challenging in forensic medicine. The increasing knowledge of the cardiac function biomarkers and the increasing sensitivity of assays provide new tools in monitoring the cardiac life-threatening pathological conditions and in the sudden death investigation in chronic abusers. In this work, cardiac dysfunction was assessed in an animal model by measuring troponin I and natriuretic peptides as biomarkers, and considering other standard endpoints used in preclinical toxicology studies. Methods Lister Hooded rats were treated with cocaine in chronic self-administration studies. Troponin I (cTnI) and atrial natriuretic peptide (ANP) were evaluated at different time points and heart weight and histopathology were assessed at the end of the treatment period. Furthermore, cocaine and its main metabolites were measured in the rat fur to assess rats’ cocaine exposure. All the procedures and endpoints considered were designed to allow an easy and complete translation from the laboratory animals to human beings, and the same approach was also adopted with a group of 10 healthy cocaine abuse volunteers with no cardiac pathologies. Results Cardiac troponin I values were unaffected, and ANP showed an increasing trend with time in all cocaine-treated animals considered. Similarly, in the healthy volunteers, no changes were observed in troponin serum levels, whereas the N-terminal brain natriuretic pro-peptide (NT proBNP) showed variations comparable with the changes observed in rats. Conclusions In conclusion, natriuretic peptides could represent an early indicator of heart dysfunction liability in chronic cocaine abusers. PMID:27326180

  11. Brain Natriuretic Peptide, Atrial Natriuretic Peptide and Endothelin-1 response to peak exercise in patients with coronary artery disease and correlation with myocardial perfusion scintigraphy abnormalities

    International Nuclear Information System (INIS)

    Aim: Plasma Brain Natriuretic Peptide (BNP) has been known as a promising marker of ventricular dysfunction in cardiac patients. There are conflicting reports about its response to exercise testing. Therefore, this study was performed to investigate the exercise induced changes in BNP, Atrial Natriuretic Peptide (ANP) and Endothelin-1 (E) levels and their correlation with perfusion abnormalities on myocardial perfusion scintigraphy (MPS). Materials and Methods: Study group consisted of 35 patients (mean age=53.9+11.8) who underwent MPS with suspicion or diagnosis of coronary artery disease. Plasma levels of BNP, ANP, and E were measured at rest and after symptom-limited ergometry. Patients were divided into two groups according to the presence of perfusion abnormality (i.e. ischemia or infarction) on MPS. Results: BNP, ANP and E levels did not change significantly with exercise, however baseline levels of BNP, ANP levels and peak-exercise level of BNP in patients with perfusion abnormalities were significantly higher. Hypertensive patients with or without perfusion abnormalities had higher baseline BNP, ANP levels, and peak-exercise BNP levels compared to normotensives. BNP levels at rest and after exercise had a significant correlation with age (r=0.57, p=0.04; r=0.58, p=0.04), as well as baseline ANP values (r=0.37, p=0.033). Highest baseline BNP, ANP and exercise BNP levels were observed in patients with infarction. Conclusion: Exercise-testing did not induce significant changes in plasma levels of BNP, ANP and E. Higher BNP levels had correlation with the presence of ischemia, infarction and hypertension, as well as, increasing age

  12. Atrial natriuretic peptide attenuates inflammatory responses on oleic acid-induced acute lung injury model in rats

    Institute of Scientific and Technical Information of China (English)

    ZHU Yao-bin; ZHANG Yan-bo; LIU Dong-hai; LI Xiao-feng; LIU Ai-jun; FAN Xiang-ming; QIAO Chen-hui

    2013-01-01

    Background An inflammatory response leading to organ dysfunction and failure continues to be a major problem after injury in many clinical conditions such as sepsis,severe burns,and trauma.It is increasingly recognized that atrial natriuretic peptide (ANP) possesses a broad range of biological activities,including effects on endothelial function and inflammation.A recent study has revealed that ANP exerts anti-inflammatory effects.In this study we tested the effects of human ANP (hANP) on lung injury in a model of oleic acid (OA)-induced acute lung injury (ALl) in rats.Methods Rats were randomly assigned to three groups (n=6 in each group).Rats in the control group received a 0.9% solution of NaCl (1 ml.kg1.h-1) by continuous intravenous infusion,after 30 minutes a 0.9% solution of NaCl (1 ml/kg) was injected intravenously,and then the 0.9% NaCl infusion was restarted.Rats in the ALl group received a 0.9% NaCl solution (1 ml·kg-1·h-1) intravenous infusion,after 30 minutes OA was injected intravenously (0.1 ml/kg),and then the 0.9% NaCl infusion was restarted.Rats in the hANP-treated ALI group received a hANP (0.1μg·kg-1·min-1) infusion,after 30 minutes OA was injected intravenously (0.1 ml/kg),and then the hANP infusion was restarted.The anti-inflammation effects of hANP were evaluated by histological examination and determination of serum cytokine levels.Results Serum intedeukin (IL)-1β,IL-6,IL-10 and tumor necrosis factor (TNF) α were increased in the ALI group at six hours.The levels of all factors were significantly lower in the hANP treated rats (P <0.005).Similarly,levels of IL-1β,IL-6,IL-10 and TNF-α were higher in the lung tissue in the ALI group at six hours.hANP treatment significantly reduced the levels of these factors in the lungs (P <0.005).Histological examination revealed marked reduction in interstitial congestion,edema,and inflammation.Conclusion hANP can attenuate inflammation in an OA-induced lung injury in rat model.

  13. Alpha-human atrial natriuretic polypeptide (. cap alpha. -hANP) specific binding sites in bovine adrenal gland

    Energy Technology Data Exchange (ETDEWEB)

    Higuchi, K.; Nawata, H.; Kato, K.I.; Ibayashi, H.; Matsuo, H.

    1986-06-13

    The effects of synthetic ..cap alpha..-human atrial natriuretic polypeptide (..cap alpha..-hANP) on steroidogenesis in bovine adrenocortical cells in primary monolayer culture were investigated. ..cap alpha..-hANP did not inhibit basal aldosterone secretion. ..cap alpha..-hANP induced a significant dose-dependent inhibition of basal levels of cortisol and dehydroepiandrosterone (DHEA) secretion and also of aCTH (10/sup -8/M)-stimulated increases in aldosterone, cortisol and DHEA secretion. Visualization of (/sup 125/I) ..cap alpha..-hANP binding sites in bovine adrenal gland by an in vitro autoradiographic technique demonstrated that these sites were highly localized in the adrenal cortex, especially the zona glomerulosa. These results suggest that the adrenal cortex may be a target organ for direct receptor-mediated actions of ..cap alpha..-hANP.

  14. Alpha-human atrial natriuretic polypeptide (α-hANP) specific binding sites in bovine adrenal gland

    International Nuclear Information System (INIS)

    The effects of synthetic α-human atrial natriuretic polypeptide (α-hANP) on steroidogenesis in bovine adrenocortical cells in primary monolayer culture were investigated. α-hANP did not inhibit basal aldosterone secretion. α-hANP induced a significant dose-dependent inhibition of basal levels of cortisol and dehydroepiandrosterone (DHEA) secretion and also of aCTH (10-8M)-stimulated increases in aldosterone, cortisol and DHEA secretion. Visualization of [125I] α-hANP binding sites in bovine adrenal gland by an in vitro autoradiographic technique demonstrated that these sites were highly localized in the adrenal cortex, especially the zona glomerulosa. These results suggest that the adrenal cortex may be a target organ for direct receptor-mediated actions of α-hANP

  15. Attenuated atrial natriuretic peptide-mediated lipolysis in subcutaneous adipocytes of obese type 2 diabetic men.

    Science.gov (United States)

    Verboven, Kenneth; Hansen, Dominique; Moro, Cedric; Eijnde, Bert O; Hoebers, Nicole; Knol, Joep; Bouckaert, Wim; Dams, Anne; Blaak, Ellen E; Jocken, Johan W E

    2016-07-01

    Catecholamines and atrial natriuretic peptide (ANP) are major regulators of adipocyte lipolysis. Although obesity is characterized by catecholamine resistance in subcutaneous adipose tissue (SCAT), data on ANP lipolytic response and sensitivity in different adipose tissue (AT) depots of metabolically distinct humans are scarce. Ex vivo catecholamine- and ANP-induced lipolysis was investigated in adipocytes derived from SCAT and visceral AT (VAT) depot of lean (n=13) and obese men, with (n=11) or without (n=18) type 2 diabetes (HbA1c lipolysis in SCAT was blunted in obese type 2 diabetics compared with age-matched lean men whereas non-diabetic obese subjects showed intermediate responses. This blunted ANP-mediated lipolytic response was accompanied by lower mRNA and protein expression of the type-A natriuretic peptide (NP) receptor and higher mRNA but reduced protein expression of the scavenging type-C receptor. Maximal ANP-induced lipolysis was lower in VAT compared with SCAT but not different between groups. Collectively, our data show that both ANP- and catecholamine-mediated lipolysis is attenuated in SCAT of obese men with type 2 diabetes, and might be partially explained by NP receptor defects. Therefore, improving maximal ANP responsiveness in adipose tissue might be a potential novel strategy to improve obesity-associated metabolic complications. PMID:27129190

  16. Atrial natriuretic peptide attenuates agonist-induced pulmonary edema in mice with targeted disruption of the gene for natriuretic peptide receptor-A.

    Science.gov (United States)

    Klinger, James R; Tsai, Shu-Whei; Green, Sabrina; Grinnell, Katie L; Machan, Jason T; Harrington, Elizabeth O

    2013-02-01

    Atrial natriuretic peptide (ANP) inhibits agonist-induced pulmonary edema formation, but the signaling pathway responsible is not well defined. To investigate the role of the particulate guanylate cyclase-linked receptor, natriuretic peptide receptor-A (NPR-A), we measured acute lung injury responses in intact mice and pulmonary microvascular endothelial cells (PMVEC) with normal and disrupted expression of NPR-A. NPR-A wild-type (NPR-A+/+), heterozygous (NPR-A+/-), and knockout (NPR-A-/-) mice were anesthetized and treated with thrombin receptor agonist peptide (TRAP) or lipopolysaccharide (LPS). Lung injury was assessed by lung wet-to-dry (W/D) weight and by protein and cell concentration of bronchoalveolar lavage (BAL) fluid. No difference in pulmonary edema formation was seen between NPR-A genotypes under baseline conditions. TRAP and LPS increased lung W/D weight and BAL fluid cell counts more in NPR-A-/- mice than in NPR-A+/- or NPR-A+/+ mice, but no genotype-related differences were seen in TRAP-induced increases in bloodless lung W/D weight or LPS-induced increases in BAL protein concentration. Pretreatment with ANP infusion completely blocked TRAP-induced increases in lung W/D weight and blunted LPS-induced increases in BAL cell counts and protein concentration in both NPR-A-/- and NPR-A+/+ mice. Thrombin decreased transmembrane electrical resistance in monolayers of PMVECs in vitro, and this effect was attenuated by ANP in PMVECs isolated from both genotypes. Administration of the NPR-C-specific ligand, cANF, also blocked TRAP-induced increases in lung W/D weight and LPS-induced increases in BAL cell count and protein concentration in NPR-A+/+ and NPR-A-/- mice. We conclude that ANP is capable of attenuating agonist-induced lung edema in the absence of NPR-A. The protective effect of ANP on agonist-induced lung injury and pulmonary barrier function may be mediated by NPR-C. PMID:23195629

  17. Incidence and predictive factors of atrial fibrillation after ablation of typical atrial flutter.

    Science.gov (United States)

    Laurent, Valérie; Fauchier, Laurent; Pierre, Bertrand; Grimard, Caroline; Babuty, Dominique

    2009-03-01

    Although cavotricuspid isthmus radiofrequency catheter ablation is considered curative therapy for typical atrial flutter, many patients develop an atrial fibrillation after ablation. The purpose of our study was to determine the incidence and the predictive factors of post-ablation atrial fibrillation. One hundred and forty eight consecutive patients underwent cavotricuspid isthmus ablation for the treatment of typical atrial flutter between January 2004 and December 2005 in our electrophysiological department. Complete cavotricuspid isthmus block was successfully obtained in 96.6% of the patients. At the end of the electrophysiological study a sustained atrial fibrillation was inducible in 20 patients (13.5%). During an average follow-up of 21.3 +/- 8.2 months, atrial fibrillation occurred in 27% of the patients. Univariate analysis identified four parameters correlated with post-ablation atrial fibrillation among the 21 parameters tested: the young age of the patients, a prior history of atrial fibrillation, an inducible atrial fibrillation, and a paroxysmal atrial flutter. Only inducible atrial fibrillation and paroxysmal atrial flutter were independent factors linked to atrial fibrillation after ablation. In our study the incidence of atrial fibrillation after cavotricuspid isthmus radiofrequency catheter ablation is 152 per 1,000 patient-years, i.e. 25 times higher than the incidence of atrial fibrillation in the general population of the same age. Twenty five percent of the patients who had neither prior history of atrial fibrillation nor structural heart disease suffered from atrial fibrillation during a mean follow-up of 21.3 +/- 8.2 months. All these results suggest that atrial flutter and fibrillation could be manifestations of a more general electrophysiologic disease. They emphasize the need for all these patients to benefit from regular, long-term cardiological follow-up after cavotricuspid isthmus ablation because of the high incidence of atrial

  18. Effects of atrial and brain natriuretic peptides upon cyclic GMP levels, potassium transport, and receptor binding in rat astrocytes

    Energy Technology Data Exchange (ETDEWEB)

    Beaumont, K.; Tan, P.K. (Univ. of California, San Diego, La Jolla (USA))

    1990-02-01

    The ability of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) to alter cyclic GMP levels and NaKCl cotransport in rat neocortical astrocytes was determined. At concentrations of 10(-9)-10(-6) M, rat ANP99-126 (rANF), rat ANP102-126 (auriculin B), and rat ANP103-126 (atriopeptin III) stimulated 6- to 100-fold increases in cyclic GMP levels. Porcine BNP (pBNP) and rat BNP (rBNP) were 20%-90% as effective as rANF over most of this concentration range, although 10(-6) M pBNP produced a greater effect than rANF. NaKCl cotransport as measured by bumetanide-sensitive 86Rb+ influx was not altered by exposure of astrocytes to 10(-6)M rANF, pBNP, or rBNP. Both pBNP and rBNP, as well as rat ANP103-123 (atriopeptin I) and des(gl18, ser19, gly20, leu21, gly22) ANF4-23-NH2 (C-ANF4-23) strongly competed for specific 125I-rANF binding sites in astrocyte membranes with affinities ranging from 0.03 to 0.4 nM, suggesting that virtually all binding sites measured at subnanomolar concentrations of 125I-rANF were of the ANP-C (ANF-R2) receptor subtype. These receptors are thought to serve a clearance function and may be linked to a guanylate cyclase activity that is chemically and pharmacologically distinct from that coupled to ANP-A (ANF-R1) receptors. ANP receptors on astrocytes may function in limiting the access of ANP and BNP to neurons involved in body fluid and cardiovascular regulation.

  19. Effects of atrial and brain natriuretic peptides upon cyclic GMP levels, potassium transport, and receptor binding in rat astrocytes

    International Nuclear Information System (INIS)

    The ability of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) to alter cyclic GMP levels and NaKCl cotransport in rat neocortical astrocytes was determined. At concentrations of 10(-9)-10(-6) M, rat ANP99-126 (rANF), rat ANP102-126 (auriculin B), and rat ANP103-126 (atriopeptin III) stimulated 6- to 100-fold increases in cyclic GMP levels. Porcine BNP (pBNP) and rat BNP (rBNP) were 20%-90% as effective as rANF over most of this concentration range, although 10(-6) M pBNP produced a greater effect than rANF. NaKCl cotransport as measured by bumetanide-sensitive 86Rb+ influx was not altered by exposure of astrocytes to 10(-6)M rANF, pBNP, or rBNP. Both pBNP and rBNP, as well as rat ANP103-123 (atriopeptin I) and des[gl18, ser19, gly20, leu21, gly22] ANF4-23-NH2 (C-ANF4-23) strongly competed for specific 125I-rANF binding sites in astrocyte membranes with affinities ranging from 0.03 to 0.4 nM, suggesting that virtually all binding sites measured at subnanomolar concentrations of 125I-rANF were of the ANP-C (ANF-R2) receptor subtype. These receptors are thought to serve a clearance function and may be linked to a guanylate cyclase activity that is chemically and pharmacologically distinct from that coupled to ANP-A (ANF-R1) receptors. ANP receptors on astrocytes may function in limiting the access of ANP and BNP to neurons involved in body fluid and cardiovascular regulation

  20. Role of atrial natriuretic peptide in mediating the blood pressure-independent natriuresis elicited by systemic inhibition of nitric oxide.

    Science.gov (United States)

    Dobrowolski, Leszek; Kuczeriszka, Marta; Castillo, Alexander; Majid, Dewan S; Navar, L Gabriel

    2015-04-01

    While it is clearly recognized that increased intrarenal nitric oxide (NO) levels elicit natriuresis, confounding data showing that systemic nitric oxide synthase inhibition (NOSi) also increases sodium excretion (UNaV) poses a conundrum. This response has been attributed to the associated increases in arterial pressure (AP); however, the increases in AP and in UNaV are temporally dissociated. The changes in regional renal haemodynamics induced by NOSi could also contribute to the alterations of UNaV. To evaluate the roles of AP and non-AP mechanisms mediating the natriuresis, N ω-nitro-L-arginine methyl ester hydrochloride (L-NAME) was infused i.v. at doses ranging from 5 to 50 μg/kg/min in anaesthetized rats. UNaV, perfusion of the cortex (cortical blood flow, CBF) and medulla (medullary blood flow, MBF) with laser-Doppler flowmetry and glomerular filtration rate (GFR) were measured. UNaV increased from 0.6 ± 0.2 to 1.6 ± 0.1 μmol/kg/min (P < 0.05) with the lower nonpressor doses. With the higher doses, AP increased from 116 ± 4 to 122 ± 4 mmHg and UNaV increased from 1.1 ± 0.3 to 3.3 ± 0.7 μmol/min/g (P < 0.002). UNaV increased similarly in a group where renal AP was maintained at baseline levels. The associated reductions in CBF (17 ± 5 and 38 ± 5 %) and MBF (27 ± 6 and 52 ± 6 %) would be expected to attenuate rather than contribute to the natriuresis. Plasma atrial natriuretic peptide (ANP) concentrations increased significantly following NOSi. Anantin, a natriuretic peptide receptor-A blocker, prevented or reversed the L-NAME-induced natriuresis without altering the L-NAME-induced changes in AP or CBF. The results indicate that increased ANP and related natriuretic peptides mediate the AP-independent natriuresis, at least partly, elicited by systemic L-NAME infusion and help resolve the conundrum of natriuresis during systemic NOSi. PMID:24953240

  1. Research Progress of Brain Natriuretic Peptide and Atrial Fibrillation Cardioversion%脑钠肽与心房颤动复律的研究进展

    Institute of Scientific and Technical Information of China (English)

    阮静

    2012-01-01

    With the deepening of population aging and the increasing incidence of cardiovascular disease,the incidence of atrial fibrillation is increasingly high. Its basic and clinical research has been the profession's hot spot. Brain natriuretic peptide as a cardiac function marker has been applied to clinical evaluation of heart failure, and in recent years, has been broadly concerned in the cardioversion of atrial fibrillation. Here reviews the physiology of brain natriuretic peptide, and its secretion mechanism when atrial fibrillation occurs,its relative research and its predictive value in atrial fibrillation caidioveision( electrically or drug).%随着人口老龄化程度的不断加深及心血管疾病发病率的增加,心房颤动(简称房颤)的发病率越来越高.其基础及临床研究一直是研究热点.脑钠肽作为一种心功能标志物,临床已应用于评价心力衰竭,近年来脑钠肽在房颤复律方面的研究已引起广泛关注.现从脑钠肽的生理学、房颤时的分泌机制及其在房颤电复律、药物复律中的相关研究和预测价值进行综述.

  2. Atrial natriuretic peptide in the locus coeruleus and its possible role in the regulation of arterial blood pressure, fluid and electrolyte homeostasis

    Energy Technology Data Exchange (ETDEWEB)

    Geiger, H.; Sterzel, R.B. (Univ. of Erlangen-Nuernberg (West Germany)); Bahner, U.; Heidland, A. (Univ. of Wuerzburg (West Germany)); Palkovits, M. (Semmelweis Univ., Budapest (Hungary))

    1991-01-01

    Atrial natriuretic factor (ANP) is present in neuronal cells of the locus coeruleus and its vicinity in the pontine tegmentum and moderate amount of ANP is detectable in this area by radioimmunoassay. The ANP is known as a neuropeptide which may influence the body salt and water homeostasis and blood pressure by targeting both central and peripheral regulatory mechanisms. Whether this pontine ANP cell group is involved in any of these regulatory mechanisms, the effect of various types of hypertension and experimental alterations in the salt and water balance on ANP levels was measured by radioimmunoassay in the locus coeruleus of rats. Adrenalectomy, as well as aldosterone and dexamethasone treatments failed to alter ANP levels in the locus coeruleus. Reduced ANP levels were measured in spontaneously hypertensive rats, and in diabetes insipidus rats with vasopressin replacement. In contrast to these situations, elevated ANP levels were found in rats with DOCA-salt or 1-Kidney-1-clip hypertension. These data suggest a link between ANP levels in the locus coeruleus and fluid volume homeostasis. Whether this link is causal and connected with the major activity of locus coeruleus neurons needs further information.

  3. Direct effect of alpha-human atrial natriuretic peptide on human vasculature in vivo and in vitro.

    Science.gov (United States)

    Hughes, A; Thom, S; Goldberg, P; Martin, G; Sever, P

    1988-02-01

    1. The effect of a alpha-human atrial natriuretic peptide (1-28) (ANP) on human vasculature was investigated in vivo and in vitro. Possible involvement of vascular dopamine receptors and the renin-angiotensin system in the response to ANP was also studied in vivo. 2. Forearm blood blow was measured by venous occlusion plethysmography. Isolated human blood vessels were studied using conventional organ bath techniques. 3. ANP (0.1-1 microgram/min, intra-arterially) produced a dose-dependent increase in forearm blood flow, corresponding to a 163% increase in net forearm blood flow in the study arm. This action of ANP was not antagonized by (R)-sulpiride (100 micrograms/min, intra-arterially), a selective vascular dopamine receptor antagonist, or 50 mg of oral captopril, an inhibitor of angiotensin-converting enzyme. 4. ANP (1 nmol/l-1 mumol/l) produced concentration-dependent relaxation of isolated human arteries, including brachial artery, but was without effect on isolated human saphenous vein. 5. ANP produces vasodilatation in vivo and relaxes isolated human arterial smooth muscle. This action of ANP may contribute to its reported hypotensive effects in vivo. PMID:2962803

  4. An analogue of atrial natriuretic peptide (C-ANP4-23) modulates glucose metabolism in human differentiated adipocytes.

    Science.gov (United States)

    Ruiz-Ojeda, Francisco Javier; Aguilera, Concepción María; Rupérez, Azahara Iris; Gil, Ángel; Gomez-Llorente, Carolina

    2016-08-15

    The present study was undertaken to investigate the effects of C-atrial natriuretic peptide (C-ANP4-23) in human adipose-derived stem cells differentiated into adipocytes over 10 days (1 μM for 4 h). The intracellular cAMP, cGMP and protein kinase A levels were determined by ELISA and gene and protein expression were determined by qRT-PCR and Western blot, respectively, in the presence or absence of C-ANP4-23. The levels of lipolysis and glucose uptake were also determined. C-ANP4-23 treatment significantly increased the intracellular cAMP levels and the gene expression of glucose transporter type 4 (GLUT4) and protein kinase, AMP-activated, alpha 1 catalytic subunit (AMPK). Western blot showed a significant increase in GLUT4 and phosphor-AMPKα levels. Importantly, the adenylate cyclase inhibitor SQ22536 abolished these effects. Additionally, C-ANP4-23 increased glucose uptake by 2-fold. Our results show that C-ANP4-23 enhances glucose metabolism and might contribute to the development of new peptide-based therapies for metabolic diseases. PMID:27181211

  5. Efficacy and Safety of 1-Hour Infusion of Recombinant Human Atrial Natriuretic Peptide in Patients With Acute Decompensated Heart Failure

    Science.gov (United States)

    Wang, Guogan; Wang, Pengbo; Li, Yishi; Liu, Wenxian; Bai, Shugong; Zhen, Yang; Li, Dongye; Yang, Ping; Chen, Yu; Hong, Lang; Sun, Jianhui; Chen, Junzhu; Wang, Xian; Zhu, Jihong; Hu, Dayi; Li, Huimin; Wu, Tongguo; Huang, Jie; Tan, Huiqiong; Zhang, Jian; Liao, Zhongkai; Yu, Litian; Mao, Yi; Ye, Shaodong; Feng, Lei; Hua, Yihong; Ni, Xinhai; Zhang, Yuhui; Wang, Yang; Li, Wei; Luan, Xiaojun; Sun, Xiaolu; Wang, Sijia

    2016-01-01

    Abstract The aim of the study was to evaluate the efficacy and safety of 1-h infusion of recombinant human atrial natriuretic peptide (rhANP) in combination with standard therapy in patients with acute decompensated heart failure (ADHF). This was a phase III, randomized, double-blind, placebo-controlled, multicenter trial. Eligible patients with ADHF were randomized to receive a 1-h infusion of either rhANP or placebo at a ratio of 3:1 in combination with standard therapy. The primary endpoint was dyspnea improvement (a decrease of at least 2 grades of dyspnea severity at 12 h from baseline). Reduction in pulmonary capillary wedge pressure (PCWP) 1 h after infusion was the co-primary endpoint for catheterized patients. Overall, 477 patients were randomized: 358 (93 catheterized) patients received rhANP and 118 (28 catheterized) received placebo. The percentage of patients with dyspnea improvement at 12 h was higher, although not statistically significant, in the rhANP group than in the placebo group (32.0% vs 25.4%, odds ratio=1.382, 95% confidence interval [CI]: 0.863–2.212, P = 0.17). Reduction in PCWP at 1 h was significantly greater in patients treated with rhANP than in patients treated with placebo (−7.74 ± 5.95 vs −1.82 ± 4.47 mm Hg, P  0.99). 1-h rhANP infusion appears to result in prompt, transient hemodynamic improvement with a small, nonsignificant, effect on dyspnea in ADHF patients receiving standard therapy. The safety of 1-h infusion of rhANP seems to be acceptable. (WHO International Clinical Trials Registry Platform [ICTRP] number, ChiCTR-IPR-14005719.) PMID:26945407

  6. Preparation of mono-radioiodinated tracers for study of the in vivo metabolism of atrial natriuretic peptide in humans

    International Nuclear Information System (INIS)

    The authors evaluate the optimum chemical conditions for labelling atrial natriuretic peptide (ANP) and its metabolites and for preparing highly purified radiotracers which can be used for in vivo kinetic studies of ANP in humans. Synthetic α h1-28ANP and some hormone metabolites were iodinated with Na125I or Na131I by means of the lactoperoxidase (ANP) or the chloramine-T (ANP metabolites) technique. The biological activity of labelled ANP was tested by means of a binding study using mouse cardiac membranes. A high-performance liquid chromatography (HPLC) procedure was used to purify the labelled hormone and the principal labelled metabolites in venous plasma samples collected up to 50 min after the injection of 125I-labelled ANP from nine healthy men. The main ANP kinetic parameters were derived from the disappearance curves of the [125I]ANP, which were satisfactorily fitted by a bi-exponential function in all subjects. The main advantages of this tracer technique are high accuracy, allowing the identification of the metabolites produced in vivo under steady-state conditions after injection of the precursor (labelled hormone) high sensitivity, allowing the detection of minimal quantities of metabolites high specificity, allowing the detection of possible in vitro artefactual generation of cleavage products of ANP using an internal labelled standard. Utilizing this tracer method, it was possible to estimate the principal parameters of ANP kinetics and also to plot the appearance curves of the labelled metabolites produced in vivo after the injection of the labelled precursor. (orig.). With 5 figs

  7. [Obesity as a risk factor for atrial fibrillation].

    Science.gov (United States)

    Duraj, Iwona; Broncel, Marlena

    2016-01-01

    Atrial fibrillation (AF) and obesity is a growing problem of public health both in Poland and in the whole world. AF risk factors may be summarized as elderliness, male sex, smoking, hypertension, diabetes, obesity, coronary heart disease, heart failure, valvular heart disease, cardiac surgery. Once obesity is an independent, potentially modifiable risk factor for AF. The connection between obesity and atrial fibrillation is very up-to-date because of incremental prevalence, almost epidemic of obesity in the whole world. The probability of AF among obese patients increases with concomitant obstructive sleep apnea. Regardless many researches it hasn't been assessed yet how obesity itself predisposes to AF. It could be an effect of change in the atrial anatomy, the rise of atrial pressure, mechanical stretch, interstitial atrial fibrosis and disruption of atrial electric integrity. A great role is ascribed to inflammation, especially proinflammatory cytokines increased by adipocites of left atrial epicardial adiposity. PMID:26891428

  8. Circulating atrial natriuretic peptide (ANP) and central blood volume (CBV) in cirrhosis

    DEFF Research Database (Denmark)

    Schütten, H J; Henriksen, Jens Henrik Sahl; Bendtsen, F; Warberg, J

    1986-01-01

    ). Arterial plasma concentration of ANP in supine patients was (mean +/- SEM) 33 +/- 4 vs 41 +/- 10 pg/ml (9.9 +/- 1.2 vs 12.3 +/- 3.0 fmol/l) in controls (n.s.), and there was a weak direct correlation with right atrial pressure (r = 0.36, P = 0.05). There was no relationship with the presence of ascites or...... diuretic treatment. Central blood volume (CBV, i.e. the blood volume in the heart cavities, lungs, and aorta), determined from the mean transit time of 125I-labelled of 125I-labelled albumin and cardiac output, was significantly reduced in cirrhotics compared to controls (1.45 +/- 0.12 vs. 1.83 +/- 0.10 l......, P less than 0.02) and inversely correlated with portal pressure (r = 0.42, P less than 0.05), whereas total plasma volume was somewhat increased (3.51 +/- 0.2 vs. 3.19 +/- 0.2, 0.05 less than P less than 0.1). A high arterio-venous extraction of ANP was found in the splanchnic system (extraction...

  9. Immunoreactive atrial natriuretic peptide and dopamine beta-hydroxylase in myocytes and chromaffin cells of the heart of the African lungfish, Protopterus aethiopicus.

    Science.gov (United States)

    Larsen, T H; Helle, K B; Saetersdal, T

    1994-07-01

    The heart of the African lungfish, Protopterus aethiopicus, was examined for immunoreactive atrial natriuretic peptide (ANP) and dopamine beta-hydroxylase (D beta H) as markers for hormone secreting myocytes and chromaffin cells, respectively. Specific antibodies raised against rat alpha-ANP and rat D beta H were used for immunofluorescence microscopy and immunogold electron microscopy. D beta H-immunoreactive cells were restricted to subendocardial areas of the atrium whereas ANP immunoreactivity occurred throughout both the atrial and the ventricular myocardium, showing particularly strong staining intensity in the atrial myocytes. The granular ANP immunostaining in the atrial myocytes was frequently accumulated in the sarcoplasm. In the ventricular myocytes ANP immunoreactivity occurred as scattered granular staining throughout the sarcoplasm. ANP and D beta H immunofluorescence staining coincided with the presence of immunoreactive specific granules and secretory vesicles in the cardiac myocytes and chromaffin cells, respectively, as revealed by electron microscopy. The number of ANP-containing specific granules was generally high in the atrial myocytes, and they were frequently observed in clusters in subsarcolemmal areas. Granular frequency was considerably lower and the mean granular diameter was smaller (0.142 +/- 0.045 micron versus 0.213 +/- 0.049 micron) in the ventricular than in the atrial myocytes. The present results indicate that ANP and D beta H are phylogenetically highly conserved proteins from the dipnoi to the rat. The large amounts of ANP and of specific granules are consistent with an endocrine myocardium in the Protopterus heart. The presence of D beta H and secretory vesicles in the subendocardial chromaffin cells of the atrium suggests a local production of catecholamines from dopamine in the heart of this dipnoan. PMID:7926645

  10. The diagnostic performance of mid-regional portion of pro-atrial natriuretic peptide for the detection of left ventricular hypertrophy in Caucasian hypertensive patients.

    Science.gov (United States)

    Bhandari, S S; Davies, J E; Struck, J; Ng, L L

    2012-12-01

    Left ventricular hypertrophy (LVH) is predictive of cardiovascular disease. The vasodilator, natriuretic and diuretic actions of atrial natriuretic peptide (ANP) support a role in the pathophysiology of hypertension. Measuring the redundant precursor fragment mid-regional portion of pro-atrial natriuretic peptide (MRproANP) overcomes the technical difficulties of quantifying the bioactive ANP. This study sought to investigate the diagnostic and prognostic utility of MRproANP in a hypertensive Caucasian patient population. A total of 194 hypertensive patients (39 patients with LVH, 69±7.82 years of age, 74% female vs 155 patients without LVH, 68±6.51 years of age, 71% female) were derived from a screening study. Plasma MRproANP concentrations were quantified using immunoluminometric assays. Hypertensive patients with LVH had higher MRproANP concentrations than those without LVH (103.04 (50.58) vs 84.11 pmol l(-1) (44.82); P=0.014). Independent predictors of left ventricular mass index were LogMRproANP (P=0.022), male gender (Pdetection of LVH was limited, yielding an area under the curve of only 0.628 (confidence interval 0.523-0.733; P=0.014). Therefore, the role of MRproANP may not lie in the diagnosis of LVH but in monitoring the response to therapy. A nonsignificant trend towards greater mortality in patients with above-median MRproANP levels compared with below-median levels (P=0.167) was observed. Larger studies are required to assess its prognostic utility further. PMID:22113442

  11. Transient silencing of Npr3 gene expression improved the circulatory levels of atrial natriuretic peptides and attenuated β-adrenoceptor activation- induced cardiac hypertrophic growth in experimental rats.

    Science.gov (United States)

    Venkatesan, Balaji; Tumala, Anusha; Subramanian, Vimala; Vellaichamy, Elangovan

    2016-07-01

    Natriuretic peptide receptor-C (NPR-C) is considered as a clearance receptor that maintains the circulatory levels of natriuretic peptides. It has been suggested that augmented expression of NPR-C as a cause for the diminished anti-hypertrophic action of natriuretic peptides in the failing heart. Hence, we sought to determine the level of Npr3 gene (coding for NPR-C) expression in the Isoproterenol (ISO) treated Wistar rats. In addition, we studied the effect of Npr3 gene silencing on the hypertrophic growth. A significant increase in heart weight-to-body weight ratio (HW/BW-24%,Pexpression was significantly increased by 4 fold as compared to control rats. In parallel, the circulatory atrial natriuretic peptide (ANP) level was significantly decreased (2 fold) in ISO treated rats. Upon treatment with siRNA-Npr3, a significant decrease in the cardiac NPR-C protein expression (70%,Pexpression were observed. Interestingly, the circulatory ANP level was increased by 1.5 fold in the siRNA-Npr3 treated rats as compared to ISO treated rats. Moreover, the cardiac collagen content, matrixmetalloprotinases-2 (MMP-2) and enzymatic antioxidant status (P<0.01, respectively) were found to be restored back to near normal upon siRNA-Npr3 treatment. Taken together, the results of this study indicates that specific down-regulation of Npr3 gene improves the circulatory levels of ANP and antioxidant system and there by attenuates the β-adrenoceptor over-activation mediated cardiac hypertrophic growth in experimental rats. PMID:27108789

  12. Prediction about severity and outcome of sepsis by pro-atrial natriuretic peptide and pro-adrenomedullin

    Institute of Scientific and Technical Information of China (English)

    WANG Rui-lan; KANG Fu-xin

    2010-01-01

    Objective:Measurement of biomarkers is a potential approach to early prediction of the risk of mortality in patients with sepsis. The aim of the present study was to evaluate the prognostic value of pro-atrial natriuretic peptide (pro-ANP) and pro-adrenomedullin (proADM) levels in a cohort of medical intensive care patients and to compare it with that of other known biomarkers and physiological scores.Methods:Blood samples of 51 consecutive critically ill patients admitted to the intensive care unit and 53 age-matched healthy control people were evaluated in this prospective study. The prognostic value of pro-ANP and pro-ADM levels was compared with that of acute physiology and chronic health evaluation (APACHE) Ⅱ scores and various biomarkers such as C-reactive protein, interleukin-6 and procalcitonin. Pro-ANP and pro-ADM were detected by a new sandwich immunoassay.Results: On admission, 25 patients had systemic inflammatory response syndrome (SIRS), 12 sepsis, 9 severe sepsis and 5 septic shock. At that time, the median levels (ng/ml) of pro-ANP and pro-ADM were 87.22 and 0.34 respectively in patients with SIRS, 1533.30 and 2.23 in those with sepsis, 1098.73 and 4.57 in those with severe sepsis, and 1933.94 and 8.21 in those with septic shock.With the increasing severity of disease, the levels of pro-ANP and pro-ADM were gradually increased. On admission,the circulating levels of pro-ANP and pro-ADM in patients with sepsis, severe sepsis,or septic shock were significantly higher in non-survivors than in survivors (P<0.05). In a receiver operating characteristic curve analysis for the survival of patients with sepsis, the areas under the curve (AUCs) for pro-ANP and pro-ADM were 0.89 and 0.87 respectively, which was similar to the AUCs for procalcitonin and APACHE Ⅱ scores.Conclusion: Pro-ANP and pro-ADM are valuable biomarkers for prediction of severity of septic patients.

  13. Characterization and purification of a protease in serum that cleaves proatrial natriuretic factor (ProANF) to its circulating forms

    International Nuclear Information System (INIS)

    Atrial natriuretic factor (ANF) is synthesized and stored in atrial cardiocytes as a 17-kilodalton (kDa), 126 amino acid polypeptide, proANF, but circulates as smaller, 24 and 28 amino acid peptide fragments of the carboxy terminus of proANF. This reports describes the purification and characterization of this proANF-cleaving protease from rat serum. The cleavages both of 35S-labeled proANF derived from rat atrial cell cultures, as assessed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE)/autoradiography, and of a synthetic p-nitroanilide-containing substrate were used as assays for the detection of enzyme activity. ProANF-cleaving activity was found in rat serum, with no such activity detectable in rat plasma. Fractionation of either whole serum or the purified enzyme by gel filtration chromatography revealed a single peak of activity corresponding to a protein with a Stokes radius of 45 A. Incubation of the purified enzyme with [3H]DFP followed by SDS-PAGE and autoradiography revealed a specifically labeled 38-kDa peptide, the substrate binding subunit. Analysis by high-performance liquid chromatography of the 3-kDa products resulting from the cleavage of 35S-labeled proANF by the purified enzyme revealed, as previously described with whole serum, two radiolabeled peptides which coeluted with the 28 and 24 amino acid C-terminal peptides. These observations imply a precursor-product relationship, with the initial cleavage of proANF to the 28 amino acid peptide, which is then cleaved to the 24 amino acid peptide. These studies indicate that the majority of proANF cleavage activity found in rat serum is represented by that of a distinct serine protease whose properties are different from a variety of well-characterized proteases. The role of this protease in the in vivo processing of proANF remains to be defined

  14. Natriuretic Peptide Metabolism, Clearance and Degradation

    OpenAIRE

    Potter, Lincoln R.

    2011-01-01

    Atrial natriuretic peptide, B-type natriuretic peptide and C-type natriuretic peptide compose a family of three structurally related, but genetically distinct, signaling molecules that regulate the cardiovascular, skeletal, nervous, reproductive and other systems by activating transmembrane guanylyl cyclases and elevating intracellular cGMP concentrations. This review broadly discusses the general characteristics of natriuretic peptides and their cognate signaling receptors, then specifically...

  15. Mid-regional pro-atrial natriuretic peptide as a prognostic marker for all-cause mortality in patients with symptomatic coronary artery disease.

    Science.gov (United States)

    von Haehling, Stephan; Papassotiriou, Jana; Hartmann, Oliver; Doehner, Wolfram; Stellos, Konstantinos; Geisler, Tobias; Wurster, Thomas; Schuster, Andreas; Botnar, Rene M; Gawaz, Meinrad; Bigalke, Boris

    2012-11-01

    In the present study, we investigated the prognostic value of MR-proANP (mid-regional pro-atrial natriuretic peptide). We consecutively evaluated a catheterization laboratory cohort of 2700 patients with symptomatic CAD (coronary artery disease) [74.1% male; ACS (acute coronary syndrome), n=1316; SAP (stable angina pectoris), n=1384] presenting to the Cardiology Department of a large primary care hospital, all of whom underwent coronary angiography. Serum MR-proANP and other laboratory markers were sampled at the time of presentation or in the catheterization laboratory. Clinical outcome was assessed by hospital chart analysis and telephone interviews. The primary end point was all-cause death at 3 months after enrolment. Follow-up data were complete in 2621 patients (97.1%). Using ROC (receiver operating characteristic) curves, the AUC (area under the curve) of 0.73 [95% CI (confidence interval), 0.67-0.79] for MR-proANP was significantly higher compared with 0.58 (95% CI, 0.55-0.62) for Tn-I (troponin-I; DeLong test, P=0.0024). According to ROC analysis, the optimal cut-off value of MR-proANP was at 236 pmol/l for all-cause death, which helped to find a significantly increased rate of all-cause death (n=76) at 3 months in patients with elevated baseline concentrations (≥236 pmol/l) compared with patients with a lower concentration level in Kaplan-Meier survival analysis (log rank, P<0.001). The predictive performance of MR-proANP was independent of other clinical variables or cardiovascular risk factors, and superior to that of Tn-I or other cardiac biomarkers (all: P<0.0001). MR-proANP may help in the prediction of all-cause death in patients with symptomatic CAD. Further studies should verify its prognostic value and confirm the appropriate cut-off value. PMID:22690794

  16. Effect of catheter radiofrequency ablation on C-reactive protein, brain natriuretic peptide and echocardiograph in patients with persistent and permanent atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Huang Qiong; Yuan Yiqiang; Qiu Chunguang; Zhao Yujie; Mao Youlin; Wang Ruimin; Wang Qian

    2014-01-01

    Background Radiofrequency catheter ablation (RFCA) for atrial fibrillation (AF) has developed rapidly,and is a commonly performed ablation in many major hospitals throughout the world,due to its satisfactory results.The aim of this study was to detect the effect of RFCA on C-reactive protein (CRP),brain natriuretic peptide (BNP),and echocardiograph in patients with persistent and permanent AF.Methods A total of 120 patients (71 males,mean age (50.8±12.0) years) with persistent and permanent AF undergoing RFCA under guidance of the Carto merge technique were studied.Left atrial diameter (LAD),right atrial diameter (RAD),left ventricular ejection fraction (LVEF),CRP,and BNP were observed 3,6 and 12 months after RFCA and compared with results before RFCA.The recurrence of atrial arrhythmias was observed 3 and 12 months after the procedure.Results Compared with that before RFCA,LAD and RAD decreased and LVEF increased significantly after RFCA.Meanwhile,the levels of CRP and BNP were reduced significantly at 3,6,and 12 months after RFCA (P<0.05).In the non-recurrent patients,LVEF was increased significantly compared with the recurrent patients at 3,6,and 12 months after RFCA (P<0.05).CRP and BNP levels were decreased significantly in the non-recurrent patients compared with the recurrent patients at 3,6,and 12 months after RFCA (P<0.05).After one or two applications of RFCA,during a follow-up of 12 months,12 patients (10.0%) had AF,10 patients (8.3%) had atrial flutter,and 5 patients had atrial tachycardia (4.2%).Conclusions Conversion of AF to sinus rhythm by RFCA,has been shown to reduce LA size and improve LVEF.It can also significantly decrease the levels of CRP and BNP in patients with persistent and permanent AF and reduce the risk of inflammation and developing heart failure.

  17. Increased susceptibility to atrial fibrillation secondary to atrial fibrosis in transgenic goats expressing transforming growth factor - B1

    Science.gov (United States)

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in people with significant morbidity and mortality. There is a strong association between atrial fibrosis and AF. Transforming growth factor B1 (TGF-B1) is an essential mediator of atrial fibrosis in animal models and human pat...

  18. Increased plasma levels and blunted effects of brain natriuretic peptide in rats with congestive heart failure.

    Science.gov (United States)

    Hoffman, A; Grossman, E; Keiser, H R

    1991-07-01

    The hemodynamic and renal effects of brain natriuretic peptide (BNP) were studied in conscious rats with experimental congestive heart failure (CHF) produced by an aortocaval fistula. The peptide had potent hypotensive, diuretic, and natriuretic effects in control rats, all of which were abolished in CHF. Plasma levels of BNP increased time-dependently during the development of CHF, and were more than four-fold higher in sodium retaining rats than in control rats. The data suggest that BNP secretion from the atria is increased in CHF, and that resistance to BNP, in addition to the relative resistance to atrial natriuretic factor, may contribute to sodium retention in CHF. PMID:1831369

  19. Prognostic value of plasma catecholamines, plasma renin activity, and plasma atrial natriuretic peptide at rest and during exercise in congestive heart failure: comparison with clinical evaluation, ejection fraction, and exercise capacity

    DEFF Research Database (Denmark)

    Madsen, B K; Keller, N; Christiansen, E;

    1995-01-01

    analysis were: plasma noradrenaline at rest (P < .0001), plasma adrenaline at rest (P = .049), and atrial natriuretic peptide at rest (P = .016). During exercise, plasma catecholamines and plasma atrial natriuretic peptide increased significantly; the change, however, was not related to survival. Six...... variables carried significant, independent prognostic information in a multivariate analysis: left ventricular ejection fraction (P = .03), plasma noradrenaline at rest (P = .009), New York Heart Association class III + IV (P = .005), increase in heart rate during exercise < or = 35 min-1 (P < .0001), serum......, however, is not related to mortality. Plasma noradrenaline at rest contributes with further prognostic information despite knowledge of clinical and exercise variables and was the only neurohormonal variable with independent, significant prognostic information on survival....

  20. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac p...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....... characterized. An ongoing characterization of the molecular heterogeneity will help appreciate the biosynthetic capacity of the endocrine heart and could introduce new diagnostic possibilities. Notably, different biosynthetic products may not be equal markers of the same pathophysiological processes. An...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...

  1. Biosynthesis of cardiac natriuretic peptides

    DEFF Research Database (Denmark)

    Goetze, Jens Peter

    2010-01-01

    Cardiac-derived peptide hormones were identified more than 25 years ago. An astonishing amount of clinical studies have established cardiac natriuretic peptides and their molecular precursors as useful markers of heart disease. In contrast to the clinical applications, the biogenesis of cardiac...... inefficient post-translational prohormone maturation will also affect the biology of the cardiac natriuretic peptide system. This review aims at summarizing the myocardial synthesis of natriuretic peptides focusing on B-type natriuretic peptide, where new data has disclosed cardiac myocytes as highly...... competent endocrine cells. The structurally related atrial natriuretic peptide will be mentioned where appropriate, whereas C-type natriuretic peptide will not be considered as a cardiac peptide of relevance in mammalian physiology....

  2. C-type natriuretic-derived peptides as biomarkers in human disease

    DEFF Research Database (Denmark)

    Lippert, Solvej Kølvraa; Goetze, Jens Peter

    2010-01-01

    and extracellular fluid volume. Atrial natriuretic peptide and B-type natriuretic peptide have gained considerable diagnostic interest as biomarkers in cardiovascular disease. By contrast, C-type natriuretic peptide has not yet been ascribed a role in human diagnostics. This perspective aims at......The natriuretic peptide system comprises three structurally related peptides: atrial natriuretic peptide, B-type natriuretic peptide and C-type natriuretic peptide. In circulation, they play an important endocrine role in the regulation of cardiovascular homeostasis by maintaining blood pressure...... recapitulating the present biochemical and clinical issues concerning C-type natriuretic peptide measurement in plasma as a potential biomarker....

  3. Significance of changes of the plasma levels of nitricoxide, endothelin and atrial natriuretic peptide in patients with lupus nephritis complicated with renal failure and receiving hemodialysis

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical significance of changes of plasma levels of nitricoxide(NO), endothelin (ET) and atrial natriuretic peptide (ANP) before and after hemodialysis in lupus nephritis(LN) patients with renal failure. Methods: Plasma NO (with biochemistry) and ET, ANP(with RIA) levels were measured in 32 lupus patients with renal failure both before and after a course of hemodialysis and 32 controls. Results: The plasma levels of NO, ET and ANP in the 32 LN patients with renal failure were significant higher than those in controls (P<0.05) before hemodialysis, the NO, ET and ANP levels were positively correlated with the BUN and creatinine levels. After a course of hemodialysis, plasma NO and ANP decreased significantly (P<0.05), but no significant changes were observed in plasma ET levels. Conclusion: The plasma level of NO, ET and ANP could help to assess the damage of renal function and hemodialysis could lower the level of NO and ANP in LN patients with renal failure. (authors)

  4. Protective effect of α-human atrial natriuretic polypeptide (α-hANP) on chemical-induced pulmonary edema

    International Nuclear Information System (INIS)

    It has been established that α-hANP, the newly discovered peptide extracted from human cardiac atria, has potent natriuretic and hypotensive actions. The authors present investigation is the first to demonstrate that α-hANP is capable of protecting against pulmonary edema caused by various chemicals, using isolated perfused guinea pig lung system. Lungs were perfused via pulmonary artery with Krebs-Ringer bicarbonate buffer at 5.0 ml/min, and wet weight of lungs and perfusion pressure of pulmonary artery (Pa) were monitored. Bolus injection of Triton-X or CHAPS into cannulated pulmonary artery produced enema as indicated by a massive increase in wet weight and a slight increase in Pa. Constant infusion of α-hANP through pulmonary artery at 200 ng/ml was effective in causing decrease in wet weight of lung. Perfusion of lung with paraquat or PGF/sub 2α'/, and repeated bolus injection of arachidonic acid or PGE2 caused elevation in both wet weight of lung and Pa

  5. 不同运动量游泳运动对大鼠心房肌细胞心钠素颗粒的影响%Effects of different loading swimming exercises on granules of atrial natriuretic peptide in atrial muscles of rats

    Institute of Scientific and Technical Information of China (English)

    韦晓英; 马彬; 吴洪海; 朱永泽

    2012-01-01

    Objective: To explore the effects of different loading swimming exercises on the granules of atrial natriuretic pep-tide in rat's right atrial muscles, so as to provide some morphological basis of the changes of physiology and pa-thology by exercise-induced injury and recuperation of cardiac muscles.Method: SD rats were randomly divided into three groups: control group, different loading exercises group and ex-haustive exercises group. In different loading exercises group, 12-week low, moderate and high loading swimming models were carried out in rats. In exhaustive exercises group, single exhaustive swimming was carried out in rats. After exercises, rat's right atrial muscles were cut off, and treated with regular procedures of transmission electron microscopy. The quantities and distributions of granules of atrial natriuretic peptide were observed, and their sizes were analyzed.Result: In control group atrial natriuretic peptides were synthesized in endoplasmic reticulum, processed and se-creted via Golgi apparatus, and formed small secreted vesicles in right atrial muscles. These small vesicles were fused into the granules of atrial natriuretic peptide. The results of different loading exercises group indicated that the formation of granules of atrial natriuretic peptide increased gradually and secreted out of cells with increasing exercises loads. The results of exhaustive exercise group showed that the granules of atrial natriuretic peptide se-creted out of cells, but it's formation did not increase.%目的:探讨不同运动量游泳运动对大鼠右心房肌细胞心钠素颗粒的影响,以期为运动对心肌的生理和病理变化研究提供形态学依据. 方法:SD大鼠分为安静对照组、不同运动量运动组和力竭运动组.不同运动量运动组进行12周的低、中和高运动量游泳运动,力竭运动组进行1次力竭游泳运动.取右心房肌进行常规透射电镜样品制备,观察心房肌细胞内心钠素颗粒的数

  6. Atrial natriuretic peptide down-regulates LPS/ATP-mediated IL-1β release by inhibiting NF-kB, NLRP3 inflammasome and caspase-1 activation in THP-1 cells.

    Science.gov (United States)

    Mezzasoma, Letizia; Antognelli, Cinzia; Talesa, Vincenzo Nicola

    2016-02-01

    Atrial natriuretic peptide (ANP) is an hormone/paracrine/autocrine factor regulating cardiovascular homeostasis by guanylyl cyclase natriuretic peptide receptor (NPR-1). ANP plays an important role also in regulating inflammatory and immune systems by altering macrophages functions and cytokines secretion. Interleukin-1β (IL-1β) is a potent pro-inflammatory cytokine involved in a wide range of biological responses, including the immunological one. Unlike other cytokines, IL-1β production is rigorously controlled. Primarily, NF-kB activation is required to produce pro-IL-1β; subsequently, NALP3 inflammasome/caspase-1 activation is required to cleave pro-IL-1β into the active secreted protein. NALP3 is a molecular platform capable of sensing a large variety of signals and a major player in innate immune defense. Due to their pleiotropism, IL-1β and NALP3 dysregulation is a common feature of a wide range of diseases. Therefore, identifying molecules regulating IL-1β/NALP3/caspase-1 expression is an important step in the development of new potential therapeutic agents. The aim of our study was to evaluate the effect of ANP on IL-1β/NALP3/caspase-1 expression in LPS/ATP-stimulated human THP1 monocytes. We provided new evidence of the direct involvement of ANP/NPR-1/cGMP axis on NF-kB/NALP3/caspase-1-mediated IL-1β release and NF-kB-mediated pro-IL-1β production. In particular, ANP inhibited both NF-kB and NALP3/caspase-1 activation leading to pro- and mature IL-1β down-regulation. Our data, pointing out a modulatory role of this endogenous peptide on IL-1β release and on NF-kB/NALP3/caspase-1 activation, indicate an important anti-inflammatory and immunomodulatory effect of ANP via these mechanisms. We suggest a possible employment of ANP for the treatment of inflammatory/immune-related diseases and IL-1β/NALP3-associated disorders, affecting millions of people worldwide. PMID:26616294

  7. Prevalence and risk factors of atrial fibrillation in hospitalized patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    王骄

    2013-01-01

    Objective Atrial fibrillation (AF) is the most common sustained tachyarrhythmia in the general population.AF and Chronic Kidney Disease (CKD) share several common risk factors.We investigated the association between chronic kidney disease and risk of atrial fibrillation

  8. Relaxin and atrial natriuretic peptide pathways participate in the anti-fibrotic effect of a melon concentrate in spontaneously hypertensive rats

    Directory of Open Access Journals (Sweden)

    Julie Carillon

    2016-04-01

    Full Text Available Background: In spontaneously hypertensive rats (SHR, a model of human essential hypertension, oxidative stress is involved in the development of cardiac hypertrophy and fibrosis associated with hypertension. Dietary supplementation with agents exhibiting antioxidant properties could have a beneficial effect in remodeling of the heart. We previously demonstrated a potent anti-hypertrophic effect of a specific melon (Cucumis melo L. concentrate with antioxidant properties in spontaneously hypertensive rats. Relaxin and atrial natriuretic peptide (ANP were reported to reduce collagen deposition and fibrosis progression in various experimental models. Objective: The aim of the present investigation was to test the hypothesis that, beside reduction in oxidative stress, the melon concentrate may act through relaxin, its receptor (relaxin/insulin-like family peptide receptor 1, RXFP1, and ANP in SHR. Design and results: The melon concentrate, given orally during 4 days, reduced cardiomyocyte size (by 25% and totally reversed cardiac collagen content (Sirius red staining in SHR but not in their normotensive controls. Treatment with the melon concentrate lowered cardiac nitrotyrosine-stained area (by 45% and increased by 17–19% the cardiac expression (Western blot of superoxide dismutase (SOD and glutathione peroxidase. In addition, plasma relaxin concentration was normalized while cardiac relaxin (Western blot was lowered in treated SHR. Cardiac relaxin receptor level determined by immunohistochemical analysis increased only in treated SHR. Similarly, the melon concentrate reversed the reduction of plasma ANP concentration and lowered its cardiac expression. Conclusions: The present results demonstrate that reversal of cardiac fibrosis by the melon concentrate involves antioxidant defenses, as well as relaxin and ANP pathways restoration. It is suggested that dietary SOD supplementation could be a useful additional strategy against cardiac hypertrophy

  9. Evaluation of cardiac sympathetic nerve activity and aldosterone suppression in patients with acute decompensated heart failure on treatment containing intravenous atrial natriuretic peptide

    Energy Technology Data Exchange (ETDEWEB)

    Kasama, Shu [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Toyama, Takuji; Kurabayashi, Masahiko [Gunma University Graduate School of Medicine, Department of Medicine and Biological Science (Cardiovascular Medicine), Maebashi, Gunma (Japan); Iwasaki, Toshiya; Sumino, Hiroyuki; Kumakura, Hisao; Minami, Kazutomo; Ichikawa, Shuichi [Cardiovascular Hospital of Central Japan (Kitakanto Cardiovascular Hospital), Department of Cardiovascular Medicine, Gunma (Japan); Matsumoto, Naoya [Nihon University School of Medicine, Department of Cardiology, Tokyo (Japan); Nakata, Tomoaki [Sapporo Medical University School of Medicine, Second (Cardiology) Department of Internal Medicine, Sapporo, Hokkaido (Japan)

    2014-09-15

    Aldosterone prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, inhibits aldosterone synthase gene expression in cultured cardiocytes. We evaluated the effects of intravenous ANP on cardiac sympathetic nerve activity (CSNA) and aldosterone suppression in patients with acute decompensated heart failure (ADHF). We studied 182 patients with moderate nonischemic ADHF requiring hospitalization and treated with standard therapy containing intravenous ANP and 10 age-matched normal control subjects. ANP was continuously infused for >96 h. In all subjects, delayed total defect score (TDS), heart to mediastinum ratio, and washout rate were determined by {sup 123}I-metaiodobenzylguanidine (MIBG) scintigraphy. Left ventricular (LV) end-diastolic volume, end-systolic volume, and ejection fraction were determined by echocardiography. All patients with acute heart failure (AHF) were examined once within 3 days and then 4 weeks after admission, while the control subjects were examined only once (when their hemodynamics were normal). Moreover, for 62 AHF patients, plasma aldosterone concentrations were measured at admission and 1 h before stopping ANP infusion. {sup 123}I-MIBG scintigraphic and echocardiographic parameters in normal subjects were more favorable than those in patients with AHF (all p < 0.001). After treatment, all these parameters improved significantly in AHF patients (all p < 0.001). We also found significant correlation between percent changes of TDS and aldosterone concentrations (r = 0.539, p < 0.001) in 62 AHF patients. The CSNA and LV performance were all improved in AHF patients. Furthermore, norepinephrine uptake of myocardium may be ameliorated by suppressing aldosterone production after standard treatment containing intravenous ANP. (orig.)

  10. Evaluation of cardiac sympathetic nerve activity and aldosterone suppression in patients with acute decompensated heart failure on treatment containing intravenous atrial natriuretic peptide

    International Nuclear Information System (INIS)

    Aldosterone prevents the uptake of norepinephrine in the myocardium. Atrial natriuretic peptide (ANP), a circulating hormone of cardiac origin, inhibits aldosterone synthase gene expression in cultured cardiocytes. We evaluated the effects of intravenous ANP on cardiac sympathetic nerve activity (CSNA) and aldosterone suppression in patients with acute decompensated heart failure (ADHF). We studied 182 patients with moderate nonischemic ADHF requiring hospitalization and treated with standard therapy containing intravenous ANP and 10 age-matched normal control subjects. ANP was continuously infused for >96 h. In all subjects, delayed total defect score (TDS), heart to mediastinum ratio, and washout rate were determined by 123I-metaiodobenzylguanidine (MIBG) scintigraphy. Left ventricular (LV) end-diastolic volume, end-systolic volume, and ejection fraction were determined by echocardiography. All patients with acute heart failure (AHF) were examined once within 3 days and then 4 weeks after admission, while the control subjects were examined only once (when their hemodynamics were normal). Moreover, for 62 AHF patients, plasma aldosterone concentrations were measured at admission and 1 h before stopping ANP infusion. 123I-MIBG scintigraphic and echocardiographic parameters in normal subjects were more favorable than those in patients with AHF (all p < 0.001). After treatment, all these parameters improved significantly in AHF patients (all p < 0.001). We also found significant correlation between percent changes of TDS and aldosterone concentrations (r = 0.539, p < 0.001) in 62 AHF patients. The CSNA and LV performance were all improved in AHF patients. Furthermore, norepinephrine uptake of myocardium may be ameliorated by suppressing aldosterone production after standard treatment containing intravenous ANP. (orig.)

  11. Effects of immobilizations stress with or without water immersion on the expression of atrial natriuretic peptide in the hearts of two rat strains.

    Science.gov (United States)

    Slavikova, Jana; Mistrova, Eliska; Klenerova, Vera; Kruzliak, Peter; Caprnda, Martin; Hynie, Sixtus; Sida, Pavel; Dvorakova, Magdalena Chottova

    2016-01-01

    Atrial natriuretic peptide (ANP) is produced and released by mammalian cardiomyocytes and induces natriuresis, diuresis, and lowering of blood pressure. The present study examined localization of ANP and a possible role of the hypothalamic-pituitary-adrenal axis (HPA) activity on the expression of proANP gene in the heart. The Sprague Dawley (SD) and Lewis (LE) rat strains were used. The animals were exposed to the two types of stress: immobilization and immobilization combined with water immersion for 1 hour. Localization of ANP was detected by immunohistochemistry and expression of the proANP mRNA by real-time qPCR in all heart compartments of control and stressed animals after 1 and 3 hours after stress termination (IS1, IS3, ICS1, and ICS3). Relatively high density of ANP-immunoreactivity was observed in both atria of both rat strains. In control rats of both strains, the expression of the proANP mRNA was higher in the atria than in ventricles. In SD rats with the intact HPA axis, an upregulation of ANP gene expression was observed in the right atrium after IS1, in both atria and the left ventricle after IS3 and in the left atrium and the left ventricle after ICS3. In LE rats with a blunted reactivity of the HPA axis, no increase or even a downregulation of the gene expression was observed. Thus, acute stress-induced increase in the expression of the proANP gene is related to the activity of the HPA axis. It may have relevance to ANP-induced protection of the heart. PMID:27508036

  12. Increased NT-pro-B-type natriuretic peptide independently predicts outcome following catheter ablation of atrial fibrillation

    DEFF Research Database (Denmark)

    Nilsson, Brian; Goetze, Jens Peter; Chen, Xu;

    2009-01-01

    AIMS: To investigate whether NT-proBNP before ablation treatment and after exercise testing has predictive information regarding the clinical outcome following pulmonary vein isolation in patients with atrial fibrillation (AF). METHODS: NT-proBNP analysis were obtained before the ablation (before...... and after exercise test), and repeated at 1, 3, and 12 months after the final procedure. RESULTS: A total of 51 patients were included. At study entry, the median NT-proBNP concentration was 14.0 pmol/L (quartiles: 8.0 and 27.0). After the exercise test, the mean NT-proBNP value increased from 13.0 pmol....../L (quartiles: 7.5 and 26.0) to 15.0 pmol/L (quartiles: 9.0 and 34.0), p NT-proBNP concentration at baseline was 10.0 pmol/L (quartiles: 7...

  13. Physiology and clinical significance of natriuretic hormones

    Directory of Open Access Journals (Sweden)

    Sandeep Chopra

    2013-01-01

    Full Text Available The natriuretic system consists of the atrial natriuretic peptide (ANP and four other similar peptides including the wrongly named brain natriuretic peptide (BNP. Chemically they are small peptide hormones predominantly secreted by the cardiac myocytes in response to stretching forces. The peptide hormones have multiple renal, hemodynamic, and antiproliferative effects through three different kinds of natriuretic receptors. Clinical interest in these peptide hormones was initially stimulated by the use of these peptides as markers to differentiate cardiac versus noncardiac causes of breathlessness. Subsequently work has been done on using these peptides to prognosticate patients with acute and chronic heart failure and those with acute myocardial infraction. Synthetic forms of both atrial- and brain-natriuretic peptides have been studied and approved for use in acute heart failure with mixed results. This review focuses on the biochemistry and physiology of this fascinating hormone system and the clinical application of these hormones.

  14. Age as Risk Factor for Stroke in Atrial Fibrillation Patients:Implications for Thromboprophylaxis

    OpenAIRE

    Konstantina Mitrousi; Gregory Y H Lip; Stavros Apostolakis

    2013-01-01

    Atrial fibrillation is associated with significant morbidity and mortality. There is a strong relationship between atrial fibrillation and aging, thromboembolism, stroke, congestive heart failure and hypertension. On the other hand, advanced age confers a powerful risk factor for stroke and thromboembolism in patients with atrial fibrillation. For many years, vitamin K antagonists were the only approved anticoagulants for the management of atrial fibrillation. Lately new anticoagulants ma...

  15. Risk factors for atrial fibrillation incidence and progression

    OpenAIRE

    Vermond, Robert Aldo

    2016-01-01

    During atrial fibrillation (AF) irregular activation of the hearts atria occur, causing an irregular heart rate and altered blood flow. AF is the most common heart rhythm disorder, causing stroke, heart failure, dementia, reduced quality of life and high health care expences. AF is diagnosed increasingly frequent, at increasingly young age. Treatment requires knowledge on factors that may cause AF, which may help prevent occurence of AF and AF progression. AF progression is the proces by whic...

  16. [Brain natriuretic peptide].

    Science.gov (United States)

    La Villa, G; Lazzeri, C; Fronzaroli, C; Franchi, F; Gentilini, P

    1995-01-01

    Brain natriuretic peptide (BNP) is a cardiac hormone with a spectrum of activities quite similar to those of atrial natriuretic peptide (ANP), including diuretic, natriuretic, hypotensive and smooth muscle relaxant activities. These effects are due to the stimulation of guanylate cyclase-linked natriuretic peptide receptors, leading to an increase in cyclic GMP concentration in target cells. BNP has a lower affinity than ANP for C (clearance) receptors, and is less susceptible to degradation by neutral endopeptidase-24.11, resulting in a longer half-life. In the kidney, BNP increases the glomerular filtration rate and inhibits sodium reabsorption in the distal tubule. It also inhibits the release of renin and aldosterone. Unlike ANP, produced by the atria, BNP is mainly synthesized and released into circulation by the left ventricle and is therefore influenced by stimuli involving this cardiac chamber, such as an increase in arterial pressure, left ventricular hypertrophy and dilation. Plasma BNP levels are very low in healthy subjects, and respond modestly, although significantly to physiological stimuli such as changes in posture or sodium intake. In contrast, plasma BNP concentrations increase in disease states such as cirrhosis with ascites, hypertension, chronic renal failure, acute myocardial infarction and congestive heart failure. In the latter condition, plasma BNP concentration is a reliable prognostic index. Evidence obtained by administering BNP to healthy subjects and hypertensive patients suggests that BNP, at physiological and pathophysiological plasma concentrations, markedly influences cardiovascular homeostasis, mainly due to its effects on sodium excretion and the renin-aldosterone axis. PMID:8718658

  17. Natriuretic peptides and their therapeutic potential.

    Science.gov (United States)

    Cho, Y; Somer, B G; Amatya, A

    1999-01-01

    Natriuretic peptides are a group of naturally occurring substances that act in the body to oppose the activity of the renin-angiotensin system. There are three major natriuretic peptides: atrial natriuretic peptide (ANP), which is synthesized in the atria; brain natriuretic peptide (BNP), which is synthesized in the ventricles; and C-type natriuretic peptide (CNP), which is synthesized in the brain. Both ANP and BNP are released in response to atrial and ventricular stretch, respectively, and will cause vasorelaxation, inhibition of aldosterone secretion in the adrenal cortex, and inhibition of renin secretion in the kidney. Both ANP and BNP will cause natriuresis and a reduction in intravascular volume, effects amplified by antagonism of antidiuretic hormone (ADH). The physiologic effects of CNP are different from those of ANP and BNP. CNP has a hypotensive effect, but no significant diuretic or natriuretic actions. Three natriuretic peptide receptors (NPRs) have been described that have different binding capacities for ANP, BNP, and CNP. Removal of the natriuretic peptides from the circulation is affected mainly by binding to clearance receptors and enzymatic degradation in the circulation. Increased blood levels of natriuretic peptides have been found in certain disease states, suggesting a role in the pathophysiology of those diseases, including congestive heart failure (CHF), systemic hypertension, and acute myocardial infarction. The natriuretic peptides also serve as disease markers and indicators of prognosis in various cardiovascular conditions. The natriuretic peptides have been used in the treatment of disease, with the most experience with intravenous BNP in the treatment of CHF. Another pharmacologic approach being used is the inhibition of natriuretic peptide metabolism by neutral endopeptidase (NEP) inhibitor drugs. The NEP inhibitors are currently being investigated as treatments for CHF and systemic hypertension. PMID:11720638

  18. The secretions of oviduct epithelial cells increase the equine in vitro fertilization rate: are osteopontin, atrial natriuretic peptide A and oviductin involved?

    Directory of Open Access Journals (Sweden)

    Canepa Sylvie

    2009-11-01

    Full Text Available Abstract Background Oviduct epithelial cells (OEC co-culture promotes in vitro fertilization (IVF in human, bovine and porcine species, but no data are available from equine species. Yet, despite numerous attempts, equine IVF rates remain low. Our first aim was to verify a beneficial effect of the OEC on equine IVF. In mammals, oviductal proteins have been shown to interact with gametes and play a role in fertilization. Thus, our second aim was to identify the proteins involved in fertilization in the horse. Methods & results In the first experiment, we co-incubated fresh equine spermatozoa treated with calcium ionophore and in vitro matured equine oocytes with or without porcine OEC. We showed that the presence of OEC increases the IVF rates. In the subsequent experiments, we co-incubated equine gametes with OEC and we showed that the IVF rates were not significantly different between 1 gametes co-incubated with equine vs porcine OEC, 2 intact cumulus-oocyte complexes vs denuded oocytes, 3 OEC previously stimulated with human Chorionic Gonadotropin, Luteinizing Hormone and/or oestradiol vs non stimulated OEC, 4 in vivo vs in vitro matured oocytes. In order to identify the proteins responsible for the positive effect of OEC, we first searched for the presence of the genes encoding oviductin, osteopontin and atrial natriuretic peptide A (ANP A in the equine genome. We showed that the genes coding for osteopontin and ANP A are present. But the one for oviductin either has become a pseudogene during evolution of horse genome or has been not well annotated in horse genome sequence. We then showed that osteopontin and ANP A proteins are present in the equine oviduct using a surface plasmon resonance biosensor, and we analyzed their expression during oestrus cycle by Western blot. Finally, we co-incubated equine gametes with or without purified osteopontin or synthesized ANP A. No significant effect of osteopontin or ANP A was observed, though

  19. Age as a Risk factor for Atrial Fibrillation and Flutter after Coronary Artery Bypass Grafting

    Directory of Open Access Journals (Sweden)

    Prashant Bhave MD

    2012-02-01

    Full Text Available Atrial fibrillation affects approximately 3 million people in the United States and creates a huge burden on the health care system, both in terms of morbidity, mortality, and cost.1 The prevalence of atrial fibrillation rises sharply with increases in age. It is estimated that 8% of people above 70 years of age have atrial fibrillation.2-4 Atrial fibrillation has long been recognized as a powerful risk factor for stroke,5 heart failure,6 and mortality.7 Advancing age amplifies the risk of all of these sequelae of atrial fibrillation.

  20. Impairment of Pulmonary Function is an Independent Risk Factor for Atrial Fibrillation: The Takahata Study

    Directory of Open Access Journals (Sweden)

    Yoko Shibata, Tetsu Watanabe, Daisuke Osaka, Shuichi Abe, Sumito Inoue, Yoshikane Tokairin, Akira Igarashi, Keiko Yamauchi, Tomomi Kimura, Hiroyuki Kishi, Yasuko Aida, Keiko Nunomiya, Takako Nemoto, Masamichi Sato, Tsuneo Konta, Sumio Kawata, Takeo Kato,

    2011-01-01

    Full Text Available Background: Chronic pulmonary disorders, such as chronic obstructive pulmonary disease (COPD and fibrosing lung diseases, and atrial fibrillation (AF, are prevalent in elderly people. The impact of cardiac co-morbidities in the elderly, where pulmonary function is impaired, cannot be ignored as they influence mortality. The relationship between the prevalence of AF and pulmonary function is unclear. The aim of this study was to evaluate this relationship in participants in a health check.Methods: Subjects aged 40 or older (n = 2,917 who participated in a community-based annual health check in Takahata, Japan, from 2004 through to 2005, were enrolled in the study. We performed blood pressure measurements, blood sampling, electrocardiograms, and spirometry on these subjects.Results: The mean FEV1 % predicted and FVC % predicted in AF subjects was significantly lower than in non-AF subjects. The prevalence of AF was higher in those subjects with airflow limitation or lung restriction than in those without. Furthermore, AF prevalence was higher in those subjects with severe airflow obstruction (FEV1 %predicted < 50 than in those who had mild or moderate airflow obstruction (FEV1 %predicted ≥ 50, although there was no difference between the prevalence of AF in subjects with 70≤ FVC %predicted <80 lung restriction and those with FVC %predicted <70. Multiple logistic regression analysis revealed that FEV1 %predicted and FVC %predicted are independent risk factors for AF (independent of age, gender, left ventricular hypertrophy, and serum levels of B-type natriuretic peptide.Conclusion: Impaired pulmonary function is an independent risk factor for AF in the Japanese general population.

  1. Frequent periodic leg movement during sleep is an unrecognized risk factor for progression of atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Mahek Mirza

    Full Text Available Sleep apnea has been recognized as a factor predisposing to atrial fibrillation recurrence and progression. The effect of other sleep-disturbing conditions on atrial fibrillation progression is not known. We sought to determine whether frequent periodic leg movement during sleep is a risk factor for progression of atrial fibrillation. In this retrospective study, patients with atrial fibrillation and a clinical suspicion of restless legs syndrome who were referred for polysomnography were divided into two groups based on severity of periodic leg movement during sleep: frequent (periodic movement index >35/h and infrequent (≤35/h. Progression of atrial fibrillation to persistent or permanent forms between the two groups was compared using Wilcoxon rank-sum test, chi-square tests and logistic regression analysis. Of 373 patients with atrial fibrillation (77% paroxysmal, 23% persistent, 108 (29% progressed to persistent or permanent atrial fibrillation during follow-up (median, 33 months; interquartile range, 16-50. Compared to patients with infrequent periodic leg movement during sleep (n=168, patients with frequent periodic leg movement during sleep (n=205 had a higher rate of atrial fibrillation progression (23% vs. 34%; p=0.01. Patients with frequent periodic leg movement during sleep were older and predominantly male; however, there were no significant differences at baseline in clinical factors that promote atrial fibrillation progression between both groups. On multivariate analysis, independent predictors of atrial fibrillation progression were persistent atrial fibrillation at baseline, female gender, hypertension and frequent periodic leg movement during sleep. In patients with frequent periodic leg movement during sleep, dopaminergic therapy for control of leg movements in patients with restless legs syndrome reduced risk of atrial fibrillation progression. Frequent leg movement during sleep in patients with restless legs syndrome is

  2. Reduced kidney function is a risk factor for atrial fibrillation.

    Science.gov (United States)

    Laukkanen, Jari A; Zaccardi, Francesco; Karppi, Jouni; Ronkainen, Kimmo; Kurl, Sudhir

    2016-08-01

    There is limited knowledge on the relationship between kidney function and incidence of atrial fibrillation. Thus, this prospective study was designed to evaluate whether various biomarkers of kidney function are associated to the risk of atrial fibrillation. The study population consisted of 1840 subjects (615 women and 1225 men) aged 61-82 years. Cystatin C- and creatinine-based estimation of glomerular filtration rate (eGFRcys and eGRFcreat , respectively) and urinary albumin/creatinine ratio (ACR) were assessed to investigate their relationship with the risk of atrial fibrillation. During a median follow-up of 3.7 years, a total of 159 incident atrial fibrillation cases occurred. After adjustment for potential confounders, the risk of atrial fibrillation was increased (hazard ratio 2.74, 95% confidence interval (CI) 1.56-4.81, P atrial fibrillation (hazard ratio 2.16, CI 1.35-2.82, P atrial fibrillation. PMID:26780558

  3. Age as a Risk factor for Atrial Fibrillation and Flutter after Coronary Artery Bypass Grafting

    OpenAIRE

    Prashant Bhave MD; Rod Passman MD, MSCE

    2012-01-01

    Atrial fibrillation affects approximately 3 million people in the United States and creates a huge burden on the health care system, both in terms of morbidity, mortality, and cost.1 The prevalence of atrial fibrillation rises sharply with increases in age. It is estimated that 8% of people above 70 years of age have atrial fibrillation.2-4 Atrial fibrillation has long been recognized as a powerful risk factor for stroke,5 heart failure,6 and mortality.7 Advancing age amplifies the risk of al...

  4. An analysis of risk factors for stroke in atrial fibrillation and hypertension patients

    Institute of Scientific and Technical Information of China (English)

    王娟

    2014-01-01

    Objective To explore the independent risk factors for the 1 year stroke event in Chinese patients with atrial fibrillation(AF)and hypertension(HT).Methods Data of AF and HT patients in the Chinese Emergency Atrial Fibrillation Registry Study were retrospectively analyzed.The eligible patients were divided into the stroke group

  5. Risk factors for prethrombotic state in elderly patients with chronic atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王会玖

    2013-01-01

    Objective To explore the correlation between prethrombotic state (PTS) and chronic atrial fibrillation in elderly patients,and to analyze the risk factors.Methods A total of 142 elderly patients with chronic atrial fibrillation from May 2009 to May 2011 were selected.Patients were divided into the PTS group (n=90) and

  6. Preoperative Arrhythmias Such as Atrial Fibrillation: Cardiovascular Surgery Risk Factor

    OpenAIRE

    Diana Anghel; Radu Anghel; Flavia Corciova; Mihail Enache; Grigore Tinica

    2014-01-01

    Atrial fibrillation is still the most common arrhythmia that occurs in heart surgery. However, there is few literature data on the manner in which preoperative atrial fibrillation may influence the postoperative outcome of various heart surgery procedures. The purpose of our research is to assess the effects of preoperative atrial fibrillation on patients having undergone different heart surgery procedures. The results of our research are a review of clinical data which were collected prospec...

  7. Growth differentiation factor-15 (GDF-15), novel biomarker for assessing atrial fibrosis in patients with atrial fibrillation and rheumatic heart disease

    OpenAIRE

    ZHOU Yong-Ming; Li, Ming-Jiang; Zhou, Yan-Li; Ma, Le-Le; Yi, Xin

    2015-01-01

    Objective: Growth differentiation factor-15 (GDF-15) has been identified as a strong biomarker of cardiovascular diseases; however, no evidence are available concerning the relationship of GDF-15 and atrial fibrosis in patients with atrial fibrillation (AF) and rheumatic heart disease (RHD). Methods: Twenty patients with rheumatic heart disease were divided into two groups, 10 cases with AF and 10 cases with sinus rhythm (SR). Clinical data and blood samples were collected; left atrial append...

  8. Major Outcomes in Atrial Fibrillation Patients with One Risk Factor

    DEFF Research Database (Denmark)

    Proietti, Marco; Lip, Gregory Y H

    2016-01-01

    p<0.001). CONCLUSIONS: In atrial fibrillation patients with only one additional stroke risk factor (i.e. CHA2DS2-VASc= 1 in males or 2 in females), rates of major adverse events (stroke/systemic thromboembolic event, mortality) were high, despite anticoagulation. TTR in warfarin-treated patients was......BACKGROUND: The benefits and harms of oral anticoagulation (OAC) therapy in patients with only one stroke risk factor (i.e. CHA2DS2-VASc= 1 in males, or 2 in females) has been subject of debate. METHODS: We analysed all patients with only one stroke risk factor from the merged datasets of SPORTIF...... III and V trials. Anticoagulation control was defined according to time in therapeutic range (TTR). RESULTS: Of the original trial cohort, 1,097 patients had only one stroke risk factor. Stroke/systemic thromboembolic event had an incidence of 0.9 per 100 patient-years, with an incidence of 1.6 per...

  9. Diagnostic Value of Serum Atrial Natriuretic Peptide in Patients With Diastolic Heart Failure%检测血心钠肽水平对舒张性心力衰竭的诊断意义

    Institute of Scientific and Technical Information of China (English)

    唐特; 杨侃

    2011-01-01

    目的:探讨测定血心钠肽(ANP)水平对诊断舒张性心力衰竭(DHF)的意义.方法:选择66例DHF患者作为实验组、64例非DHF的呼吸困难患者作为对照组,应用酶联免疫吸附测定法(ELISA)测定其血清ANP和脑钠素(BNP)水平,同时行心脏B超检查.并据ANP水平等对实验组和对照组进行分析判断.结果:DHF组的ANP水平明显高于对照组(P<0.05);以ANP高于正常值或正常值的2倍、3倍作为DHF判断标准时,均有统计学意义(P<0.05),并且以高于2倍时意义最大;联合试验ANP与BNP水平时能明显提高DHF的诊断价值.结论:测定ANP可能对DHF有较好的诊断价值.联合检测ANP和BNP水平可提高DHF的诊断准确性.%Objective:To investigate the diagnostic value of serum level of atrial natriuretic peptide (ANP) in patients with diastolic heart failure (DHF). Methods: Sixty-six patients with DHF were selected as experimental group, 64 patients with dyspnea but without DHF as control group. Levels of ANP and brain natriuretic peptide ( BNP) were detected by enzyme linked immunosorbent assay (ELISA). Ultrasonic cardiac examination was made as well. Results: Serum levels of ANP in patients with DHF were significantly higher than that without DHF {P <0. 05). There was statistical significance when it was considered that ANP was higher than normal or double or triple than normal value as a criteria of diagnosis of DHF (P <0.05). Combined determination of serum levels of ANP and BNP would help to increase the diagnostic value for DHF. Conclusions: Serum level of ANP is a good predictor for diagnosis of DHF. Combined detection of serum levels of ANP and BNP will help to increase the accuracy for diagnosis.

  10. Mechanical stretch up-regulates the B-type natriuretic peptide system in human cardiac fibroblasts: a possible defense against transforming growth factor-ß mediated fibrosis

    LENUS (Irish Health Repository)

    Watson, Chris J

    2012-07-07

    AbstractBackgroundMechanical overload of the heart is associated with excessive deposition of extracellular matrix proteins and the development of cardiac fibrosis. This can result in reduced ventricular compliance, diastolic dysfunction, and heart failure. Extracellular matrix synthesis is regulated primarily by cardiac fibroblasts, more specifically, the active myofibroblast. The influence of mechanical stretch on human cardiac fibroblasts’ response to pro-fibrotic stimuli, such as transforming growth factor beta (TGFβ), is unknown as is the impact of stretch on B-type natriuretic peptide (BNP) and natriuretic peptide receptor A (NPRA) expression. BNP, acting via NPRA, has been shown to play a role in modulation of cardiac fibrosis.Methods and resultsThe effect of cyclical mechanical stretch on TGFβ induction of myofibroblast differentiation in primary human cardiac fibroblasts and whether differences in response to stretch were associated with changes in the natriuretic peptide system were investigated. Cyclical mechanical stretch attenuated the effectiveness of TGFβ in inducing myofibroblast differentiation. This finding was associated with a novel observation that mechanical stretch can increase BNP and NPRA expression in human cardiac fibroblasts, which could have important implications in modulating myocardial fibrosis. Exogenous BNP treatment further reduced the potency of TGFβ on mechanically stretched fibroblasts.ConclusionWe postulate that stretch induced up-regulation of the natriuretic peptide system may contribute to the observed reduction in myofibroblast differentiation.

  11. Mechanical stretch up-regulates the B-type natriuretic peptide system in human cardiac fibroblasts: a possible defense against transforming growth factor-β mediated fibrosis

    Directory of Open Access Journals (Sweden)

    Watson Chris J

    2012-07-01

    Full Text Available Abstract Background Mechanical overload of the heart is associated with excessive deposition of extracellular matrix proteins and the development of cardiac fibrosis. This can result in reduced ventricular compliance, diastolic dysfunction, and heart failure. Extracellular matrix synthesis is regulated primarily by cardiac fibroblasts, more specifically, the active myofibroblast. The influence of mechanical stretch on human cardiac fibroblasts’ response to pro-fibrotic stimuli, such as transforming growth factor beta (TGFβ, is unknown as is the impact of stretch on B-type natriuretic peptide (BNP and natriuretic peptide receptor A (NPRA expression. BNP, acting via NPRA, has been shown to play a role in modulation of cardiac fibrosis. Methods and results The effect of cyclical mechanical stretch on TGFβ induction of myofibroblast differentiation in primary human cardiac fibroblasts and whether differences in response to stretch were associated with changes in the natriuretic peptide system were investigated. Cyclical mechanical stretch attenuated the effectiveness of TGFβ in inducing myofibroblast differentiation. This finding was associated with a novel observation that mechanical stretch can increase BNP and NPRA expression in human cardiac fibroblasts, which could have important implications in modulating myocardial fibrosis. Exogenous BNP treatment further reduced the potency of TGFβ on mechanically stretched fibroblasts. Conclusion We postulate that stretch induced up-regulation of the natriuretic peptide system may contribute to the observed reduction in myofibroblast differentiation.

  12. Risk factors for atrial fibrillation incidence and progression

    NARCIS (Netherlands)

    Vermond, Robert Aldo

    2016-01-01

    During atrial fibrillation (AF) irregular activation of the hearts atria occur, causing an irregular heart rate and altered blood flow. AF is the most common heart rhythm disorder, causing stroke, heart failure, dementia, reduced quality of life and high health care expences. AF is diagnosed increas

  13. Cardiovascular Risk Factors and Atrial Fibrillation: What is the Link?

    OpenAIRE

    Yaariv Khaykin

    2009-01-01

    Atrial fibrillation is a common cardiac arrhythmia. It is well known to occur in older patients with comorbid conditions such congestive heart failure and ischemic heart disease.1-3 In these otherwise sick individuals it is associated with higher long term morbidity and mortality.

  14. Midregional-proAtrial Natriuretic Peptide and High Sensitive Troponin T Strongly Predict Adverse Outcome in Patients Undergoing Percutaneous Repair of Mitral Valve Regurgitation.

    Directory of Open Access Journals (Sweden)

    Jochen Wöhrle

    Full Text Available It is not known whether biomarkers of hemodynamic stress, myocardial necrosis, and renal function might predict adverse outcome in patients undergoing percutaneous repair of severe mitral valve insufficiency. Thus, we aimed to assess the predictive value of various established and emerging biomarkers for major adverse cardiovascular events (MACE in these patients.Thirty-four patients with symptomatic severe mitral valve insufficiency with a mean STS-Score for mortality of 12.6% and a mean logistic EuroSCORE of 19.7% undergoing MitraClip therapy were prospectively included in this study. Plasma concentrations of mid regional-proatrial natriuretic peptide (MR-proANP, Cystatin C, high-sensitive C-reactive protein (hsCRP, high-sensitive troponin T (hsTnT, N-terminal B-type natriuretic peptide (NT-proBNP, galectin-3, and soluble ST-2 (interleukin 1 receptor-like 1 were measured directly before procedure. MACE was defined as cardiovascular death and hospitalization for heart failure (HF.During a median follow-up of 211 days (interquartile range 133 to 333 days, 9 patients (26.5% experienced MACE (death: 7 patients, rehospitalization for HF: 2 patients. Thirty day MACE-rate was 5.9% (death: 2 patients, no rehospitalization for HF. Baseline concentrations of hsTnT (Median 92.6 vs 25.2 ng/L, NT-proBNP (Median 11251 vs 1974 pg/mL and MR-proANP (Median 755.6 vs 318.3 pmol/L, all p<0.001 were clearly higher in those experiencing an event vs event-free patients, while other clinical variables including STS-Score and logistic EuroSCORE did not differ significantly. In Kaplan-Meier analyses, NT-proBNP and in particular hsTnT and MR-proANP above the median discriminated between those experiencing an event vs event-free patients. This was further corroborated by C-statistics where areas under the ROC curve for prediction of MACE using the respective median values were 0.960 for MR-proANP, 0.907 for NT-proBNP, and 0.822 for hsTnT.MR-proANP and hsTnT strongly

  15. 心力衰竭合并心房颤动患者血浆脑钠肽含量变化观察%Observation of plasma brain natriuretic peptide changes for patients with heart failure combined with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    高阿妮

    2015-01-01

    目的::观察心力衰竭合并心房颤动患者血浆脑钠肽( BNP)含量变化。方法:选取85例心衰合并房颤患者,根据NYHA心功能分组,25例心功能Ⅱ级患者作为A组,32例心功能Ⅲ级患者作为B组,28例心功能Ⅳ级患者作为C组。比较上述3组患者在入院时、复律后24 h、复律后4周时BNP含量及治疗效果。结果:B、C组患者入院时BNP高于A组;A、B、C 3组患者复律后24 h、复律后4周BNP均较入院时下降;A组患者总有效率高于B、C两组,差异均有统计学意义(P<0.05)。结论:心衰合并房颤患者BNP含量高于正常值,心功能越差, BNP含量越高,复律后BNP含量下降,可将BNP含量作为心衰合并房颤病情严重程度和治疗效果的评价指标。%Objective:To observe changes of plasma brain natriuretic peptide ( BNP) for patients with heart failure combined with atrial fibrillation. Methods:85 patients with heart failure combined with atrial fibrillation were selected and divided into A group (25 patients with cardiac function class II), B group (32 patients with cardiac function class III), and C group (28 patients with car-diac function class IV) according to NYHA heart function. The BNP levels and therapeutic effects of the three groups at admission, 24h after cardioversion, and 4 weeks after cardioversion were compared. Results:The BNP levels at admission of B and C groups were higher than that of A group. 24h and 4 weeks after cardioversion, all BNP levels were reduced. The total effective rate of A group was higher than those of B and C groups, and the differences were statistically significant (P<0. 05). Conclusions:For the patients with heart failure combined with atrial fibrillation, the BNP level is higher than the normal value; and the worse cardiac function is, the higher the BNP level is. After cardioversion, it is reduced, therefore, the BNP levels can be merged as an evaluation index for severity of heart failure combined with

  16. The role of natriuretic peptides in volume assessment and mortality prediction in Haemodialysis patients

    OpenAIRE

    Sivalingam, Murugan; Vilar, Enric; Mathavakkannan, Suresh; Farrington, Ken

    2015-01-01

    Background Maintaining optimal fluid balance is essential in haemodialysis (HD) patients but clinical evaluation remains problematic. Other technologies such as bioimpedance are emerging as valuable adjuncts. This study was undertaken to explore the potential utility of the natriuretic peptides – atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in the assessment of fluid status and cardiovascular risk in this setting. Methods This was a cross-sectional study carried out i...

  17. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has......-atrial natriuretic peptide and pro-B-type natriuretic peptide are useful plasma markers in heart failure. New data have defined cardiac myocytes as competent endocrine cells in posttranslational processing and cellular secretion....

  18. Efficacy and Safety of 1-Hour Infusion of Recombinant Human Atrial Natriuretic Peptide in Patients With Acute Decompensated Heart Failure: A Phase III, Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.

    Science.gov (United States)

    Wang, Guogan; Wang, Pengbo; Li, Yishi; Liu, Wenxian; Bai, Shugong; Zhen, Yang; Li, Dongye; Yang, Ping; Chen, Yu; Hong, Lang; Sun, Jianhui; Chen, Junzhu; Wang, Xian; Zhu, Jihong; Hu, Dayi; Li, Huimin; Wu, Tongguo; Huang, Jie; Tan, Huiqiong; Zhang, Jian; Liao, Zhongkai; Yu, Litian; Mao, Yi; Ye, Shaodong; Feng, Lei; Hua, Yihong; Ni, Xinhai; Zhang, Yuhui; Wang, Yang; Li, Wei; Luan, Xiaojun; Sun, Xiaolu; Wang, Sijia

    2016-03-01

    The aim of the study was to evaluate the efficacy and safety of 1-h infusion of recombinant human atrial natriuretic peptide (rhANP) in combination with standard therapy in patients with acute decompensated heart failure (ADHF).This was a phase III, randomized, double-blind, placebo-controlled, multicenter trial. Eligible patients with ADHF were randomized to receive a 1-h infusion of either rhANP or placebo at a ratio of 3:1 in combination with standard therapy. The primary endpoint was dyspnea improvement (a decrease of at least 2 grades of dyspnea severity at 12 h from baseline). Reduction in pulmonary capillary wedge pressure (PCWP) 1 h after infusion was the co-primary endpoint for catheterized patients. Overall, 477 patients were randomized: 358 (93 catheterized) patients received rhANP and 118 (28 catheterized) received placebo. The percentage of patients with dyspnea improvement at 12 h was higher, although not statistically significant, in the rhANP group than in the placebo group (32.0% vs 25.4%, odds ratio=1.382, 95% confidence interval [CI]: 0.863-2.212, P = 0.17). Reduction in PCWP at 1 h was significantly greater in patients treated with rhANP than in patients treated with placebo (-7.74 ± 5.95 vs -1.82 ± 4.47 mm Hg, P  0.99).1-h rhANP infusion appears to result in prompt, transient hemodynamic improvement with a small, nonsignificant, effect on dyspnea in ADHF patients receiving standard therapy. The safety of 1-h infusion of rhANP seems to be acceptable. (WHO International Clinical Trials Registry Platform [ICTRP] number, ChiCTR-IPR-14005719.). PMID:26945407

  19. Prevalence and risk factors of atrial fibrillation in preterminal inpatients aged 60 years and over

    Institute of Scientific and Technical Information of China (English)

    YANG Jie-fu; LIU Bing; LIU Dong-ge; LUO Yao; FANG Fang

    2008-01-01

    Background Atrial fibrillation is a common arrhythmia and a major risk factor for ischaemic stroke. We investigated the prevalence of atrial fibrillation and its relation to age, gender and underlying heart disease in patients aged 60 years and over who died during hospitalization.Methods Between 1955 and 2005, 1519 autopsies of in-hospital deaths in Beijing Hospital were performed. Among them, 540 cases met criteria of age ≥60 years and full clinical history including electrocardiogram, echocardiogram, myocardial perfusion images and detailed cardiac pathology records from autopsy.Results Atrial fibrillation occurred in 193 of 540 patients and prevalence increased with age (10.5% in patients younger than 60 years, 39.6% (80-89 years) and 54.8% (≥90 years)) being higher in patients with underlying heart disease than without heart disease (P<0.0001). Coronary artery disease (CAD), congestive heart failure, cardiac valve dysfunction and chronic renal failure were associated with a higher prevalence of atrial fibrillation (P<0.001). CAD with anterior myocardial infarction or left anterior descending artery disease was also associated with an increased prevalence of atrial fibrillation (P <0.05). Following autopsy, clinical misdiagnosis of CAD increased with age and missed clinical diagnosis of CAD decreased with age. Multivariate Logistic regression analysis revealed independent predictors of atrial fibrillation: age (OR=1.335, 95% Cl: 1.114-1.600, P<0.0001), underlying heart disease (OR=2.019, 95% CI: 1.244-3.278, P <0.005), chronic heart failure (OR=1.873, 95% CI: 1.272-2.757, P <0.005), mitral regurgitation (OR=2.163, 95% Cl: 1.093-4.278, P<0.05) and mitral stenosis (OR=33.575, 95% CI: 2.852-395.357, P<0.05). Conclusions A high prevalence of atrial fibrillation was found in Chinese patients

  20. Novel Bifunctional Natriuretic Peptides as Potential Therapeutics*

    Science.gov (United States)

    Dickey, Deborah M.; Burnett, John C.; Potter, Lincoln R.

    2008-01-01

    Synthetic atrial natriuretic peptide (carperitide) and B-type natriuretic peptide (BNP; nesiritide) are used to treat congestive heart failure. However, despite beneficial cardiac unloading properties, reductions in renal perfusion pressures limit their clinical effectiveness. Recently, CD-NP, a chimeric peptide composed of C-type natriuretic peptide (CNP) fused to the C-terminal tail of Dendroaspis natriuretic peptide (DNP), was shown to be more glomerular filtration rate-enhancing than BNP in dogs. However, the molecular basis for the increased responsiveness was not determined. Here, we show that the DNP tail has a striking effect on CNP, converting it from a non-agonist to a partial agonist of natriuretic peptide receptor (NPR)-A while maintaining the ability to activate NPR-B. This effect is specific for human receptors because CD-NP was only a slightly better activator of rat NPR-A due to the promiscuous nature of CNP in this species. Interesting, the DNP tail alone had no effect on any NPR even though it is effective in vivo. To further increase the potency of CD-NP for NPR-A, we converted two different triplet sequences within the CNP ring to their corresponding residues in BNP. Both variants demonstrated increased affinity and full agonist activity for NPR-A, whereas one was as potent as any NPR-A activator known. In contrast to a previous report, we found that DNP binds the natriuretic peptide clearance receptor (NPR-C). However, none of the chimeric peptides bound NPR-C with significantly higher affinity than endogenous ligands. We suggest that bifunctional chimeric peptides represent a new generation of natriuretic peptide therapeutics. PMID:18940797

  1. Novel bifunctional natriuretic peptides as potential therapeutics.

    Science.gov (United States)

    Dickey, Deborah M; Burnett, John C; Potter, Lincoln R

    2008-12-12

    Synthetic atrial natriuretic peptide (carperitide) and B-type natriuretic peptide (BNP; nesiritide) are used to treat congestive heart failure. However, despite beneficial cardiac unloading properties, reductions in renal perfusion pressures limit their clinical effectiveness. Recently, CD-NP, a chimeric peptide composed of C-type natriuretic peptide (CNP) fused to the C-terminal tail of Dendroaspis natriuretic peptide (DNP), was shown to be more glomerular filtration rate-enhancing than BNP in dogs. However, the molecular basis for the increased responsiveness was not determined. Here, we show that the DNP tail has a striking effect on CNP, converting it from a non-agonist to a partial agonist of natriuretic peptide receptor (NPR)-A while maintaining the ability to activate NPR-B. This effect is specific for human receptors because CD-NP was only a slightly better activator of rat NPR-A due to the promiscuous nature of CNP in this species. Interesting, the DNP tail alone had no effect on any NPR even though it is effective in vivo. To further increase the potency of CD-NP for NPR-A, we converted two different triplet sequences within the CNP ring to their corresponding residues in BNP. Both variants demonstrated increased affinity and full agonist activity for NPR-A, whereas one was as potent as any NPR-A activator known. In contrast to a previous report, we found that DNP binds the natriuretic peptide clearance receptor (NPR-C). However, none of the chimeric peptides bound NPR-C with significantly higher affinity than endogenous ligands. We suggest that bifunctional chimeric peptides represent a new generation of natriuretic peptide therapeutics. PMID:18940797

  2. Risk factors for stroke and thromboembolism in relation to age among patients with atrial fibrillation: the loire valley atrial fibrillation project

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Fauchier, Laurent; Lane, Deirdre A; Taillandier, Sophie; Lip, Gregory Y H

    2012-01-01

    According to the latest European guidelines on the management of nonvalvular atrial fibrillation (NVAF), all patients aged ≥ 65 years should be treated with oral anticoagulation (if not contraindicated). Therefore, stroke risk factors should be investigated exclusively in patients with NVAF aged ...

  3. High circulating N-terminal pro-brain natriuretic peptide and tumor necrosis factor-α in mixed cryoglobulinemia

    Institute of Scientific and Technical Information of China (English)

    Alessandro Antonelli; Clodoveo Ferri; Silvia Martina Ferrari; Fabio Galetta; Ferdinando Franzoni; Gino Santoro; Salvatore De Marco; Emiliano Ghiri; Poupak Fallahi

    2009-01-01

    AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex-and age-matched controls.RESULTS: Cryoglobulinemic patients showed significantly higher mean NTproBNP and TNF-α levels than controls ( P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ~2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ~2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as the patients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ~2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients.The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.

  4. Atrial Fibrillation and Pacing Algorithms

    OpenAIRE

    Terranova, Paolo; Severgnini, Barbara; Valli, Paolo; Dell'Orto, Simonetta; Greco, Enrico Maria

    2006-01-01

    Pacing prevention algorithms have been introduced in order to maximize the benefits of atrial pacing in atrial fibrillation prevention. It has been demonstrated that algorithms actually keep overdrive atrial pacing, reduce atrial premature contractions, and prevent short-long atrial cycle phenomenon, with good patient tolerance. However, clinical studies showed inconsistent benefits on clinical endpoints such as atrial fibrillation burden. Factors which may be responsible for neutral results ...

  5. Atrial Ectopics Precipitating Atrial Fibrillation

    OpenAIRE

    Johnson Francis

    2015-01-01

    Holter monitor tracing showing blocked atrial ectopics and atrial ectopic precipitating atrial fibrillation is being demonstrated. Initially it was coarse atrial fibrillation, which rapidly degenerated into fine atrial fibrillation.

  6. RELATION BETWEEN LEFT ATRIAL SIZE AND ATRIAL FIBRILLATION IN DIFFERENT DISEASES

    OpenAIRE

    Rajith; Divya

    2014-01-01

    BACKGROUND: Atrial fibrillation is the most common cardiac dysrhythmia and left atrial size is an important factor in the development of atrial fibrillation. In the presence of atrial fibrillation an increase in left atrial size is associated with increased risk of stroke as well as increased morbidity and mortality. In this context, this study entitled “relation between left atrial size and atrial fibrillation in different diseases” was undertaken to study the left atrial size in different d...

  7. Evaluation of New Diagnostic Biomarkers in Pediatric Sepsis: Matrix Metalloproteinase-9, Tissue Inhibitor of Metalloproteinase-1, Mid-Regional Pro-Atrial Natriuretic Peptide, and Adipocyte Fatty-Acid Binding Protein.

    Directory of Open Access Journals (Sweden)

    Mashael F Alqahtani

    Full Text Available Elevated plasma concentrations of matrix metalloproteinase-9 (MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1, mid-regional pro-atrial natriuretic peptide (mrProANP, and adipocyte fatty-acid-binding proteins (A-FaBPs have been investigated as biomarkers for sepsis or detection of acute neurological injuries in adults, but not children. We carried out a single-center, prospective observational study to determine if these measures could serve as biomarkers to identify children with sepsis. A secondary aim was to determine if these biomarkers could identify children with neurologic complications of sepsis. A total of 90 patients ≤ 18 years-old were included in this study. 30 with severe sepsis or septic shock were compared to 30 age-matched febrile and 30 age-matched healthy controls. Serial measurements of each biomarker were obtained, beginning on day 1 of ICU admission. In septic patients, MMP9-/TIMP-1 ratios (Median, IQR, n were reduced on day 1 (0.024, 0.004-0.174, 13, day 2 (0.020, 0.002-0.109, 10, and day 3 (0.018, 0.003-0.058, 23 compared with febrile (0.705, 0.187-1.778, 22 and healthy (0.7, 0.4-1.2, 29 (p< 0.05 controls. A-FaBP and mrProANP (Median, IQR ng/mL, n were elevated in septic patients compared to control groups on first 2 days after admission to the PICU (p <0.05. The area under the curve (AUC for MMP-9/TIMP-1 ratio, mrProANP, and A-FaBP to distinguish septic patients from healthy controls were 0.96, 0.99, and 0.76, respectively. MMP-9/TIMP-1 ratio was inversely and mrProANP was directly related to PIM-2, PELOD, and ICU and hospital LOS (p<0.05. A-FaBP level was associated with PELOD, hospital and ICU length of stay (p<0.05. MMP-9/TIMP-1 ratio associated with poor Glasgow Outcome Score (p<0.05. A-FaBP levels in septic patients with neurological dysfunction (29.3, 17.2-54.6, 7 were significantly increased compared to septic patients without neurological dysfunction (14.6, 13.3-20.6, 11. MMP-9/TIMP-1 ratios were

  8. 心房钠尿肽对力竭小鼠心脏的抗氧化作用及其分泌机制%Exhaustive atrial natriuretic peptide on mouse heart antioxidant and secretion mechanism

    Institute of Scientific and Technical Information of China (English)

    李廷武; 徐敬

    2014-01-01

    目的 探讨血浆心房钠尿肽(ANP)在游泳力竭小鼠分泌及其抗氧化作用机制.方法 对小鼠进行分组后,让其负重游泳,并检测小鼠力竭后血浆ANP、丙二醛(MDA)、乳酸(LD)及乳酸脱氢酶(LDH)水平.结果 力竭组小鼠心脏LD为(1.69±0.29) mmol/g蛋白、LDH为(23.69±5.28) U/mg蛋白、ANP为(13.65±1.69)mg/L,显著高于对照组,差异有统计学意义(P<0.05).ANP对双氧水(H2O2)引起的心脏组织损伤具有保护作用,而LY83583阻断剂破坏该种保护作用,从而导致小鼠MDA水平增加,与ANP组比较差异有统计学意义(P<0.05).结论 ANP对心脏具有一定的抗氧化作用,在一定程度上能保护心脏免受损伤,其释放途径主要是通过环磷酸鸟苷(cGMP)-蛋白激酶C(PKC)信号传输途径实现.%Objective To investigate plasma atrial natriuretic peptide (ANP) secretion in mice exhaustive swimming and antioxidant mechanisms.Methods The experimental mice were grouped,let loaded swimming,and after exhaustive tests in mice plasma ANP,malondialdehyde (MDA),lactic acid (LD) and lactate dehydrogenase (LDH) levels.Results The levels of LD (1.69 ± 0.29) mmol/g prot,LDH (23.69 ±5.28) U/mg prot,ANP (13.65 ± 1.69) mg/L of exhausted group mouse heart were significantly higher,the difference was statistically significant (P < 0.05).ANP on hydrogen peroxide (H2O2)-induced cardiac tissue injury has a protective effect,while LY83583 blockers disrupt the kind of protection,resulting in mice LD,LDH and MDA levels increased,compared with the ANP group,the difference was statistically significant (P < 0.05).Conclusion ANP on the heart has some antioxidant effects,to a certain extent,protect the heart from damage,the release pathway mainly through cyclic guanosine monophosphate (cGMP)-protein kinase C (PKC) signaling pathway implementation.

  9. Atrial Fibrillation and Hyperthyroidism*

    OpenAIRE

    2005-01-01

    Atrial fibrillation occurs in 10 – 15% of patients with hyperthyroidism. Low serum thyrotropin concentration is an independent risk factor for atrial fibrillation. Thyroid hormone contributes to arrythmogenic activity by altering the electrophysiological characteristics of atrial myocytes by shortening the action potential duration, enhancing automaticity and triggered activity in the pulmonary vein cardio myocytes. Hyperthyroidism results in excess mortality from increased incidence of circu...

  10. Atrial fibrillation (acute onset)

    OpenAIRE

    Lip, Gregory Y. H.; Watson, Timothy

    2008-01-01

    Acute atrial fibrillation is rapid, irregular, and chaotic atrial activity of less than 48 hours' duration. It resolves spontaneously within 24 to 48 hours in over 50% of people. In this review we have included studies on patients with onset up to 7 days previously. Risk factors for acute atrial fibrillation include increasing age, CVD, alcohol abuse, diabetes, and lung disease.Acute atrial fibrillation increases the risk of stroke and heart failure.

  11. Obesity, Exercise, Obstructive Sleep Apnea, and Modifiable Atherosclerotic Cardiovascular Disease Risk Factors in Atrial Fibrillation.

    Science.gov (United States)

    Miller, Jared D; Aronis, Konstantinos N; Chrispin, Jonathan; Patil, Kaustubha D; Marine, Joseph E; Martin, Seth S; Blaha, Michael J; Blumenthal, Roger S; Calkins, Hugh

    2015-12-29

    Classically, the 3 pillars of atrial fibrillation (AF) management have included anticoagulation for prevention of thromboembolism, rhythm control, and rate control. In both prevention and management of AF, a growing body of evidence supports an increased role for comprehensive cardiac risk factor modification (RFM), herein defined as management of traditional modifiable cardiac risk factors, weight loss, and exercise. In this narrative review, we summarize the evidence demonstrating the importance of each facet of RFM in AF prevention and therapy. Additionally, we review emerging data on the importance of weight loss and cardiovascular exercise in prevention and management of AF. PMID:26718677

  12. Natriuretic peptide receptors in the fetal rat.

    Science.gov (United States)

    Brown, J; Zuo, Z

    1995-08-01

    In vitro autoradiography of rat fetuses from embryonic days 12-19 (E12-E19) showed widespread high-affinity specific binding sites for natriuretic peptides. The sites on E16 somites avidly bound C-type natriuretic peptide [CNP-(1-22)] as well as C-ANP, a synthetic ligand that selects the C-type natriuretic peptide receptor (NPR-C). Most somitic binding sites had high affinity for atrial natriuretic peptide [ANP-(1-28)], confirming their resemblance to NPR-C. A few had a lower apparent affinity for ANP-(1-28), suggesting that they might be NPR-B. CNP-(1-22) was more powerful than ANP-(1-28) as an agonist of guanosine 3',5'-cyclic monophosphate production in somites, and ATP augmented the action of CNP-(1-22). These observations further suggest the presence of NPR-B. However, with cross-linking of 3-[125I]iodo-0-tyrosyl rat CNP-(1-22) to somitic membranes followed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, only a single 64-kDa binding protein was detected under reducing conditions. This is not consistent with intact approximately 120-kDa NPR-B. In vitro autoradiography of the binding of natriuretic peptides to E16 liver implied the presence of NPR-A and NPR-C-like receptors. Hepatic guanosine 3',5'-cyclic monophosphate production was most powerfully stimulated by ANP-(1-28), as expected for NPR-A. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis also identified NPR-A and NPR-C-like proteins in E16 hepatic membranes. Thus different NPRs are expressed by specific fetal tissues. This may be developmentally significant. PMID:7653543

  13. Neutral endopeptidase-resistant C-type natriuretic peptide variant represents a new therapeutic approach for treatment of fibroblast growth factor receptor 3-related dwarfism.

    Science.gov (United States)

    Wendt, Daniel J; Dvorak-Ewell, Melita; Bullens, Sherry; Lorget, Florence; Bell, Sean M; Peng, Jeff; Castillo, Sianna; Aoyagi-Scharber, Mika; O'Neill, Charles A; Krejci, Pavel; Wilcox, William R; Rimoin, David L; Bunting, Stuart

    2015-04-01

    Achondroplasia (ACH), the most common form of human dwarfism, is caused by an activating autosomal dominant mutation in the fibroblast growth factor receptor-3 gene. Genetic overexpression of C-type natriuretic peptide (CNP), a positive regulator of endochondral bone growth, prevents dwarfism in mouse models of ACH. However, administration of exogenous CNP is compromised by its rapid clearance in vivo through receptor-mediated and proteolytic pathways. Using in vitro approaches, we developed modified variants of human CNP, resistant to proteolytic degradation by neutral endopeptidase, that retain the ability to stimulate signaling downstream of the CNP receptor, natriuretic peptide receptor B. The variants tested in vivo demonstrated significantly longer serum half-lives than native CNP. Subcutaneous administration of one of these CNP variants (BMN 111) resulted in correction of the dwarfism phenotype in a mouse model of ACH and overgrowth of the axial and appendicular skeletons in wild-type mice without observable changes in trabecular and cortical bone architecture. Moreover, significant growth plate widening that translated into accelerated bone growth, at hemodynamically tolerable doses, was observed in juvenile cynomolgus monkeys that had received daily subcutaneous administrations of BMN 111. BMN 111 was well tolerated and represents a promising new approach for treatment of patients with ACH. PMID:25650377

  14. Decreased expression of natriuretic peptides associated with lipid accumulation in cardiac ventricle of obese mice

    DEFF Research Database (Denmark)

    Bartels, E.D.; Nielsen, J.M.; Bisgaard, L.S.;

    2010-01-01

    cultured cardiomyocytes and three different mouse models to examine the impact of obesity and cardiac lipid accumulation on cardiac natriuretic peptide expression. The cardiac ventricular expression of atrial natriuretic peptide (ANP) and BNP mRNA and ANP peptide was decreased 36-72% in obese ob/ob, db......% (P <0.005) depression of ANP mRNA expression in cultured HL-1 atrial myocytes. The data suggest that obesity and altered cardiac lipid metabolism are associated with reduced production of ANP and BNP in the cardiac ventricles in the setting of normal as well as impaired cardiac function.......Plasma B-type natriuretic peptide (BNP) and proBNP are established markers of cardiac dysfunction. Even though obesity increases the risk of cardiovascular disease, obese individuals have reduced plasma concentrations of natriuretic peptides. The underlying mechanism is not established. We used...

  15. Urodilatin. A renal natriuretic peptide

    International Nuclear Information System (INIS)

    Development and validation of a radioimmunoassay for endogenous URO in urine and synthetic URO in plasma is described. The first obstacle to overcome was to produce an antibody specific for URO. A polyclonal URO antibody with a cross-reactivity with the structural highly homologous atrial natriuretic peptide (ANP) was developed by immunization of rabbits with the whole URO(95-126). Purification of the polyclonal URO antiserum with CNBr-activated Sepharose affinity chromatography was a simple way of producing a URO-specific antibody without cross-reactivity with ANP analogues. A reliable 125I-labelled URO tracer was made with the Iodo-Gen method. Prior to the assay, the urine samples were prepared by ethanol with a recovery of unlabelled URO between 80 - 100% and the plasma samples were Sep-Pak C18 extracted with a recovery of about 50%. The radioimmunoassay is performed in 3 days, using polyethylene glycol for separation. The sensitivity of the assay was improved by sample preparation and concentration, reducing the amount of tracer and late addition, reducing the amount of antibody and increasing the incubation time and lowering the temperature of incubation. The infusion rate of 20 ng URO kg-1 min-1 was most potential and well tolerated in healthy subjects. The short-term natriuretic and diuretic effects were closely associated with a significant diminished sodium reabsorption in the distal nephron. Further studies are needed to exploit the therapeutical potential of URO, for example in patients with sodium-water retaining disorders. The therapeutical dose range will probably be narrow due to the blood pressure lowering effect of URO with infusion rates higher than 20-30 ng kg-1 min-1. (EHS)

  16. The prevalence of and factors associated with chronic atrial fibrillation in Medicare/Medicaid-eligible dialysis patients.

    Science.gov (United States)

    Wetmore, James B; Mahnken, Jonathan D; Rigler, Sally K; Ellerbeck, Edward F; Mukhopadhyay, Purna; Spertus, John A; Hou, Qingjiang; Shireman, Theresa I

    2012-03-01

    Atrial fibrillation is an important comorbidity with substantial therapeutic implications in dialysis patients but its prevalence varies in different studies. We used a database that includes patients in the United States on hemodialysis who were eligible for government assistance with prescription drugs. We then used ICD-9 codes from billing claims in this database to identify patients with chronic atrial fibrillation. Multivariable logistic regression was used to determine adjusted prevalence odds ratios for associated factors. Of 63,884 individuals, the prevalence of chronic atrial fibrillation was 7%. The factors of age over 60 years, male, Caucasian, body mass index over 25 kg/m(2), coronary artery disease, and heart failure were all significantly associated with chronic atrial fibrillation. Prevalence rates, particularly in younger patients, were far higher than those reported in an age group-matched nondialysis population. Thus, given its clinical impact, future efforts are needed to examine risk factors for adverse outcomes in chronic atrial fibrillation, and to identify appropriate management strategies for this disorder, as well as opportunities for quality improvement in this vulnerable population. PMID:22189842

  17. Predictive value of natriuretic peptides in dogs with mitral valve disease

    DEFF Research Database (Denmark)

    Tarnow, Inge; Olsen, Lisbeth Høier; Kvart, Clarence;

    2009-01-01

    Natriuretic peptides are useful in diagnosing heart failure in dogs. However, their usefulness in detecting early stages of myxomatous mitral valve disease (MMVD) has been debated. This study evaluated N-terminal (NT) fragment pro-atrial natriuretic peptide (NT-proANP) and NT-pro-brain natriuretic...... peptide (NT-proBNP) in 39 Cavalier King Charles Spaniels (CKCS) with pre-clinical mitral valve regurgitation (MR), sixteen dogs with clinical signs of heart failure (HF) and thirteen healthy control dogs. Twenty seven CKCS and ten control dogs were re-examined 4 years after the initial examination and the...

  18. Factors related to sinus rhythm at discharge after radiofrequency ablation of permanent atrial fibrillation in patients undergoing mitral valve surgery.

    Science.gov (United States)

    Rostagno, Carlo; Gelsomino, Sandro; Capecchi, Irene; Rossi, Alessandra; Montesi, Gian Franco; Stefàno, Pier Luigi

    2016-04-01

    Late recovery of sinus rhythm is unusual in patients with permanent AF treated by (radiofrequency) RF maze procedure during mitral valve surgery. Identification of clinical and instrumental preoperative factors predictive of early success of RF ablation in patients with permanent AF undergoing mitral valve surgery may improve selection of subjects to obtain long-term results. Hundred and thirty consecutive patients with permanent AF and mitral valve disease underwent modified RF maze procedure during concomitant mitral valve surgery. Rheumatic valve disease (61 pts) and mitral valve prolapse (41 pts) were the more common aetiology of valve abnormalities. Mitral valve replacement was performed in 54 % of patients and mitral valve repair in the remaining 46 %. Four patients died after surgery. At discharge, 87 patients (69 %) were in sinus rhythm (group 1) and 43 patients in AF persisted (group 2). At an average 24-month follow-up, sinus rhythm was present in 67 % of patients, and 33 % were in atrial fibrillation. In this period, late recovery of sinus rhythm was observed only in five patients, while eight discharged in sinus rhythm developed again atrial fibrillation. Among preoperative parameters at univariate analysis female sex, atrial fibrillation >24 months, left atrial diameter >54 mm, left atrial area >24 cm(2), rheumatic valve disease and NYHA class were associated with persistence of AF. At Cox regression multivariate analysis, increased left atrial area (OR 1.07 per unit increase-95 % CI 1.01-1.131) and rheumatic aetiology of valve disease (OR 4.52, 95 % CI 1.65-12.4) were associated with persistence of AF at hospital discharge. Persistence of AF after RF ablation in patients undergoing mitral valve surgery is related to aetiology, e.g. rheumatic valve disease, and to increasing left atrial diameter. Due to low rate of late recovery of sinus rhythm, indication to RF ablation associated with MV surgery should be carefully considered in patients with large

  19. Four functionally distinct C-type natriuretic peptides found in fish reveal evolutionary history of the natriuretic peptide system

    OpenAIRE

    Inoue, Koji; Naruse, Kiyoshi; Yamagami, Sayaka; Mitani, Hiroshi; Suzuki, Norio; Takei, Yoshio

    2003-01-01

    Natriuretic peptides (NPs) are major cardiovascular and osmoregulatory hormones in vertebrates. Although tetrapods generally have three subtypes, atrial NP (ANP), B-type NP (BNP), and C-type NP (CNP), some teleosts lack BNP, and sharks and hagfish have only one NP. Thus, NPs have diverged during fish evolution, possibly reflecting changes in osmoregulatory systems. In this study, we found, by cDNA cloning, four distinct CNPs (1 through 4) in the medaka (Oryzias latipes...

  20. Insulin/glucose induces natriuretic peptide clearance receptor in human adipocytes: a metabolic link with the cardiac natriuretic pathway.

    Science.gov (United States)

    Bordicchia, M; Ceresiani, M; Pavani, M; Minardi, D; Polito, M; Wabitsch, M; Cannone, V; Burnett, J C; Dessì-Fulgheri, P; Sarzani, R

    2016-07-01

    Cardiac natriuretic peptides (NP) are involved in cardiorenal regulation and in lipolysis. The NP activity is largely dependent on the ratio between the signaling receptor NPRA and the clearance receptor NPRC. Lipolysis increases when NPRC is reduced by starving or very-low-calorie diet. On the contrary, insulin is an antilipolytic hormone that increases sodium retention, suggesting a possible functional link with NP. We examined the insulin-mediated regulation of NP receptors in differentiated human adipocytes and tested the association of NP receptor expression in visceral adipose tissue (VAT) with metabolic profiles of patients undergoing renal surgery. Differentiated human adipocytes from VAT and Simpson-Golabi-Behmel Syndrome (SGBS) adipocyte cell line were treated with insulin in the presence of high-glucose or low-glucose media to study NP receptors and insulin/glucose-regulated pathways. Fasting blood samples and VAT samples were taken from patients on the day of renal surgery. We observed a potent insulin-mediated and glucose-dependent upregulation of NPRC, through the phosphatidylinositol 3-kinase pathway, associated with lower lipolysis in differentiated adipocytes. No effect was observed on NPRA. Low-glucose medium, used to simulate in vivo starving conditions, hampered the insulin effect on NPRC through modulation of insulin/glucose-regulated pathways, allowing atrial natriuretic peptide to induce lipolysis and thermogenic genes. An expression ratio in favor of NPRC in adipose tissue was associated with higher fasting insulinemia, HOMA-IR, and atherogenic lipid levels. Insulin/glucose-dependent NPRC induction in adipocytes might be a key factor linking hyperinsulinemia, metabolic syndrome, and higher blood pressure by reducing NP effects on adipocytes. PMID:27101299

  1. Development of a transgenic goat model wih cardiac-specific overexpression of transforming growth factor - {beta} 1 to study the relationship between atrial fibrosis and atrial fibrillation

    Science.gov (United States)

    Studies on patients, large animal models and transgenic mouse models have shown a strong association of atrial fibrosis with atrial fibrillation (AF). However, it is unclear whether there is a causal relationship between atrial fibrosis and AF or whether these events appear as a result of independen...

  2. Oral anticoagulation and the risk of stroke or death in patients with atrial fibrillation and one additional stroke risk factor

    DEFF Research Database (Denmark)

    Fauchier, Laurent; Lecoq, Coralie; Clementy, Nicolas; Bernard, Anne; Angoulvant, Denis; Ivanes, Fabrice; Babuty, Dominique; Lip, Gregory Y H

    2016-01-01

    Background: It remains uncertain whether patients with atrial fibrillation (AF) and a single additional stroke risk factor (CHA2DS2-VASc score = 1 in males, 2 in females) should be treated with oral anticoagulation (OAC). We investigated the risk of ischemic stroke, systemic embolism and death in...

  3. Óxido nítrico e peptídeo atrial natriurético na predição de complicações da gestação Nitric oxide and atrial natriuretic peptide in the prediction of pregnancy complications

    Directory of Open Access Journals (Sweden)

    Fabrício da Silva Costa

    2007-01-01

    Full Text Available OBJETIVO: verificar a acurácia das dosagens séricas maternas do peptídeo atrial natriurético (ANP e óxido nítrico (NO para predição de complicações da gravidez. MÉTODOS: a casuística compreendeu 49 mulheres primigestas. As gestantes foram incluídas no estudo na 18ªsemana, momento em que foi coletada a amostra sangüínea para a realização das dosagens séricas. O ANP foi dosado pelo método de radioimunoensaio, utilizando kits Euro-dianostica (2000, considerando anormais valores superiores a 237,4 pg/mL (percentil 95. A dosagem do NO foi realizada pelo método de quimiluminescência, sendo considerados como anormais valores superiores a 17,8 µmol/L (percentil 95. Para análise estatística, utilizaram-se o teste t não pareado para a análise das variáveis quantitativas contínuas de distribuição normal; o teste de Mann-Whitney para amostras quantitativas não-paramétricas; o teste exato de Fisher na avaliação dos parâmentros qualitativos; e o teste de Pearson na avaliação das correlações. RESULTADOS: os dados não mostraram diferença significativa na concentração sérica do ANP, considerando o grupo que apresentou complicações gestacionais e/ou perinatais (média de 139,3±77,1 pg/mL e o grupo controle (média de 119,6±47,0 pg/mlL, e nem na concentração sérica do NO, entre o grupo com complicações gestacionais e/ou perinatais (média de 11,1±4,6 µmol/L e o grupo controle (média de 10,0±3,4 µmol/L. CONCLUSÕES: os resultados mostram que o ANP e o NO não foram bons indicadores de complicações da gestação.PURPOSE: to verify the effectiveness of the maternal blood serum assays of the atrial natriuretic peptide (ANP and nitric oxide (NO to predict pregnancy complications. METHODS: the sample was made of 49 primigravidae women. They were included in the study at the 18th week of gestation, when blood sample was collected in order to analyze the serum assays. ANP was assayed by radioimmunoassay, using

  4. 5-氮胞苷对培养兔骨髓基质细胞心房利钠肽表达的影响%Effects of 5-azacytidine on expression of atrial natriuretic polypeptide in cultured rabbit bone marrow cell

    Institute of Scientific and Technical Information of China (English)

    方志成; 周昌娥; 王玮; 王晓勋; 王卫民; 刘志祥; 李瑞明

    2006-01-01

    目的:研究5-氮胞苷(5-azacytidine,5-aza)对体外培养兔骨髓基质细胞中心肌特异性心房利钠肽(atrial natriuretic polypeptide, ANP)表达的影响,探讨骨髓基质细胞向心肌样细胞分化的条件.方法:体外分离培养兔骨髓基质细胞用不同浓度5-aza诱导培养,以RT-PCR方法测定诱导前后ANP的表达.结果:正常培养兔骨髓基质细胞不表达ANP.经5-aza诱导并继续培养24h后,骨髓基质细胞表达ANP,在一定时间、浓度范围内ANP含量逐渐增加.结论:5-aza诱导体外培养兔骨髓基质细胞表达心肌特异性ANP,与诱导时间及浓度呈正相关,提示可诱导兔骨髓基质细胞向心肌样细胞分化.

  5. Atrial fibrillation in The Tromsø Study 1994-2007. Risk factors, occurrence and gender differences.

    OpenAIRE

    Nyrnes, Audhild

    2016-01-01

    Summary Atrial fibrillation (AF) is a common cardiac arrhythmia, which increases morbidity and mortality and thereby imposes high health costs on society. The prevalence of AF has increased for several decades, and is expected to increase further, with the rising numbers of elderly people and survivors of heart diseases. Several risk factors for AF related to genetics and diseases have been established. Focus is now also set on novel risk factors related to symptoms, life style and infla...

  6. Interleukin-6 Is a Risk Factor for Atrial Fibrillation in Chronic Kidney Disease: Findings from the CRIC Study

    OpenAIRE

    Amdur, Richard L.; Mukherjee, Monica; Go, Alan; Barrows, Ian R.; Ramezani, Ali; Shoji, Jun; Reilly, Muredach P.; Gnanaraj, Joseph; Deo, Raj; Roas, Sylvia; Keane, Martin; Master, Steve; Teal, Valerie; Soliman, Elsayed Z; Yang, Peter

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic kidney disease (CKD). In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. AF was determined at baseline by self-report and electrocardiogram (ECG). Plasma concentrations of interleukin(IL)-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor-β, high sensiti...

  7. Phosphorylation of the Kinase Homology Domain Is Essential for Activation of the A-Type Natriuretic Peptide Receptor

    OpenAIRE

    Potter, Lincoln R.; Hunter, Tony

    1998-01-01

    Natriuretic peptide receptor A (NPR-A) is the biological receptor for atrial natriuretic peptide (ANP). Activation of the NPR-A guanylyl cyclase requires ANP binding to the extracellular domain and ATP binding to a putative site within its cytoplasmic region. The allosteric interaction of ATP with the intracellular kinase homology domain (KHD) is hypothesized to derepress the carboxyl-terminal guanylyl cyclase catalytic domain, resulting in the synthesis of the second messenger, cyclic GMP. H...

  8. B and C types natriuretic peptides modify norepinephrine uptake and release in the rat adrenal medulla.

    Science.gov (United States)

    Vatta, M S; Presas, M F; Bianciotti, L G; Rodriguez-Fermepin, M; Ambros, R; Fernandez, B E

    1997-01-01

    We have previously reported that atrial natriuretic factor (ANF) modulates adrenomedullar norepinephrine (NE) metabolism. On this basis, the aim of the present work was to study the effects of B and C types natriuretic peptides (BNP and CNP) on the uptake, intracellular distribution and release of 3H-NE. Experiments were carried out in rat adrenal medulla slices incubated "in vitro." Results showed that 100 nM of both, CNP and BNP, enhanced total and neuronal NE uptake. Both peptides (100 nM) caused a rapid increase in NE uptake during the first minute, which was sustained for 60 min. NE intracellular distribution was only modified by CNP (100 nM), which increased the granular fraction and decreased the cytosolic pool. On the other hand, spontaneous as well as evoked (KCl) NE release, was decreased by BNP and CNP (50 and 100 nM for spontaneous release and 1, 10, 50 and 100 nM for evoked output). The present results suggest that BNP and CNP may regulate catecholamine secretion and modulate adrenomedullary biological actions mediated by catecholamines, such as blood arterial pressure, smooth muscle tone, and metabolic activities. PMID:9437706

  9. B and C types natriuretic peptides modulate norepinephrine uptake and release in the rat hypothalamus.

    Science.gov (United States)

    Vatta, M S; Presas, M; Bianciotti, L G; Zarrabeitia, V; Fernández, B E

    1996-09-16

    We previously reported that atrial natriuretic factor (ANF) regulates catecholamine metabolism in the central nervous system. ANF, B and C types natriuretic peptides (BNP and CNP) also play a regulatory role in body fluid homeostasis, cardiovascular activity and hormonal and neuro-hormonal secretions. The aim of the present work was to investigate BNP and CNP effects on the uptake and release of norepinephrine (NE) in rat hypothalamic slices incubated in vitro. Results showed that BNP (100 nM) and CNP (1, 10 and 100 nM) enhanced total and neuronal [3H]NE uptake but did not modify non-neuronal uptake. BNP (100 nM) and CNP (1 nM) caused a rapid increase in NE uptake (1 min), which was sustained for 60 min. BNP (100 nM) did not modify the intracellular distribution of NE; however, 1 nM CNP increased the granular store and decreased the cytosolic pool of NE. BNP (100 nM) and CNP (1, 10 and 100 nM), diminished spontaneous NE release. In addition, BNP (1, 10, 100 nM) and CNP (1, 10 and 100 pM, as well as 1, 10 and 100 nM) reduced NE output induced by 25 mM KCl. These results suggest that BNP and CNP may be involved in the regulation of several central as well as peripheral physiological functions through the modulation of noradrenergic neurotransmission at the presynaptic neuronal level. Present results provide evidence to consider CNP as the brain natriuretic peptide since physiological concentrations of this peptide (pM) diminished NE evoked release. PMID:8897640

  10. CHA2DS2-VASc score, left atrial size and atrial fibrillation as stroke risk factors in the Tromsø Study

    Science.gov (United States)

    Tiwari, Sweta; Løchen, Maja-Lisa; Jacobsen, Bjarne K; Hopstock, Laila A; Nyrnes, Audhild; Njølstad, Inger; Mathiesen, Ellisiv B; Schirmer, Henrik

    2016-01-01

    Objective CHA2DS2-VASc score, left atrial (LA) size and atrial fibrillation (AF) have individually been associated with stroke risk. Our aim was to investigate the predictive ability of combinations of these factors for the odds of incident stroke in a population-based cohort study. Methods We followed 2844 participants from the Tromsø Study from 1994 to 2012. Information on LA size and CHA2DS2-VASc score (age, sex, congestive heart failure, hypertension, vascular disease, stroke and diabetes) were obtained at baseline. AF status was recorded from medical records. The outcome measure was all strokes. The association between covariates and stroke was investigated by means of multivariate logistic regression analysis. Results A total of 325 participants (45% women, mean age at baseline 59.3 years) had a stroke. Incidence rates for stroke were 6.4 in women and 8.4 in men per 1000 person-years. Participants with CHA2DS2-VASc ≥1 and LA size <2.8 had ∼4 times (95% CI 2.6 to 5.3) increased odds of stroke, whereas participants with CHA2DS2-VASc ≥1 and LA size ≥2.8 had ∼9 times (95% CI 5.3 to 16.4) increased odds of stroke, compared with participants with CHA2DS2-VASc score 0, irrespective of AF status. Adjustment for significant covariates had minimal impact on the OR estimates. Conclusions Combining CHA2DS2-VASc score ≥1 and enlarged LA size identified participants with high odds of stroke regardless of AF status.

  11. Clinical utility of natriuretic peptides and troponins in hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kehl, Devin W; Buttan, Anshu; Siegel, Robert J; Rader, Florian

    2016-09-01

    The diagnosis of hypertrophic cardiomyopathy (HCM) is based on clinical, echocardiographic and in some cases genetic findings. However, prognostication remains limited except in the subset of patients with high-risk indicators for sudden cardiac death. Additional methods are needed for risk stratification and to guide clinical management in HCM. We reviewed the available data regarding natriuretic peptides and troponins in HCM. Plasma levels of natriuretic peptides, and to a lesser extent serum levels of troponins, correlate with established disease markers, including left ventricular thickness, symptom status, and left ventricular hemodynamics by Doppler measurements. As a reflection of left ventricular filling pressure, natriuretic peptides may provide an objective measure of the efficacy of a specific therapy. Both natriuretic peptides and troponins predict clinical risk in HCM independently of established risk factors, and their prognostic power is additive. Routine measurement of biomarker levels therefore may be useful in the clinical evaluation and management of patients with HCM. PMID:27236124

  12. Subclinical Atrial Fibrillation and the Risk of Stroke

    NARCIS (Netherlands)

    Healey, Jeff S.; Connolly, Stuart J.; Gold, Michael R.; Israel, Carsten W.; Van Gelder, Isabelle C.; Capucci, Alessandro; Lau, C. P.; Fain, Eric; Yang, Sean; Bailleul, Christophe; Morillo, Carlos A.; Carlson, Mark; Themeles, Ellison; Kaufman, Elizabeth S.; Hohnloser, Stefan H.

    2012-01-01

    BACKGROUND One quarter of strokes are of unknown cause, and subclinical atrial fibrillation may be a common etiologic factor. Pacemakers can detect subclinical episodes of rapid atrial rate, which correlate with electrocardiographically documented atrial fibrillation. We evaluated whether subclinica

  13. Growth-differentiation factor-15, endoglin and N-terminal pro-brain natriuretic peptide induction in athletes participating in an ultramarathon foot race.

    Science.gov (United States)

    Tchou, Isabelle; Margeli, Alexandra; Tsironi, Maria; Skenderi, Katerina; Barnet, Marc; Kanaka-Gantenbein, Christina; Papassotiriou, Ioannis; Beris, Photis

    2009-09-01

    We investigated the actions of growth-differentiation factor (GDF)-15, endoglin and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in 15 male athletes who participated in the ultradistance foot race of the 246 km 'Sparthathlon'. Measurements were performed before (phase I), at the end of the race (phase II) and 48 h post-race (phase III). GDF-15 and endoglin serum concentrations were determined with enzyme-linked immunosorbent assay and NT-pro-BNP plasma levels by electrochemiluminescence. GDF-15 levels were increased from phase I (563.9 +/- 57.1 pg ml(-1)) to phase II (2311.1 +/- 462.3 pg ml(-1)) and decreased at phase III (862.0 +/- 158.0 pg ml(-1)) (p < 0.0002). NT-pro-BNP levels followed a similar pattern to that of GDF-15 from 38.1 +/- 4.8 pg ml(-1) at phase I to 1280.6 +/- 259.0 pg ml(-1) at phase II and 89.8 +/- 13.6 pg ml(-1) at phase III (p < 0.0001) and at the same time points, endoglin levels were 4.7 +/- 0.2 ng ml(-1) at phase I, 5.8 +/- 0.2 ng ml(-1) at phase II and 4.3 +/- 0.2 ng ml(-1) at phase III (p < 0.002). These findings indicate that circulating GDF-15, endoglin and NT-pro-BNP levels reflect a transient endothelial dysfunction in these athletes who participated in a foot race consisting of continuous, prolonged and brisk exercise. PMID:19563304

  14. Calpain-Calcineurin-Nuclear Factor Signaling and the Development of Atrial Fibrillation in Patients with Valvular Heart Disease and Diabetes

    Science.gov (United States)

    Zhao, Yong; Cui, Guo-ming; Zhou, Nan-nan; Li, Cong; Zhang, Qing; Sun, Hui; Han, Bo; Zou, Cheng-wei; Wang, Li-juan; Li, Xiao-dong; Wang, Jian-chun

    2016-01-01

    Calpain, calcineurin (CaN), and nuclear factor of activated T cell (NFAT) play a key role in the development of atrial fibrillation. Patients with valvular heart disease (VHD) are prone to develop atrial fibrillation (AF). Thus, our current study was aimed at investigating whether activation of calpain-CaN-NFAT pathway is associated with the incidence of AF in the patients with VHD and diabetes. The expressions of calpain 2 and alpha- and beta-isoforms of CaN catalytic subunit (CnA) as well as NFAT-c3 and NFAT-c4 were quantified by quantitative reverse transcription-polymerase chain reaction in atrial tissues from 77 hospitalized patients with VHD and diabetes. The relevant protein content was measured by Western blot and calpain 2 in human atrium was localized by immunohistochemistry. We found that the expressions of calpain 2, CnA alpha and CnA beta, and NFAT-c3 but not NFAT-c4 were significantly elevated in the samples from patients with AF compared to those with sinus rhythm (SR). Elevated protein levels of calpain 2 and CnA were observed in patients with AF, and so was the enhanced localization of calpain 2. We thereby concluded that CaN together with its upstream molecule, calpain 2, and its downstream effector, NFAT-c3, might contribute to the development of AF in patients with VHD and diabetes. PMID:27123462

  15. The Research of Joint Detection of C-Reactive Protein,Fibrinogen and N-terminal Pro-brain Natri-uretic Peptide in Patients with Chronic Atrial Fibrillation Complicated by Possible Heart Failure%CRP、Fib和NT-proBNP联合检测在慢性心房颤动并发心力衰竭患者中的意义

    Institute of Scientific and Technical Information of China (English)

    张军艳; 何启强; 陆明海

    2015-01-01

    目的:探究慢性或持续性心房颤动(房颤)并发心力衰竭(心衰)或伴有心衰前期症状患者血清C反应蛋白(CRP)、纤维蛋白原(Fib)、氨基末端脑钠肽前体(NT-proBNP)特点。方法回顾性分析2009年1月至2013年6月十堰市中医医院住院治疗的78例房颤或者房颤并发其他并发症患者,其中房颤并发重度心衰21例( A 组);持续性或持久性房颤伴明显心衰前期症状患者34例( B组);阵发性房颤患者23例( C组)。同时选取对照组健康正常人群30例( D组)。 A、B、C组患者入院时抽血,D组抽血时间不定,检测血清CRP、Fib、NT-proBNP水平。结果 A、B、C和D四组CRP水平分别为(120.3±22.7)、(50.3±15.7)、(4.1±1.3)mg/L和(3.7±1.2)mg/L,4组间差异有统计学意义(P<0.01);4组Fib分别(287.2±38.3)、(41.2±11.6)、(4.5±0.8) mg/L和(2.7±0.3) mg/L,其中A组Fib水平显著高于 B、C、D 组,差异有统计学意义( P <0.05);NT-proBNP分别为(1092.8±218.3)、(692.4±101.5)、(395.3±51.8) ng/L 和(172.4±32.0) ng/L,差异有统计学意义(P <0.01)。 CRP、Fib和NT-proBNP在房颤伴有心衰患者血清中升高呈正相关(P<0.05),但是在C组仅CRP与T-proBNP呈正相关(P<0.05)。结论 CRP、Fib和 NT-proBNP在房颤并发早期心衰患者血清中水平升高,明显高于正常健康人群血清水平,联合诊断可以提高房颤并发早期心衰诊断敏感性,使得临床及早干预。%Objective To research the characteristics of C-reactive protein(CRP),fibrinogen(Fib), and N-terminal pro-brain natriuretic peptide(NT-proBNP) in patients with chronic or persistent atrial fibril-lation possibly complicated with heart failure or early symptoms of heart failure .Methods From Jan.2009 to Jun.2013,a retrospective

  16. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B;

    2010-01-01

    conclude that in premature neonates with persistent arterial ducts; in teenagers with tetralogy of Fallot and pulmonary regurgitation; and in children with heart transplants and potential allograft rejection cardiac peptides can provide the clinician with additional information, but in children with atrial......It is still uncertain if cardiac natriuretic peptides are useful biomarkers in paediatric cardiology. In this review we identify four clinical scenarios in paediatric cardiology, where clinical decision-making can be difficult, and where we feel the paediatric cardiologists need additional...

  17. [Acute effects of ventricular and bicameral stimulation on plasma levels of natriuretic hormone].

    Science.gov (United States)

    Lo Bianco, F; Altamura, G; Bianconi, L; Toscano, S; Pandozi, C; Castro, A; Magliocca, V; Gentilucci, G; Magris, B; Santini, M

    1997-10-01

    Atrial natriuretic factor (ANF) is a peptide produced by the atrium in response to increases in atrial pressure. It is a potent vasodilator and recent studies suggest that ANF may modulate vasomotor changes in patients (pts) with pacemaker (PM) syndrome. To evaluate the incidence of pacing mode on peptide secretion, plasma concentrations of ANF were determined in 32 pts (18 men and 14 women, mean age 71 +/- 4 years) with a DDD PM implant. Blood samples were collected one hour after a randomly assigned PM programming either in VVI or DDD mode at 70 ppm. Mean plasma ANF levels were 84.12 +/- 51 pg/ml in DDD mode and 156.0 +/- 15 pg/ml in VVI mode (p < 0.05). In 12 pts presenting ventriculoatrial retroconduction, the ANF levels were 77.16 +/- 50 pg/ml during DDD stimulation and 219.0 +/- 16 pg/ml during VVI stimulation (p < 0.05). ANF level was 88.50 +/- 46 pg/ml in DDD mode and 114.25 +/- 65 pg/ml in VVI mode in the 20 pts without AV retroconduction (p < 0.05). During DDD mode, 18 patients showed a DVI stimulation whereas 14 showed a VDD stimulation: the mean ANF level was 67.40 +/- 15 pg/ml during DVI and 100.40 +/- 28 pg/ml during VDD stimulation; the difference between these data was not significant. The increase in ANF levels during VVI pacing confirms the lower haemodynamic performance of this stimulation mode. The increase of ANF levels during VVI stimulation, which was in the subgroup without AV retroconduction, confirms the benefits of DDD stimulation also in this group of patients as well. Atrial pacing at physiological rates does not trigger the release of ANF. PMID:9410771

  18. Natriuretic peptide and diastolic heart failure in the elderly

    Directory of Open Access Journals (Sweden)

    Antonia Macarie

    2009-08-01

    Full Text Available Objective: To determine the possible correlation of amino-terminal pro B natriuretic peptide(NT-proBNP and other factors with the diastolic dysfunction (DD in elderly diagnosed with heart failure(HF. Material and methods: 87 Patients aged over 65 years, diagnosed with HF, were included in study.Biochemical markers and imagistic parameters were determined, and the presence or absence ofcomorbidities was noted. Results:. The logistic regression has determined the odd ratio (OR and theconfidence interval 95% (CI 95% for studied factors: Log NT-proBNP – OR 2.6, CI 95% 1.3-5, p=0.004;anemia – OR 1.1, CI 95% 0.5-2.5, p=0.75; low estimated glomerular filtration rate (eGFR – OR 3, CI95% 1.1-8, p=0.02; age – OR 0.8, CI 95% 0.77-1.02, p=0.1; arterial hypertension – OR 1.2, CI 95%0.5-3.3, p=0.59; atrial fibrillation - OR 1.2, CI 95% 0.61-2.65, p=0.51; coronary disease - OR 1.7, CI95% 0.71-4.06, p=0.22: diabetes - OR 0.7, CI 95% 0.24-2.4, p=0.64; sex OR 1.8, CI 95% 0.84-3.93,p=0.12. Conclusion: NT-proBNP and eGFR were associated with severe DD in elderly with HF.

  19. Cardiopulmonary factors associated with atrial fibrillation in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    E. I. Leonova

    2016-03-01

    Full Text Available Aim. To study the relationships between clinical and functional features of chronic obstructive pulmonary disease (COPD and status of cardiovascular system with focus on identifying factors associated with the atrial fibrillation (AF in patients with COPD.Material and methods. Patients (n=94 with COPD out of exacerbation and airways obstruction of 2-4 degree (GOLD 2013 were examined. The spirometry, daily pulse oximetry, 24-hour ECG and blood pressure monitoring with vascular wall stiffness estimation, echocardiography were performed. Levels of high-sensitivity C-reactive protein (CRP werealso assessed.Results. AF paroxysms were found in 46 patients, including newly diagnosed ones in 22 patients. According to the results of multiple correlation analysis, the frequency of AF paroxysms correlated with forced expiratory volume in 1 sec (FEV1 (R=-0.348; p=0.013, minimum oxygen saturation of the blood (min%SpO2 (R=-0.356; p=0.011, CRP level (R=0.442; p=0.001, the sizes of both atria (p<0.001, isovolumic relaxation time (IVRT of left ventricle (LV (R=0.350; p=0.022, the right ventricle (RV size (R=0.478; p<0.001, systolic blood pressure level in the pulmonary artery (PASP (р<0.001, vascular stiffness - pulse wave velocity in aorta (PWao (p=0.001. The influence of FEV1 on the left atrium volume index (χ2=7.0; p=0.008 and IVRT LV (χ2=7.9; p=0.005 was revealed. Correlations between min%SpO2 and IVRT and PWao were observed.Conclusion. Severe bronchial obstruction, hypoxemia, systemic inflammation with increase in vascular stiffness (PWao and myocardium remodeling (increase in the sizes of both atria, PASP, RV size and diastolic dysfunction of LV are the factors that associated with the occurrence of AF in patients with COPD.

  20. Left atrial appendage dysfunction in a patient with premature ventricular contractions - a risk factor for stroke?

    Science.gov (United States)

    Patel, Sandeep M; Ackerman, Michael J; Asirvatham, Samuel J

    2013-01-01

    A 16-year-old female with ventricular dysfunction and frequent ventricular arrhythmia presented with a cardioembolic stroke. Prior electrophysiology study and ablation was performed for ventricular tachycardia (VT). For remaining ventricular ectopy, the patient was maintained on carvedilol and mexiletine. After one year on this regimen, she presented with an acute stroke. Transesophageal echocardiography revealed no evidence of an intracardiac or ventricular thrombus but demonstrated markedly decreased left atrial appendage (LAA) flow velocity worsened during frequent premature ventricular contractions (PVC). In the absence of atrial fibrillation (AF), the LAA dysfunction was considered secondary to the frequent PVCs and was thought to be the underlying cause for the stroke. We present this case to highlight a potential under recognized association between LAA dysfunction and ventricular arrhythmia, similar to that observed with atrioventricular dyssynchronous pacing. PMID:24086095

  1. Natriuretic peptides in the monitoring of anthracycline induced reduction in left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Daugaard, Gedske; Lassen, Ulrik; Bie, Peter; Pedersen, Erling Bjerregaard; Jensen, Kaare Troels; Abildgaard, Ulrik; Hesse, Birger; Kjaer, Andreas

    2005-01-01

    BACKGROUND: The use of anthracyclines in treatment of cancer is limited by cardiotoxicity of these compounds and may lead to heart failure. Therefore monitoring of cardiac function is necessary during therapy. AIM: We evaluated the value of natriuretic peptides (N-terminal pro-atrial natriuretic...... peptide (N-ANP) and brain natriuretic peptide (BNP)) for monitoring and predicting anthracycline induced cardiotoxicity using radionuclide left ventricular ejection fraction (EF) measurements as reference. METHODS AND RESULTS: A total of 107 consecutive patients receiving anthracycline as part of their...... chemotherapy for malignant disease were studied. Plasma concentrations of the peptides were measured by radioimmunoassay and EF by radionuclide cardiography. For reduced EF values, i.e. below 0.50 a fairly strong correlation was found between N-ANP or BNP and EF. Of 48 patients with serial EF and peptide...

  2. Relative antidipsogenic potencies of six homologous natriuretic peptides in eels.

    Science.gov (United States)

    Miyanishi, Hiroshi; Nobata, Shigenori; Takei, Yoshio

    2011-10-01

    Atrial natriuretic peptide (ANP) exhibits a potent antidipsogenic effect in seawater (SW) eels to limit excess Na(+) uptake, thereby effectively promoting SW adaptation. Recently, cardiac ANP, BNP and VNP and brain CNP1, 3 and 4, have been identified in eels. We examined the antidipsogenic effect of all homologous NPs using conscious, cannulated eels in both FW and SW together with parameters that affect drinking. A dose-response study (0.01-1 nmol/kg) in SW eels showed the relative potency of the antidipsogenic effect was in the order ANP ≥ VNP > BNP = CNP3 > CNP1 ≥ CNP4, while the order was ANP = VNP = BNP > CNP3 = CNP1 = CNP4 for the vasodepressor effect. The minimum effective dose of ANP for the antidipsogenic effect is much lower than that in mammals. ANP, BNP and VNP at 0.3 nmol/kg decreased drinking, plasma Na(+) concentration and aortic pressure and increased hematocrit in SW eels. The cardiac NPs induced similar changes in drinking, aortic pressure and hematocrit in FW eels, but aside from BNP no change in plasma Na(+) concentration. CNPs had no effect on drinking, plasma Na(+) concentration and hematocrit but induced mild hypotension in both FW and SW eels, except for CNP3 that inhibited drinking in SW eels. These results show that ANP, BNP and VNP are potent antidipsogenic hormones in eels in spite of other regulatory factors working to induce drinking, and that CNPs are without effects on drinking except for the ancestor of the cardiac NPs, CNP3. PMID:21967218

  3. High Incidence of Atrial Fibrillation or Flutter in Stroke Patients Who Have the Clinical Risk Factors for Stroke

    Directory of Open Access Journals (Sweden)

    Jacob I. Haft; Louis E. Teichholz

    2013-08-01

    Full Text Available The incidence of stroke in patients with atrial fibrillation or flutter (AF is well known and depends on the presence of risk factors. The incidence of AF in patients who have a stroke and its relationship to risk factors is not clear, however, because many stroke patients may have occult intermittent AF that is not present at the time of stroke and is not diagnosed. To better assess the incidence of AF, we studied the clinical records and all the 12 lead ECGs in a 14 year medical center data base of 985 patients admitted with ischemic stroke over a 3 year period and correlated the incidence of AF with the presence of the stroke risk factors. Of the stroke patients with congestive heart failure 61.9% had AF (95%CL 54.4, 68.9, with age >/= 75 years 45.2% had AF (CL 41.0,49.4, with coronary artery disease 42.9 had AF (CL 36.8, 49.2, with diabetes 39.2% had AF (CL 32.8,46.1 and with hypertension 33.7% had AF (CL 30.5, 37.1, all significantly higher than without these risk factors. Patients with more than one risk factor or with echo abnormalities, especially left atrial enlargement, had an even higher incidence of AF. These findings suggest that AF may be a very common mechanism whereby the stroke risk factors cause stroke. Stroke patients in normal sinus rhythm with these risk factors should be monitored for AF so they can receive anticoagulation to prevent a subsequent stroke if AF is diagnosed.

  4. Effect of 5-azacytidine on expressions of atrial natriuretic peptide and β-myosin heavy chain in cultured rat bone marrow stromal cells%5-氮胞苷对大鼠骨髓基质细胞心钠素及β-肌球蛋白重链表达的影响

    Institute of Scientific and Technical Information of China (English)

    赵阳; 卢新政

    2010-01-01

    Objective To assess the effect of 5-azacytidine (5-AZ) on the expressions of atrial natriuretic peptide (ANP) and β-myosin heavy chain (β-MHC) genes in cultured rat bone marrow stromal cells (BMSCs). Methods Neonatal rat cardiomyocytes and adult rat BMSCs were isolated and cultured. BMSCs were incubated with 5-AZ and (or) myocardiocytes culture medium. RT-PCR was used to measure the expressions of cardiac ANP and β-MHC genes. Results Normally cultured rat BMSCs didn't express cardiac ANP or β-MHC. After inducing by 5-AZ, rat BMSCs expressed ANP or β-MHC. The myocardiocytes culture medium enhanced expression of β-MHC, but didn't affect the expression of ANP. Conclusions The 5-AZ induces the rat BMSCs to express either cardiac ANP or β-MHC, and the former could be enhanced by cardiomyocytes culture medium.%目的 观察5-氮胞苷(5-AZ)诱导后体外培养骨髓基质细胞(BMSCs)心钠素(ANP)、β肌球蛋白重链(β-MHC)表达的变化.方法 分离培养SD大鼠BMSCs及新生乳鼠心室肌细胞.BMSCs的诱导分化采用第8代BMSCs,于传代后第3 d分为4组:正常对照组、上清液组、5-AZ组、5-AZ+上清液组.反转录聚合酶链反应法测定心肌特异性蛋白ANP、β-MHC基因表达水平的变化.结果 正常培养及心肌细胞上清培养液诱导的BMSCs不表达心肌特异性ANP、β-MHC;5-AZ诱导后的BMSCs表达ANP、β-MHC,分别31.5±5.6、32.1±8.3和33.7±5.6、46.6±8.3.心肌细胞上清培养液增加5-AZ诱导的BMSCs中β-MHC的表达水平,而对ANP表达无影响.结论 体外培养大鼠成体BMSCs在5-AZ诱导下可表达心肌特异性ANP、β-MHC.心肌细胞上清培养液可增加β-MHC表达水平.

  5. Blood angiotensin II (AT-II), vascular endothelial growth factor (VEGF), endothelin (ET) and atrial natriuretic peptide (ANP) levels before and after treatment in patients with diabetic nephropathy

    International Nuclear Information System (INIS)

    Objective: To evaluate the treatment effect of chinese herb medicine by observing variations of blood AT-II, VEGF, ET and ANP levels in patients with diabetic nephropathy (DN). Methods: Seventy DN patients were divided into two groups: combined chinese herb with western medicine treated group (n=35) and western medicine only (group n=35). Blood was tested for levels of AT-II, ET, ANP (with RIA) and VEGF (with ELISA) in all the patients both before and 12 weeks after starting the treatment as well as in 35 controls. Results: AT-II, VEGF, ET and ANP levels were significantly higher in patients of the two DN groups than those in the controls (p<0.05-0.01) and decreased significantly after treatment in both groups (p<0.05-0.01). In the two DN groups, AT-II level was positively correlated to VEGF level (r=0.465, p<0.05) and ET was positively correlated to ANP (r=0.61, p<0.05). Result of treatment was slightly better in the herb combined group. Conclusion: Blood AT-II, VEGF, ET and ANP were substances that played important role in the pathogenesis of DN; measurement of which were ideal for evaluation of treatment effect. Result of treatment was more desirable with additional herb medicine

  6. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roberto A.Franken; Ronaldo F.Rosa; Silvio CM Santos

    2012-01-01

    This review discusses atrial fibrillation according to the guidelines of Brazilian Society of Cardiac Arrhythmias and the Brazilian Cardiogeriatrics Guidelines. We stress the thromboembolic burden of atrial fibrillation and discuss how to prevent it as well as the best way to conduct cases of atrial fibrillatios in the elderly, reverting the arrhythmia to sinus rhythm, or the option of heart rate control. The new methods to treat atrial fibrillation, such as radiofrequency ablation, new oral direct thrombin inhibitors and Xa factor inhibitors, as well as new antiarrhythmic drugs, are depicted.

  7. Edoxaban: A Novel Factor Xa Inhibitor for the Management of Non-valvular Atrial Fibrillation and Venous Thromboembolism.

    Science.gov (United States)

    Kubli, Kara A; Snead, Jessica A; Cheng-Lai, Angela

    2016-01-01

    Warfarin has been a highly prevalent agent for over 70 years; however, its use has been limited by drug-drug interactions, adverse events, and the need for frequent monitoring. To minimize these complications, several non-vitamin K oral anticoagulants have been approved, including the latest agent, edoxaban. Edoxaban is a factor Xa inhibitor approved for the prevention of stroke/systemic embolism in patients with non-valvular atrial fibrillation and for the treatment of venous thromboembolism. Edoxaban was largely studied in the Edoxaban versus Warfarin in Patients with Atrial Fibrillation (ENGAGE AF-TIMI 48) and Edoxaban versus Warfarin for the Treatment of Symptomatic Venous Thromboembolism (Hokusai-VTE) trials, both showing noninferiority when compared with warfarin. Similar to other oral anticoagulants, the most serious adverse effects of edoxaban are related to bleeding. However, there are currently no approved reversal agents. Andexanet alfa and ciraparantag are the latest agents being studied for reversal. This article provides an overview of the safety and efficacy along with the advantages and disadvantages of edoxaban. PMID:26991962

  8. Hypercoagulability causes atrial fibrosis and promotes atrial fibrillation

    NARCIS (Netherlands)

    Spronk, Henri M H; De Jong, Anne Margreet; Verheule, Sander; De Boer, Hetty C; Maass, Alexander H; Lau, Dennis H; Rienstra, Michiel; van Hunnik, Arne; Kuiper, Marion; Lumeij, Stijn; Zeemering, Stef; Linz, Dominik; Kamphuisen, Pieter Willem; Ten Cate, Hugo; Crijns, Harry J; Van Gelder, Isabelle C; van Zonneveld, Anton Jan; Schotten, Ulrich

    2016-01-01

    AIMS: Atrial fibrillation (AF) produces a hypercoagulable state. Stimulation of protease-activated receptors by coagulation factors provokes pro-fibrotic, pro-hypertrophic, and pro-inflammatory responses in a variety of tissues. We studied the effects of thrombin on atrial fibroblasts and tested the

  9. Non-Alcoholic Fatty Liver Disease as a Predictor of Atrial Fibrillation in Middle-Aged Population (OPERA Study.

    Directory of Open Access Journals (Sweden)

    Aki J Käräjämäki

    Full Text Available Non-alcoholic fatty liver disease (NAFLD and atrial fibrillation (AF are widespread diseases and have multiple common risk factors and comorbidities. No studies of association between ultrasonography-diagnosed NAFLD and AF exist in other than diabetic population. The goal of this prospective study was to study the value of NAFLD as a predictor of atrial fibrillation. This study had 958 subjects from the OPERA (Oulu Project Elucidating Risk of Atherosclerosis cohort, and the mean follow-up time was 16.3 years. NAFLD was diagnosed if the subject had fatty liver in ultrasonography and no excess alcohol intake. AF was followed in the National Registers. In this study 249 subjects (26.0% had NAFLD and 37 (14.9% of these had AF whereas only 56 (7.9% of those without NAFLD experienced AF during the follow-up time (p = 0.001. In the multiple Cox regression analysis including potential confounders (age, sex, study group, diabetes, body mass index (BMI, waist circumference, alcohol consumption, smoking, serum alanine aminotransferase concentration (ALT, systolic blood pressure, quick index, left ventricular mass index, left atrial diameter, coronary artery disease (CAD, atrial natriuretic peptide (ANP and high sensitive C-reactive protein (hs-CRP, NAFLD remained as an independent predictor of AF (Adjusted OR, 1.88 (95% Confidence interval (CI 1.03-3.45. In conclusion, our data shows that NAFLD is independently associated with the risk of AF.

  10. Atrial fibrillation post cardiac bypass surgery

    OpenAIRE

    Mostafa, Ashraf; EL-Haddad, Mohamed A.; Shenoy, Maithili; Tuliani, Tushar

    2012-01-01

    Atrial fibrillation occurs in 5-40% patients after coronary artery bypass graft surgery. Atrial fibrillation increases mortality and morbidity in the post-operative period. We sought to conduct a comprehensive review of literature focusing on pathophysiology, risk factors, prevention and treatment of post coronary artery bypass graft atrial fibrillation.

  11. Natriuretic peptides in relation to the cardiac innervation and conduction system.

    Science.gov (United States)

    Hansson, Magnus

    2002-09-01

    During the past two decades, the heart has been known to undergo endocrine action, harbouring peptides with hormonal activities. These, termed "atrial natriuretic peptide (ANP)," "brain natriuretic peptide (BNP)," and "C-type natriuretic peptide (CNP)," are polypeptides mainly produced in the cardiac myocardium, where they are released into the circulation, producing profound hypotensive effects due to their diuretic, natriuretic, and vascular dilatory properties. It is, furthermore, well established that cardiac disorders such as congestive heart failure and different forms of cardiomyopathy are combined with increased expression of ANP and BNP, leading to elevated levels of these peptides in the plasma. Besides the occurrence of natriuretic peptides (NPs) in the ordinary myocardium, the presence of ANP in the cardiac conduction system has been described. There is also evidence of ANP gene expression in nervous tissue such as the nodose ganglion and the superior cervical ganglion of the rat, ganglia known to be involved in the neuronal regulation of the heart. Furthermore, in the mammalian heart, ANP appears to affect the cardiac autonomic nervous system by sympathoinhibitory and vagoexcitatory actions. This article provides an overview of the relationship between the cardiac conduction system, the cardiac innervation and NPs in the mammalian heart and provides data for the concept that ANP is also involved in neuronal cardiac regulation. PMID:12226807

  12. Probucol attenuates atrial autonomic remodeling in a canine model of atrial fibrillation produced by prolonged atrial pacing

    Institute of Scientific and Technical Information of China (English)

    GONG Yong-tai; LI Wei-min; LI Yue; YANG Shu-sen; SHENG Li; YANG Ning; SHAN Hong-bo; XUE Hong-jie; LIU Wei; YANG Bao-feng; DONG De-li; LI Bao-xin

    2009-01-01

    Background We hypothesize that increased atrial oxidative stress and inflammation may play an important role in atrial nerve sprouting and heterogeneous sympathetic hyperinnervation during atrial fibrillation (AF). To test the hypothesis, we examined whether the antioxidant and anti-inflammatory treatment with probucol attenuates atrial autonomic remodeling in a canine model of AF produced by prolonged rapid right atrial pacing. Methods Twenty-one dogs were divided into a sham-operated group, a control group and a probucol group. Dogs in the control group and probucol group underwent right atrial pacing at 400 beats per minute for 6 weeks, and those in the probucol group received probucol 1 week before rapid atrial pacing until pacing stopped. After 6-week rapid atrial pacing, general properties including left atrial structure and function, atrial hemodynamics and the inducibility and duration of AF were measured in all the groups. Atrial oxidative stress markers and serum C-reactive protein (CRP) concentration were estimated. The degree of nerve sprouting and sympathetic innervation at the right atrial anterior wall (RAAW) and the left atrial anterior wall (LAAW) were quantified by immunohistochemistry, atdal norepinephrine contents were also detected. Atrial beta-nerve growth factor (beta-NGF) mRNA and protein expression at the RAAW and LAAW were assessed by real-time quantitative RT-PCR and Western blotting respectively. Results Atrial tachypacing induced significant nerve sprouting and heterogeneous sympathetic hyperinnervation, and the magnitude of nerve sprouting and hyperinnervation was higher in the RAAW than in the LAAW. Atrial beta-NGF mRNA and protein levels were significantly increased at the RAAW and LAAW, and the upregulation of beta-NGF expression was greater at the RAAW than at the LAAW in the control group. The beta-NGF protein level was positively correlated with the density of sympathetic nerves in all groups. Probucol decreased the increase of

  13. Increased natriuretic peptide receptor A and C gene expression in rats with pressure-overload cardiac hypertrophy

    DEFF Research Database (Denmark)

    Christoffersen, Tue E.H.; Aplin, Mark; Strom, Claes C.;

    2006-01-01

    Both atrial (ANP) and brain (BNP) natriuretic peptide affect development of cardiac hypertrophy and fibrosis via binding to natriuretic peptide receptor (NPR)-A in the heart. A putative clearance receptor, NPR-C, is believed to regulate cardiac levels of ANP and BNP. The renin-angiotensin system...... also affects cardiac hypertrophy and fibrosis. In this study we examined the expression of genes for the NPRs in rats with pressure-overload cardiac hypertrophy. The ANG II type 1 receptor was blocked with losartan (10 mg.kg(-1).day(-1)) to investigate a possible role of the renin-angiotensin system in...

  14. Relationship between N-terminal pro-B-type natriuretic peptide levels and metabolic syndrome

    OpenAIRE

    Bao, Yuanyuan; Shang, Xiliang; Zhou, Linuo; Hu, Renming; Li, Yiming; Ding, Wei

    2011-01-01

    Introduction Previous studies have shown that obese individuals have reduced natriuretic peptide levels. But conflicting data exist on the relation of natriuretic peptide levels to other metabolic risk factors. Material and methods We investigated the relationship between plasma N-terminal pro-B-type natriuretic peptide levels (NT-proBNP) and metabolic syndrome (MetS) and metabolic risk factors in 469 patients free of heart failure. Two hundred thirty diagnosed MetS cases and 239 non-MetS cas...

  15. Analysis of risk factors for embolism in patients with chronic atrial fibrillation%慢性房颤并发栓塞的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    康钊

    2014-01-01

    Objective To investigate the risk factors for embolism in patients with chronic atrial fibrillation and analyze their prognostic impacts. Methods Sixty patients with chronic atrial fibrillation were selected, and 40 of them had embolism. The medical history including diabetes, hypertension, hyperlipidemia, age, body mass index, and smoking is recorded. The risk factors for embolism in chronic atrial fibrillation were determined. Results The above risk factors were closely related to embolism in chronic atrial fibrillation. Conclusion Eliminating or reducing these risk factors is of great significance for preventing embolism in patients with chronic atrial fibrillation.%目的:研究慢性房颤并发栓塞与哪些危险因素相关,并分析对其预后的影响。方法选择慢性房颤的患者60例,其中并发栓塞患者40例,然后记录糖尿病,高血压,高血脂,年龄,体重指数(BMI),吸烟等病史,讨论慢性房颤并发栓塞的危险因素。结果以上相关的危险因素都与慢性房颤并发栓塞有着密切的关系。结论尽量的消除或降低这些危险因素对预防其并发栓塞有重要意义。

  16. Atrial Fibrillation: Diagnosis

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Diagnosis Past Issues / Winter 2015 Table of Contents ... of your body's cells and organs. Read More "Atrial Fibrillation" Articles Atrial Fibrillation / Who Is at Risk for ...

  17. Cardiovascular biomarker midregional proatrial natriuretic peptide during and after preeclamptic pregnancies.

    Science.gov (United States)

    Sugulle, Meryam; Herse, Florian; Hering, Lydia; Mockel, Martin; Dechend, Ralf; Staff, Anne Cathrine

    2012-02-01

    Preeclampsia is associated with increased risk of cardiovascular disease. Midregional proatrial natriuretic peptide (MR-proANP), a precursor of the atrial natriuretic peptide, is a biomarker for cardiovascular disease. We obtained plasma from 184 pregnant women in gestational weeks 24 to 42 (normotensive pregnancies: n=77, preeclampsia: n=107), from 25 of these women at 5 to 8 years after index pregnancy (normotensive pregnancies: n=11, preeclampsia: n=14), and from 49 normotensive, nonpregnant women and analyzed them by immunoassay for MR-proANP. To investigate potential sources, placental and decidual atrial natriuretic peptide mRNA expression levels were analyzed by quantitative real-time PCR in 21 normotensive and 23 preeclamptic pregnancies, as well as in human heart and kidney samples. For further confirmation, we measured circulating MR-proANP and performed expression studies in a transgenic rat model for preeclampsia. MR-proANP was significantly elevated in maternal plasma in preeclampsia compared with normotensive pregnancies (135 versus 56 pmol/L; PMR-proANP differences between preeclamptic and normotensive pregnancies (10.9±1.9 versus 4.3±0.3 pmol/L; P=0.05). Atrial natriuretic peptide expression was high in the heart but negligible in the uteroplacental unit in both normotensive humans and rats, whereas expression in maternal and fetal hearts in the preeclamptic rats was significantly increased, compared with controls. MR-proANP is a serviceable biomarker in preeclampsia, both in humans and a rat model, probably reflecting cardiovascular hemodynamic stress. PMID:22184318

  18. Anticoagulation in atrial fibrillation.

    Science.gov (United States)

    Steinberg, Benjamin A; Piccini, Jonathan P

    2014-01-01

    Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also available. These novel oral anticoagulants (direct thrombin inhibitors and factor Xa inhibitors) obviate many of warfarin's shortcomings, and they have demonstrated safety and efficacy in large randomized trials of patients with non-valvular atrial fibrillation. However, the management of patients taking warfarin or novel agents remains a clinical challenge. There are several important considerations when selecting anticoagulant therapy for patients with atrial fibrillation. This review will discuss the rationale for anticoagulation in patients with atrial fibrillation; risk stratification for treatment; available agents; the appropriate implementation of these agents; and additional, specific clinical considerations for treatment. PMID:24733535

  19. Ablate and pace revisited: long term survival and predictors of permanent atrial fibrillation

    OpenAIRE

    Queiroga, A; Marshall, H J; Clune, M; Gammage, M. D.

    2003-01-01

    Objective: To assess long term mortality and identify factors associated with the development of permanent atrial fibrillation after atrioventricular (AV) node ablation for drug refractory paroxysmal atrial fibrillation.

  20. Down-regulation does not mediate natriuretic peptide-dependent desensitization of natriuretic peptide receptor (NPR)-A or NPR-B: guanylyl cyclase-linked natriuretic peptide receptors do not internalize.

    Science.gov (United States)

    Fan, Danhua; Bryan, Paula M; Antos, Laura K; Potthast, Regine J; Potter, Lincoln R

    2005-01-01

    Natriuretic peptide receptor A (NPR-A/GC-A) and B (NPR-B/GC-B) are members of the transmembrane guanylyl cyclase family that mediate the effects of natriuretic peptides via the second messenger, cGMP. Despite numerous reports of these receptors being down-regulated in response to various pathological conditions, no studies have actually measured desensitization and receptor internalization in the same cell line. Furthermore, the ligand-dependent trafficking properties of NPR-A remain controversial, whereas nothing is known about the trafficking of NPR-B. In this report, we tested whether down-regulation explains the ligand-dependent desensitization of NPR-A and NPR-B and characterized their trafficking properties using a combination of hormone-binding and antibody-based assays. Quantitative partition analysis indicated that (125)I-atrial natriuretic peptide (ANP) was rapidly released into the medium after 293T cells stably expressing NPR-A were warmed from 4 degrees to 37 degrees C. High-performance liquid chromatography fractionation of medium supplemented with the protease inhibitor phosphoramidon indicated that the (125)I-ANP was mostly intact. In contrast, (125)I-ANP purified from medium bathing cells expressing NPR-C, a receptor known to internalize natriuretic peptides, was degraded. Cleavable biotinylation and noncleavable biotinylation assays indicated that neither NPR-A nor NPR-B was internalized or degraded in response to natriuretic peptide binding. In contrast, agonist-dependent internalization of a G protein-coupled receptor was clearly apparent in the same cell line. Finally, we show that NPR-A and NPR-B are desensitized in cells in which they are not internalized. We suggest that mechanisms other than receptor down-regulation account for the desensitization of NPR-A and NPR-B that occurs in response to various physiological and pathological stimuli. PMID:15459247

  1. Annexins V and VI: major calcium-dependent atrial secretory granule-binding proteins.

    Science.gov (United States)

    Doubell, A F; Bester, A J; Thibault, G

    1991-11-01

    Atrial natriuretic peptide is stored by atrial myocytes in secretory granules, known as atrial specific granules, and is released from these granules by exocytosis. We have isolated a group of atrial proteins by affinity chromatography that bind to atrial specific granules in a calcium-dependent manner. The two major proteins isolated (32.5 kd and 67 kd) are calcium-binding proteins and have been identified as annexins V and VI by immunoblotting with specific antisera. The calcium dependence of their binding to atrial specific granules has been characterized in vitro and indicates that this interaction takes place at micromolar levels of calcium. In addition, the group of proteins isolated includes another calcium-binding protein of 20 kd, as well as GTP-binding proteins of 22 to 26 kd. Membrane interactions during exocytosis are presumably mediated by the interaction of specific proteins with the granule membrane. The properties of the proteins described here, and their ability to bind to atrial specific granules in a calcium-dependent manner, make them likely candidates in the search for regulatory proteins mediating atrial natriuretic peptide secretion. PMID:1834552

  2. Interleukin-6 Is a Risk Factor for Atrial Fibrillation in Chronic Kidney Disease: Findings from the CRIC Study.

    Directory of Open Access Journals (Sweden)

    Richard L Amdur

    Full Text Available Atrial fibrillation (AF is the most common sustained arrhythmia in patients with chronic kidney disease (CKD. In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC study. AF was determined at baseline by self-report and electrocardiogram (ECG. Plasma concentrations of interleukin(IL-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF-α, transforming growth factor-β, high sensitivity C-Reactive protein, and fibrinogen, measured at baseline. At baseline, 642 subjects had history of AF, but only 44 had AF in ECG recording. During a mean follow-up of 3.7 years, 108 subjects developed new-onset AF. There was no significant association between inflammatory biomarkers and past history of AF. After adjustment for demographic characteristics, comorbid conditions, laboratory values, echocardiographic variables, and medication use, plasma IL-6 level was significantly associated with presence of AF at baseline (Odds ratio [OR], 1.61; 95% confidence interval [CI], 1.21 to 2.14; P = 0.001 and new-onset AF (OR, 1.25; 95% CI, 1.02 to 1.53; P = 0.03. To summarize, plasma IL-6 level is an independent and consistent predictor of AF in patients with CKD.

  3. Interleukin-6 Is a Risk Factor for Atrial Fibrillation in Chronic Kidney Disease: Findings from the CRIC Study

    Science.gov (United States)

    Amdur, Richard L.; Mukherjee, Monica; Go, Alan; Barrows, Ian R.; Ramezani, Ali; Shoji, Jun; Reilly, Muredach P.; Gnanaraj, Joseph; Deo, Raj; Roas, Sylvia; Keane, Martin; Master, Steve; Teal, Valerie; Soliman, Elsayed Z.; Yang, Peter; Feldman, Harold; Kusek, John W.; Tracy, Cynthia M.; Raj, Dominic S.

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic kidney disease (CKD). In this study, we examined the association between inflammation and AF in 3,762 adults with CKD, enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study. AF was determined at baseline by self-report and electrocardiogram (ECG). Plasma concentrations of interleukin(IL)-1, IL-1 Receptor antagonist, IL-6, tumor necrosis factor (TNF)-α, transforming growth factor-β, high sensitivity C-Reactive protein, and fibrinogen, measured at baseline. At baseline, 642 subjects had history of AF, but only 44 had AF in ECG recording. During a mean follow-up of 3.7 years, 108 subjects developed new-onset AF. There was no significant association between inflammatory biomarkers and past history of AF. After adjustment for demographic characteristics, comorbid conditions, laboratory values, echocardiographic variables, and medication use, plasma IL-6 level was significantly associated with presence of AF at baseline (Odds ratio [OR], 1.61; 95% confidence interval [CI], 1.21 to 2.14; P = 0.001) and new-onset AF (OR, 1.25; 95% CI, 1.02 to 1.53; P = 0.03). To summarize, plasma IL-6 level is an independent and consistent predictor of AF in patients with CKD. PMID:26840403

  4. Effect of Professional Exercises on Brain Natriuretic Peptide

    Directory of Open Access Journals (Sweden)

    MA Babaee Beigi

    2009-12-01

    Full Text Available Background: Brain natriuretic peptide (BNP reflects myocardial wall stress. BNP activities are similar to those of atrial natriuretic peptide, including diuresis, natriuresis, hypotension and smooth muscle relaxation as well as ability to inhibit the rennin aldosterone system. It is mainly produced and released into the circulation by the ventricle in response to increased ventricular wall pressure or stretching. Therefore, BNP can be served as a marker of left ventricular dysfunction. The aim of this study was to investigate effect of various professional exercises on plasma BNP levels.Methods: We enrolled 20 consecutive healthy professional athletic males from different sporting disciplines including 5 football players, 5 volleyball players, 5 bodybuilders and 5 water- polo players. Plasma BNP samples were taken immediately before and 1 hour after exercise.Results: Plasma BNP level was significantly increased after exercise (30.01 ± 23.46 vs. 16.72 ± 10.86 pg/ml; P= 0.042. The highest increase in BNP level was found among volleyball players (mean values: 19.12 to 43.38 pg/ml; 126.3% increase after volleyball compared to other exercises. Conclusion: Exercise can increase plasma BNP levels, particularly among volleyball players.

  5. Porcine brain natriuretic peptide receptor in bovine adrenal cortex

    International Nuclear Information System (INIS)

    The action of porcine brain natriuretic peptide (pBNP) on the steroidogenesis was investigated in cultured bovine adrenocortical cells. Porcine BNP induced a significant dose-dependent inhibition of both ACTH- and A II-stimulated aldosterone secretion. 10/sup /minus/8/M and 10/sup /minus/7/M pBNP also significantly inhibited ACTH-stimulated cortisol and dehydroepiandrosterone (DHEA) secretions. Binding studies of [125I]-pBNP to bovine adrenocortical membrane fractions showed that adrenal cortex had high-affinity and low-capacity pBNP binding sites, with a dissociation constant (Kd) of 1.70 x 10/sup /minus/10/M and a maximal binding capacity (Bmax) of 19.9 fmol/mg protein. Finally, the 135 Kd radioactive band was specially visualized in the affinity labeling of bovine adrenal cortex with disuccinimidyl suberate (DSS). These results suggest that pBNP may have receptor-mediated suppressive actions on bovine adrenal steroidogenesis, similar to that in atrial natriuretic peptide

  6. Porcine brain natriuretic peptide receptor in bovine adrenal cortex

    Energy Technology Data Exchange (ETDEWEB)

    Higuchi, K.; Hashiguchi, T.; Ohashi, M.; Takayanagi, R.; Haji, M.; Matsuo, H.; Nawata, H.

    1989-01-01

    The action of porcine brain natriuretic peptide (pBNP) on the steroidogenesis was investigated in cultured bovine adrenocortical cells. Porcine BNP induced a significant dose-dependent inhibition of both ACTH- and A II-stimulated aldosterone secretion. 10/sup /minus/8/M and 10/sup /minus/7/M pBNP also significantly inhibited ACTH-stimulated cortisol and dehydroepiandrosterone (DHEA) secretions. Binding studies of (/sup 125/I)-pBNP to bovine adrenocortical membrane fractions showed that adrenal cortex had high-affinity and low-capacity pBNP binding sites, with a dissociation constant (Kd) of 1.70 x 10/sup /minus/10/M and a maximal binding capacity (Bmax) of 19.9 fmol/mg protein. Finally, the 135 Kd radioactive band was specially visualized in the affinity labeling of bovine adrenal cortex with disuccinimidyl suberate (DSS). These results suggest that pBNP may have receptor-mediated suppressive actions on bovine adrenal steroidogenesis, similar to that in atrial natriuretic peptide (ANP).

  7. Natriuretic Hormones, Endogenous Ouabain, and Related Sodium Transport Inhibitors

    Directory of Open Access Journals (Sweden)

    John eHamlyn

    2014-12-01

    Full Text Available The work of deWardener and colleagues stimulated longstanding interest in natriuretic hormones (NH. In addition to the atrial peptides (APs, the circulation contains unidentified physiologically-relevant NHs. One NH is controlled by the central nervous system (CNS and likely secreted by the pituitary. Its circulating activity is modulated by salt intake and the prevailing sodium concentration of the blood and intracerebroventricular fluid, and contributes to postprandial and dehydration natriuresis. The other NH, mobilized by atrial stretch, promotes natriuresis by increasing the production of intrarenal dopamine and/or nitric oxide. Both NHs have short (<35 minutes circulating half lives, depress renotubular sodium transport, and neither requires the renal nerves. The search for NHs led to endogenous cardiotonic steroids (CTS including ouabain-, digoxin-, and bufadienolide-like materials. These CTS, given acutely in high nanomole to micromole amounts into the general or renal circulations, inhibit sodium pumps and are natriuretic. Among these CTS, only bufalin is cleared sufficiently rapidly to qualify for an NH-like role. Ouabain-like CTS are cleared slowly, and when given chronically in low daily nanomole amounts, promote sodium retention, augment arterial myogenic tone, reduce renal blood flow and glomerular filtration, suppress nitric oxide in the renal vasa recta, and increase sympathetic nerve activity and blood pressure. Moreover, lowering total body sodium raises circulating endogenous ouabain. Thus, ouabain-like CTS have physiological actions that, like aldosterone, support renal sodium retention and blood pressure. In conclusion, the mammalian circulation contains two non-AP NHs. Identification of the CNS NH should be a priority.

  8. Incidence and Risk Factors for Atrial Fibrillation in Korea: the National Health Insurance Service Database (2002–2010)

    Science.gov (United States)

    Son, Mi Kyoung; Lim, Nam-Kyoo; Cho, Myeong-Chan

    2016-01-01

    Background and Objectives Atrial fibrillation (AF) is a common arrhythmia that is known as an important independent risk factor for stroke. However, limited information is available on AF in Korea. This study evaluated the incidence of AF, its associated co-morbidities and risk factors for AF in Korea. Subjects and Methods The National Health Insurance Service database between 2002 and 2010 was used in the study. Individuals<30 years old and those diagnosed with AF between 2002 and 2004 were excluded. Hazard ratios (HRs) according to co-morbidities and risk factors for AF were determined using a Cox proportional hazard model. Population attributable fractions (PAFs) of AF risk factors were determined. Results During a 6-year follow-up period, 3517 (1.7%) developed AF. The incidence rates in men and women aged 30-39 years were 0.82 and 0.55 per 1000 person-years, respectively; the incidence rates further increased with age to 13.09 and 11.54 per 1000 person-years in men and women aged≥80 years, respectively. The risk factors for incident AF were age, sex, body mass index (BMI), hypertension, ischemic heart disease (IHD) and heart failure. After adjusting for variables related to AF, the risk of AF was significantly associated with hypertension (HR 1.667), IHD (HR 1.639), heart failure (HR 1.521), and the PAFs for age, sex, BMI, hypertension, IHD, heart failure and diabetes mellitus were 30.6%, 10.1%, 3.4%, 16.6%, 8.2%, 5.3% and 0.8%, respectively. Conclusion Incidence of AF increased with age and was higher in men than in women. A larger proportion of AF events was attributable to hypertension than to other co-morbidities. PMID:27482260

  9. Natriuretic peptide receptor-B (guanylyl cyclase-B) mediates C-type natriuretic peptide relaxation of precontracted rat aorta.

    Science.gov (United States)

    Drewett, J G; Fendly, B M; Garbers, D L; Lowe, D G

    1995-03-01

    The most potent known agonist for the natriuretic peptide receptor-B (NPR-B)/guanylyl cyclase-B is C-type natriuretic peptide (CNP). A homologous ligand-receptor system consists of atrial natriuretic peptide (ANP) and NPR-A/guanylyl cyclase-A. A third member of this family is NPR-C, a non-guanylyl cyclase receptor. Monoclonal antibodies were raised against NPR-B by immunizing mice with a purified receptor-IgG fusion protein consisting of the extracellular domain of NPR-B and the Fc portion of human IgG-gamma 1. One monoclonal antibody, 3G12, did not recognize NPR-A or NPR-C and bound to human and rat NPR-B. CNP binding to NPR-B and stimulation of cGMP synthesis were inhibited by 3G12. With cells isolated from either the media or adventitia layers of rat thoracic aorta, 3G12 did not interfere with ANP-stimulated cGMP synthesis, but it inhibited CNP-stimulated cGMP levels in cells from both layers. CNP (IC50 = 10 nM) and ANP (IC50 = 1 nM) caused relaxation of phenylephrine-contracted rat aortic rings. 3G12 caused a marked increase in the IC50 for CNP, from 10 nM to 140 nM, but failed to affect ANP-mediated relaxation. Therefore, our results for the first time demonstrate that CNP relaxes vascular smooth muscle by virtue of its binding to NPR-B. PMID:7876238

  10. Agonist selectivity for three species of natriuretic peptide receptor-A.

    Science.gov (United States)

    Schoenfeld, J R; Sehl, P; Quan, C; Burnier, J P; Lowe, D G

    1995-01-01

    We determined the nucleotide sequence of mouse natriuretic peptide receptor-A (NPR-A) cDNA and compared the revised deduced amino acid sequence with those of rat and human NPR-A. The ligand selectivity of these three receptor/guanylyl cyclases was examined by whole-cell stimulation of cGMP production. The 28-amino acid atrial natriuretic peptide (ANP) has only one difference among these three species, i.e., human Met-12 versus rat and mouse Ile-12. However, despite the nearly invariant ANP sequence among these species, ANP analogs have marked differences in ED50 values and maximal cGMP responses among the three receptors. With the natriuretic peptide analogs we tested, human NPR-A is less sensitive than rat or mouse NPR-A to changes in the 17-amino acid, disulfide-bonded ring of ANP and to the species differences in brain natriuretic peptide (BNP) but is more sensitive to deletions in the carboxyl tail of ANP. The ANP determinants of agonist potency have therefore changed for different species of NPR-A. This is reflected in the amino acid sequence divergence in the receptor extracellular domains and in the divergence and specificity of BNP among species. Our results suggest that the coevolution of NPR-A and BNP has thus been constrained within the context of the conserved ANP sequence. PMID:7838126

  11. The prevalence of and factors associated with chronic atrial fibrillation in Medicare/Medicaid-eligible dialysis patients

    OpenAIRE

    Wetmore, James B.; Mahnken, Jonathan D.; Rigler, Sally K.; Ellerbeck, Edward F.; Mukhopadhyay, Purna; Spertus, John A.; Hou, Qingjiang; Shireman, Theresa I.

    2011-01-01

    Atrial fibrillation is an important comorbidity with substantial therapeutic implications in dialysis patients but its prevalence varies in different studies. We used a database that includes patients in the United States on hemodialysis who were eligible for government assistance with prescription drugs. We then used ICD-9 codes from billing claims in this database to identify patients with chronic atrial fibrillation. Multivariable logistic regression was used to determine adjusted prevalen...

  12. Association of Plasma Transforming Growth Factor-β1 Levels and the Risk of Atrial Fibrillation: A Meta-Analysis

    Science.gov (United States)

    Li, Jiao; Yang, Yajuan; Ng, Chee Yuan; Zhang, Zhiwei; Liu, Tong; Li, Guangping

    2016-01-01

    Introduction Numerous studies have demonstrated that plasma transforming growth factor-β1 (TGF-β1) may be involved in the pathogenesis of atrial fibrillation (AF), but some discrepancy remained. We performed a meta-analysis to evaluate the association between the plasma level of TGF-β1 and the risk of AF. Methods Published clinical studies evaluating the association between the plasma level of TGF-β1 and the risk of AF were retrieved from PubMed and EMBASE databases. Two reviewers independently evaluated the quality of the included studies and extracted study data. Subgroup analysis and sensitivity analysis were performed to evaluate for heterogeneity between studies. Results Of the 395 studies identified initially, 13 studies were included into our analysis, with a total of 3354 patients. Higher plasma level of TGF-β1 was associated with increased risk of AF when evaluated as both a continuous variable (SMD 0.67; 95%CI 0.29–1.05) and a categorical variable (OR 1.01, 95% CI 1.01–1.02). Conclusions This meta-analysis suggests an association between elevated plasma TGF-β1 and new onset AF. Additional studies with larger sample sizes are needed to further investigate the relationship between plasma TGF-β1 and the occurrence of AF. PMID:27171383

  13. Prevalence and Risk Factors of Atrial Fibrillation in Chinese Elderly: Results from the Chinese Longitudinal Healthy Longevity Survey

    Institute of Scientific and Technical Information of China (English)

    Choy-Lye Chei; Prassanna Raman; Chi Keong Ching; Zhao-Xue Yin; Xiao-Ming Shi; Yi Zeng; David B Matchar

    2015-01-01

    Background:Prevalence of atrial fibrillation (AF) is increasing as the world ages.AF is associated with higher risk of mortality and disease,including stroke,hypertension,heart failure,and dementia.Prevalence of AF differs with each population studied,and research on non-Western populations and the oldest old is scarce.Methods:We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey,a community-based study in eight longevity areas in China,to estimate AF prevalence in an elderly Chinese population (n =1418,mean age =85.6 years) and to identify risk factors.We determined the presence of AF in our participants using single-lead electrocardiograms.The weighted prevalence of AF was estimated in subjects stratified according to age groups (65-74,75-84,85-94,95 years and above) and gender.We used logistic regressions to determine the potential risk factors of AF.Results:The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF (P < 0.05).AF was associated with weight extremes of being underweight or overweight/obese.Finally,advanced age (85-94 years),history of stroke or heart disease,low high-density lipoprotein levels,low triglyceride levels,and lack of regular physical activity were associated with AF.Conclusions:In urban elderly,AF prevalence increased with age (P < 0.05),and in rural elderly,women had higher AF prevalence (P < 0.05).Further exploration of population-specific risk factors is needed to address the AF epidemic.

  14. Multiple factors of atrial fibrillation in patients with chronic heart failure%慢性心衰患者发生房颤的多因素分析

    Institute of Scientific and Technical Information of China (English)

    储红斌

    2014-01-01

    Objective To explore multiple factors of atrial fibrillation in patients with chronic heart failure through retrospective analysis of clinical data .Methods Three hundred and thirty patients with chronic heart failure ( NYHAII-IV) treated in the Hospital of Langxi County during the period from January 2009 to January 2011 were assigned into AF group and non AF group according to whether the patients had atrial fibrillation (AF)or not,and the clinical data of the two groups were used for statistical analysis .Results Of 330 pa-tients with chronic heart failure 85 cases (25.76%) with atrial fibrillation were assigned into AF group ,while the other 245 patients without atrial fibrillation were in non AF group .Single factor COX regression analysis showed that severe heart failure ( III+IV level ) , age,diabetes,left ventricular hypertrophy ,left atrialdiameter,blood urea nitrogen,blood creatinine,blood uric acid and spironolactone were risk factors for atrial fibrillation while ACEI ,digitalis,blood sodium and blood chlorine were protective factors for atrial fibrillation . Multivariate COX analysis showed that ACEI was the independent protective factor for primary AF ,while severe heart failure and left at-rialdiameter of left ventricular hypertrophy were risk factors for AF .Conclusions Severe heart failure and left atrial diameter of left ventricular hypertrophy are risk factors for AF .ACEI is an independent protective factor for primary AF in heart failure patients ,which can reduce the incidence of AF .%目的:通过回顾性分析慢性心衰患者的临床资料,对慢性心衰患者发生房颤的因素进行分析。方法选择2009年1月至2011年1月期间该院心脏科收治的慢性心力衰竭( NYHAII-IV)患者330例,根据患者是否发生心房颤动( AF)将其分为AF组与非AF组两组,并对两组患者的临床资料进行统计分析。结果330慢性心力衰竭患者中共发生房颤85例(25.76%)为AF组,其余245

  15. Atrial fibrillation

    NARCIS (Netherlands)

    Lip, Gregory Y H; Fauchier, Laurent; Freedman, Saul B; Van Gelder, Isabelle; Natale, Andrea; Gianni, Carola; Nattel, Stanley; Potpara, Tatjana; Rienstra, Michiel; Tse, Hung-Fat; Lane, Deirdre A

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, and increases in prevalence with increasing age and the number of cardiovascular comorbidities. AF is characterized by a rapid and irregular heartbeat that can be asymptomatic or lead to symptoms such as palpitations, dys

  16. Atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Morten S; Nielsen, Morten W; Haunsø, Stig;

    2014-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia affecting 1-2% of the general population. A number of studies have demonstrated that AF, and in particular lone AF, has a substantial genetic component. Monogenic mutations in lone and familial AF, although rare, have been recognized...

  17. The correlation study of von willebrand factor level and the occurrence of atrial ifbrillation in coronary heart disease patients with heart failure%血管性血友病因子水平与冠状动脉性心脏病合并心力衰竭患者发生心房颤动的相关性研究

    Institute of Scientific and Technical Information of China (English)

    邢令; 曹秋梅; 刘易新; 马炳辰; 王大为; 刘宇欣

    2016-01-01

    目的:探讨血管性血友病因子(von willebrand factor,vWF)水平与冠状动脉性心脏病(冠心病)合并心力衰竭患者发生心房颤动(房颤)的相关性。方法选取冠心病合并心力衰竭患者106例,每3个月随访1次,至患者随访期间发生房颤或随访期满18个月中止,根据随访结果将患者分为房颤组和非房颤组。比较两组患者vWF水平的差异,分析vWF的相关因素,通过Logistic回归分析及ROC曲线分析研究vWF对冠心病心力衰竭患者发生房颤的预测价值。结果房颤组患者的vWF水平高于非房颤组(P<0.05)。vWF水平与N末端脑钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-proBNP)(r=0.401,P=0.00)、超敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP)(r=0.322,P=0.00)、年龄(r=0.310,P=0.002)、心室率(r=0.202,P=0.038)、左房前后径(r=0.201,P=0.045)均存在正相关。vWF是冠心病心力衰竭患者发生房颤的独立危险因素(OR=1.002,95%CI1.001~1.004),其预测冠心病心力衰竭患者发生房颤的ROC曲线下面积为0.638(95%CI0.530~0.746)。结论 vWF水平对冠心病心力衰竭患者发生房颤有预测价值,预测的最佳截断值为3154.09ng/L。%ObjectiveTo explore the correlation of the von willebrand factor(vWF) level and occurrence of atrial fibrillation(af) in coronary heart disease patients with heart failure.Method Choose 106 coronary heart disease patients with heart failure. Once every 3 months follow-up, until they happen atrial fibrillation during the follow-up period or to expire before 18 months. According to the results divided the subject into two groups:atrial fibrillation and non atrial fibrillation group. The difference of the vWF level between the two groups was compared, and the related factors with vWF level was analyzed. To study the predictive value of VWF in the occurrence of atrial fibrillation in patients

  18. Determinants of recurrent atrial flutter after cardioversion.

    OpenAIRE

    Pozen, R G; Pastoriza, J; Rozanski, J J; Kessler, K M; Myerburg, R J

    1983-01-01

    Eighteen male patients (mean age 59 years) who were electrically cardioverted for pure atrial flutter were retrospectively studied to determine those factors influencing the maintenance of regular sinus rhythm or reversion to atrial flutter. Six months after successful cardioversion, 10 patients (55%) had recurrent atrial flutter and eight patients (45%) were still in sinus rhythm. The two groups were not significantly different with respect to age, symptomatology, abnormalities on the 12 lea...

  19. Almanac 2015: atrial fibrillation research in Heart.

    Science.gov (United States)

    Jawad-Ul-Qamar, Muhammad; Kirchhof, Paulus

    2016-04-15

    Atrial fibrillation continues to attract interest in the cardiovascular community and inHeart Over 60 original research and review papers published inHeartin 2014-2015 cover various aspects of atrial fibrillation, from associated conditions and precipitating factors to new approaches to management. Here, we provide an overview of articles on atrial fibrillation published inHeartin 2014-2015, highlighting new developments, emerging concepts and novel approaches to treatment. PMID:26791994

  20. Implementation of antithrombotic management in atrial fibrillation

    OpenAIRE

    Lairikyengbam, S; Davies, A; Jones, P.

    2000-01-01

    The aim of the study was to assess the extent to which published recommendations on the antithrombotic management of atrial fibrillation had been adopted into clinical practice in a busy district general hospital, and the impact of clinical audit on subsequent management. In the initial audit, 185 consecutive patients with atrial fibrillation were studied using their case notes to identify any further clinical risk factors for stroke. A management algorithm stratified patients with atrial fib...

  1. Atrial Fibrillation and Stroke

    Science.gov (United States)

    ... Find People About NINDS NINDS Atrial Fibrillation and Stroke Information Page Table of Contents (click to jump ... done? Clinical Trials What is Atrial Fibrillation and Stroke? Atrial fibrillation (AF) describes the rapid, irregular beating ...

  2. Atrial Fibrillation: Treatment

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Treatment Past Issues / Winter 2015 Table of Contents Treatment for atrial fibrillation depends on how often you have symptoms, how ...

  3. Living with Atrial Fibrillation

    Science.gov (United States)

    ... Topics » Atrial Fibrillation » Living With Atrial Fibrillation Explore Atrial Fibrillation What Is... Types Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Arrhythmia ...

  4. B-type natriuretic peptide measurement in primary care; magnitude of associations with cardiovascular risk factors and their therapies. Observations from the STOP-HF (St. Vincent's Screening TO Prevent Heart Failure) study.

    LENUS (Irish Health Repository)

    Conlon, Carmel M

    2012-02-01

    BACKGROUND: An effective prevention strategy for heart failure in primary care requires a reliable screening tool for asymptomatic ventricular dysfunction. Preliminary data indicate that B-type natriuretic peptide (BNP) may be suitable for this task. However, for the most effective use of this peptide, the interrelationships between associated risk factors and their therapies on BNP, and in particular their magnitude of effect, needs to be established in a large primary care population. Therefore, the objective of the study was to establish the extent of the association between BNP, cardiovascular risk factors and their therapies. METHODS: BNP measurement and clinical review was preformed on 1122 primary care patients with cardiovascular risk factors. Multivariate analyses identified significant associates of BNP concentrations which were further explored to establish the magnitude of their association. RESULTS: Associates of BNP were age (1.36-fold increase in BNP\\/decade), female (1.28), beta-blockers (1.90), myocardial infarction (1.36), arrhythmia (1.98), diastolic blood pressure; all p<0.01. A novel method was devised that plotted median BNP per sliding decade of age for the various combinations of these principal associates. CONCLUSIONS: The data presented underline the importance of considering several clinical and therapeutic factors when interpreting BNP concentrations. Most of these variables were associated with increased concentrations, which may in part explain the observed false-positive rates for detecting ventricular dysfunction using this peptide. Furthermore, the design of studies or protocols using BNP as an endpoint or a clinical tool should take particular account of these associations. This analysis provides the foundation for age, risk factor and therapy adjusted reference ranges for BNP in this setting.

  5. MMP9 Rs3918242 Polymorphism Affects Tachycardia-Induced MMP9 Expression in Cultured Atrial-Derived Myocytes but Is Not a Risk Factor for Atrial Fibrillation among the Taiwanese

    OpenAIRE

    Fu-Chih Hsiao; Yung-Hsin Yeh; Wei-Jan Chen; Yi-Hsin Chan; Chi-Tai Kuo; Chun-Li Wang; Chi-Jen Chang; Hsin-Yi Tsai; Feng-Chun Tsai; Lung-An Hsu

    2016-01-01

    Matrix metalloproteinase (MMP) plays an important role in the pathogenesis of atrial fibrillation (AF). The MMP9 promoter has a functional polymorphism rs3918242 that can regulate the level of gene transcription. This study recruited 200 AF patients and 240 controls. The MMP9 rs3918242 was examined by polymerase chain reactions. HL-1 atrial myocytes were cultured and electrically stimulated. Right atrial appendages were obtained from six patients with AF and three controls with sinus rhythm u...

  6. Simulation of Daily Snapshot Rhythm Monitoring to Identify Atrial Fibrillation in Continuously Monitored Patients with Stroke Risk Factors

    OpenAIRE

    Yano, Yuichiro; Greenland, Philip; Lloyd-Jones, Donald M.; Daoud, Emile G.; Koehler, Jodi L.; Ziegler, Paul D.

    2016-01-01

    Background New technologies are diffusing into medical practice swiftly. Hand-held devices such as smartphones can record short-duration (e.g., 1-minute) ECGs, but their effectiveness in identifying patients with paroxysmal atrial fibrillation (AF) is unknown. Methods We used data from the TRENDS study, which included 370 patients (mean age 71 years, 71% men, CHADS2 score≥1 point: mean 2.3 points) who had no documentation of atrial tachycardia (AT)/AF or antiarrhythmic or anticoagulant drug u...

  7. Efficacy and safety of rivaroxaban compared with warfarin among elderly patients with nonvalvular atrial fibrillation in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF)

    DEFF Research Database (Denmark)

    Halperin, Jonathan L; Hankey, Graeme J; Wojdyla, Daniel M;

    2014-01-01

    BACKGROUND: Nonvalvular atrial fibrillation is common in elderly patients, who face an elevated risk of stroke but difficulty sustaining warfarin treatment. The oral factor Xa inhibitor rivaroxaban was noninferior to warfarin in the Rivaroxaban Once Daily, Oral, Direct Factor Xa Inhibition Compar...

  8. Natriuretic peptides and cerebral hemodynamics

    DEFF Research Database (Denmark)

    Guo, Song; Barringer, Filippa; Zois, Nora Elisabeth;

    2014-01-01

    decompensated disease. In contrast, their biological effects on the cerebral hemodynamics are poorly understood. In this mini-review, we summarize the hemodynamic effects of the natriuretic peptides with a focus on the cerebral hemodynamics. In addition, we will discuss its potential implications in diseases...... where alteration of the cerebral hemodynamics plays a role such as migraine and acute brain injury including stroke. We conclude that a possible role of the peptides is feasible as evaluated from animal and in vitro studies, but more research is needed in humans to determine the precise response on...... cerebral vessels....

  9. Subclinical Hypothyroidism: An Overlooked Cause of Atrial Fibrillation?

    Directory of Open Access Journals (Sweden)

    Theofilos M. Kolettis, MD

    2012-12-01

    Full Text Available The association between clinical1 or subclinical2 hyperthyroidism and atrial fibrillation is established from large prospective cohort studies, with serum free thyroxin (T4 concentrations correlating with atrial fibrillation rates.3 However, the role of subclinical hypothyroidism as a causal factor for atrial fibrillation has not been elucidated.

  10. Heart failure and atrial fibrillation: current concepts and controversies

    OpenAIRE

    Berg, van den, T.J.T.P.; Tuinenburg, A. E.; Crijns, H. J. G. M.; Gelder, De; Gosselink, A. T.; Lie, K. I.

    1997-01-01

    Heart failure and atrial fibrillation are very common, particularly in the elderly. Owing to common risk factors both disorders are often present in the same patient. In addition, there is increasing evidence of a complex, reciprocal relation between heart failure and atrial fibrillation. Thus heart failure may cause atrial fibrillation, with electromechanical feedback and neurohumoral activation playing an important mediating role. In addition, atrial fibrillation may promote heart failure; ...

  11. Natriuretic peptides in cardiometabolic regulation and disease

    DEFF Research Database (Denmark)

    Zois, Nora E; Bartels, Emil D; Hunter, Ingrid; Kousholt, Birgitte S; Olsen, Lars Henning; Goetze, Jens P

    2014-01-01

    decade. Dysregulation of the natriuretic peptide system has been associated with obesity, glucose intolerance, type 2 diabetes mellitus, and essential hypertension. Moreover, the natriuretic peptides have been implicated in the protection against atherosclerosis, thrombosis, and myocardial ischaemia. All......In the 30 years since the identification of the natriuretic peptides, their involvement in regulating fluid and blood pressure has become firmly established. Data indicating a role for these hormones in lifestyle-related metabolic and cardiovascular disorders have also accumulated over the past...... role in lifestyle-related metabolic and cardiovascular disorders....

  12. Plant natriuretic peptides are apoplastic and paracrine stress response molecules

    KAUST Repository

    Wang, Yuhua

    2011-04-07

    Higher plants contain biologically active proteins that are recognized by antibodies against human atrial natriuretic peptide (ANP). We identified and isolated two Arabidopsis thaliana immunoreactive plant natriuretic peptide (PNP)-encoding genes, AtPNP-A and AtPNP-B, which are distantly related members of the expansin superfamily and have a role in the regulation of homeostasis in abiotic and biotic stresses, and have shown that AtPNP-A modulates the effects of ABA on stomata. Arabidopsis PNP (PNP-A) is mainly expressed in leaf mesophyll cells, and in protoplast assays we demonstrate that it is secreted using AtPNP-A:green fluorescent protein (GFP) reporter constructs and flow cytometry. Transient reporter assays provide evidence that AtPNP-A expression is enhanced by heat, osmotica and salt, and that AtPNP-A itself can enhance its own expression, thereby generating a response signature diagnostic for paracrine action and potentially also autocrine effects. Expression of native AtPNP-A is enhanced by osmotica and transiently by salt. Although AtPNP-A expression is induced by salt and osmotica, ABA does not significantly modulate AtPNP-A levels nor does recombinant AtPNP-A affect reporter expression of the ABA-responsive RD29A gene. Together, these results provide experimental evidence that AtPNP-A is stress responsive, secreted into the apoplastic space and can enhance its own expression. Furthermore, our findings support the idea that AtPNP-A, together with ABA, is an important component in complex plant stress responses and that, much like in animals, peptide signaling molecules can create diverse and modular signals essential for growth, development and defense under rapidly changing environmental conditions. © 2011 The Author.

  13. Aliskiren protecting atrial structural remodeling from rapid atrial pacing in a canine model.

    Science.gov (United States)

    Zhao, Zhiqiang; Chen, Yan; Li, Weimin; Wang, Xinghua; Li, Jian; Yang, Wansong; Cheng, Lijun; Liu, Tong; Liu, Enzhao; Li, Guangping

    2016-08-01

    Atrial fibrillation (AF) contributing to the increasing mortality risk is the most common disease in clinical practice. Owing to the side effects and relative inefficacy of current antiarrhythmic drugs, some research focuses on renin-angiotensin-aldosterone system (RAS) for finding out the new treatment of AF. The purpose of this study is to confirm whether aliskiren as a proximal inhibitor of renin, which completely inhibits RAS, has beneficial effects on atrial structural remodeling in AF. In this study, rapid atrial pacing was induced at 500 beats per minute for 2 weeks in a canine model. A different dose of aliskiren was given orally for 2 weeks before rapid atrial pacing. HE staining and Masson's staining were used for analysis of myocardial fibrosis. TGF-β1, signal pathways, and pro-inflammatory cytokines were shown for the mechanism of structural remodeling after the treatment of aliskiren. Serious atrial fibrosis was induced by rapid atrial pacing, followed by the elevated TGF-β1, upregulated MEK and ERK1/2, and increased inflammatory factors. Aliskiren could apparently improve myocardial fibrosis by reducing the expression of TGF-β1, inhibiting MEK and ERK1/2 signal pathways, and decreasing IL-18 and TLR4 in both serum and atrial tissue. In conclusion, aliskiren could prevent atrial structural remodeling from rapid atrial pacing for 2 weeks. Aliskiren may play a potential beneficial role in the treatment of AF induced by rapid atrial pacing. PMID:27118660

  14. ATRIAL FIBROSIS IS A MORPHOLOGICAL BASIS OF ATRIAL FIBRILLATION

    OpenAIRE

    DRAPKINA O.M.; A. V. Emelyanov

    2015-01-01

    Mechanisms of atrial fibrosis including the role of serotonin in the development of this lesion in patients with atrial fibrillation are presented. New approaches to the treatment of atrial fibrillation aimed at atrial fibrosis reduction are discussed.

  15. Hyperuricemia and Atrial Fibrillation.

    Science.gov (United States)

    Maharani, Nani; Kuwabara, Masanari; Hisatome, Ichiro

    2016-07-27

    The importance of atrial fibrillation (AF) as a cause of mortality and morbidity has prompted research on its pathogenesis and treatment. Recognition of AF risk factors is essential to prevent it and reduce the risk of death. Hyperuricemia has been widely accepted to be associated with the incidence of paroxysmal or persistent AF, as well as to the risk of AF in post cardiovascular surgery patients. The possible explanations for this association have been based on their relation with either oxidative stress or inflammation. To investigate the link between hyperuricemia and AF, it is necessary to refer to hyperuricemia-induced atrial remodeling. So far, both ionic channel and structural remodeling caused by hyperuricemia might be plausible explanations for the occurrence of AF. Inhibition of xanthine oxidase and nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase, or the use of antioxidants, along with serum uric acid (SUA) level reduction to prevent inflammation, might be useful. Uric acid transporters (UATs) play a key role in the regulation of intracellular uric acid concentration. Intracellular rather than serum uric acid level is considered more important for the pathogenesis of AF. Identification of UATs expressed in cells is thus important, and targeting UATs might become a potential strategy to reduce the risk of hyperuricemia-induced atrial fibrillation. PMID:27396561

  16. Atrial fibrillation.

    Science.gov (United States)

    Lip, Gregory Y H; Fauchier, Laurent; Freedman, Saul B; Van Gelder, Isabelle; Natale, Andrea; Gianni, Carola; Nattel, Stanley; Potpara, Tatjana; Rienstra, Michiel; Tse, Hung-Fat; Lane, Deirdre A

    2016-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder, and increases in prevalence with increasing age and the number of cardiovascular comorbidities. AF is characterized by a rapid and irregular heartbeat that can be asymptomatic or lead to symptoms such as palpitations, dyspnoea and dizziness. The condition can also be associated with serious complications, including an increased risk of stroke. Important recent developments in the clinical epidemiology and management of AF have informed our approach to this arrhythmia. This Primer provides a comprehensive overview of AF, including its epidemiology, mechanisms and pathophysiology, diagnosis, screening, prevention and management. Management strategies, including stroke prevention, rate control and rhythm control, are considered. We also address quality of life issues and provide an outlook on future developments and ongoing clinical trials in managing this common arrhythmia. PMID:27159789

  17. Cardiac natriuretic peptide gene expression and plasma concentrations during the first 72 hours of life in piglets

    DEFF Research Database (Denmark)

    Smith, Julie; Christoffersen, Christina; Nørgaard, Linn Maiken;

    2013-01-01

    Plasma measurement of cardiac natriuretic peptides constitutes promising markers of congenital heart disease. However, concentrations change rapidly and dramatically during the first days after delivery even in healthy neonates, which complicates clinical interpretation. It is unknown whether the......, resembling the transition from fetal to neonate circulation. However, the cardiac gene expression does not explain plasma concentrations....... 72 hours of life (from 2 litters, n = 44). Chamber-specific ANP and BNP mRNA levels reflected hemodynamic neonate changes at birth but did not correlate with circulating natriuretic peptide concentrations. However, plasma pro-ANP and creatinine concentrations were closely correlated (P < .0001; r = 0.......73). Plasma pro-ANP levels were highest on the day of delivery (5580 pmol/L [4320-6786] decreasing to 2484 pmol/L [1602-2898] after 72 hours, P < .0001). During the 72 hours, gel chromatography suggested that the translational products in circulation and in atrial tissue were immature, ie, unprocessed pro...

  18. Increased synthesis and release of atrial peptide during DOCA escape in conscious dogs

    International Nuclear Information System (INIS)

    The escape from the sodium-retaining effects of prolonged mineralocorticoid treatment in animals and humans was first noted over 40 yr ago, but despite intense study the mechanisms responsible for the escape phenomenon have not been identified. Putative natriuretic hormones have been proposed to account for the escape phenomenon. To determine whether atrial natriuretic peptides (ANP) could participate in the escape phenomenon, the mineralocorticoid deoxycorticosterone acetate (DOCA) was administered to conscious dogs for 14 days. Escape was accompanied by a doubling of plasma ANP concentration, determined by radioimmunoassay, and four- to sevenfold increases in caridac ANP messenger RNA. There were also significant increases in mean arterial blood pressure during the last 8 days of DOCA treatment. Thus increases in the synthesis and secretion of ANP and increases in atrial pressure may represent mechanisms that contribute to the escape from mineralocorticoid-induced sodium retention

  19. Atrial fibrillation - discharge

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000237.htm Atrial fibrillation - discharge To use the sharing features on this ... have been in the hospital because you have atrial fibrillation . This condition occurs when your heart beats faster ...

  20. Atrial fibrillation or flutter

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000184.htm Atrial fibrillation or flutter To use the sharing features on this page, please enable JavaScript. Atrial fibrillation or flutter is a common type of abnormal ...

  1. Practical application of natriuretic peptides in paediatric cardiology

    DEFF Research Database (Denmark)

    Smith, Julie; Goetze, Jens P; Andersen, Claus B;

    2010-01-01

    diagnostic tools. Natriuretic peptide measurements could be that extra tool. We discuss and suggest N-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide reference intervals for children without cardiovascular disease and cut-off points for the four specific paediatric heart conditions. We...

  2. Identification of a Possible Role for Atrial Natiuretic Peptide in MDMA-induced hyperthermia

    OpenAIRE

    Hrometz, Sandra L; Thatcher, Karen E; Ebert, Jeremy A; Mills, Edward M.; Sprague, Jon E

    2011-01-01

    MDMA (3,4-methylenedioxymethamphetamine) induces thermogenesis in a mitochondrial uncoupling protein 3-dependent manner. There is evidence that this hyperthermia is mediated in part by the lipolytic release of free fatty acids, that subsequently activate uncoupling protein 3 in skeletal muscle mitochondria. We hypothesize that atrial natriuretic peptide (ANP), a strong lipolytic mediator, may contribute to the induction and maintenance of MDMA-induced thermogenesis. The specific aims of this ...

  3. Old Atrial Fibrillation Related Crisis Prevention and Factor Analysis%老年心房颤动相关危险因素分析及其预防措施

    Institute of Scientific and Technical Information of China (English)

    郭海涛; 鲁传龙

    2013-01-01

    Objective:To investigate older cadres troops in the clinical characteristics of atrial fibrillation provides theoretical basis for prevention and treatment.Methods:Department of Senior Officers our hospital all diagnosed cases of Atrial Fibrillation and material complete 120 cases as the research object,and select the same hospital without atrial fibrillation sinus rhythm,the age of 120 patients matched controls,using dynamic electrocardiogram and statistical methods to analysis with coronary heart disease and various kinds of atrial fibrillation risk factors.Results:This study were 240 patients,men,women,168 72 cases,and sex of 2.3:1,the incidence of atrial fibrillation 58.32%,atrial fibrillation prevalence along with the growth of the age and increased significantly,atrial fibrillation group significantly increased prevalence coronary heart disease,atrial fibrillation patients with high blood pressure,diabetes,hyperlipidemia, chronic obstructive pulmonary disease incidence increased significantly,Multiple logistic regression analysis by multiple,age,organic heart disease,chronic cardiac insufficiency,mitral stenosis,mitral valve insufficency af risk factors.The prevalence of atrial fibrillation with the increase of age and increased significantly,atrial fibrillation group significantly increased prevalence coronary heart disease. Conclusion:Coronary prevalence increase as atrial fibrillation,age organic heart disease,chronic cardiac insufficiency,mitral stenosis and mitral valve insufficency are atrial fibrillation risk factors.%  目的:探讨军队老年干部心房颤动(房颤)的临床特点,为预防和治疗提供理论依据.方法:以我院干诊科所有诊断为房颤并且资料完整的病例120例为研究对象,同时选取同期住院无房颤的窦性心律、年龄匹配的患者120例为对照组,用动态心电图和统计学方法来分析房颤与冠心病以及各种危险因素的关系.结果:本研究共240例,男性168

  4. MMP9 Rs3918242 Polymorphism Affects Tachycardia-Induced MMP9 Expression in Cultured Atrial-Derived Myocytes but Is Not a Risk Factor for Atrial Fibrillation among the Taiwanese.

    Science.gov (United States)

    Hsiao, Fu-Chih; Yeh, Yung-Hsin; Chen, Wei-Jan; Chan, Yi-Hsin; Kuo, Chi-Tai; Wang, Chun-Li; Chang, Chi-Jen; Tsai, Hsin-Yi; Tsai, Feng-Chun; Hsu, Lung-An

    2016-01-01

    Matrix metalloproteinase (MMP) plays an important role in the pathogenesis of atrial fibrillation (AF). The MMP9 promoter has a functional polymorphism rs3918242 that can regulate the level of gene transcription. This study recruited 200 AF patients and 240 controls. The MMP9 rs3918242 was examined by polymerase chain reactions. HL-1 atrial myocytes were cultured and electrically stimulated. Right atrial appendages were obtained from six patients with AF and three controls with sinus rhythm undergoing open heart surgery. The MMP9 expression and activity were determined using immunohistochemical analysis and gelatin zymography, respectively. Rapid pacing induces MMP9 secretion from HL-1 myocytes in a time- and dose-dependent manner. The responsiveness of MMP9 transcriptional activity to tachypacing was significantly enhanced by rs3918242. The expression of MMP9 was increased in fibrillating atrial tissue than in sinus rhythm. However, the distribution of rs3918242 genotypes and allele frequencies did not significantly differ between the control and AF groups. HL-1 myocyte may secrete MMP9 in response to rapid pacing, and the secretion could be modulated by rs3918242. Although the MMP9 expression of human atrial myocyte is associated with AF, our study did not support the association of susceptibility to AF among Taiwanese subjects with the MMP9 rs3918242 polymorphism. PMID:27070579

  5. MMP9 Rs3918242 Polymorphism Affects Tachycardia-Induced MMP9 Expression in Cultured Atrial-Derived Myocytes but Is Not a Risk Factor for Atrial Fibrillation among the Taiwanese

    Directory of Open Access Journals (Sweden)

    Fu-Chih Hsiao

    2016-04-01

    Full Text Available Matrix metalloproteinase (MMP plays an important role in the pathogenesis of atrial fibrillation (AF. The MMP9 promoter has a functional polymorphism rs3918242 that can regulate the level of gene transcription. This study recruited 200 AF patients and 240 controls. The MMP9 rs3918242 was examined by polymerase chain reactions. HL-1 atrial myocytes were cultured and electrically stimulated. Right atrial appendages were obtained from six patients with AF and three controls with sinus rhythm undergoing open heart surgery. The MMP9 expression and activity were determined using immunohistochemical analysis and gelatin zymography, respectively. Rapid pacing induces MMP9 secretion from HL-1 myocytes in a time- and dose-dependent manner. The responsiveness of MMP9 transcriptional activity to tachypacing was significantly enhanced by rs3918242. The expression of MMP9 was increased in fibrillating atrial tissue than in sinus rhythm. However, the distribution of rs3918242 genotypes and allele frequencies did not significantly differ between the control and AF groups. HL-1 myocyte may secrete MMP9 in response to rapid pacing, and the secretion could be modulated by rs3918242. Although the MMP9 expression of human atrial myocyte is associated with AF, our study did not support the association of susceptibility to AF among Taiwanese subjects with the MMP9 rs3918242 polymorphism.

  6. Atrial Fibrillation: Complications

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Atrial Fibrillation Atrial Fibrillation: Complications Past Issues / Winter 2015 Table of Contents ... has two major complications—stroke and heart failure. Atrial Fibrillation and Stroke Click to enlarge image This illustration ...

  7. Atrial Fibrillation in Children

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Atrial Fibrillation in Children Updated:Jul 18,2016 Does your ... content was last reviewed on 04/16/14. Atrial Fibrillation • Introduction • What is Atrial Fibrillation? • Why AFib Matters • ...

  8. Atrial Fibrillation Factsheet

    Science.gov (United States)

    Atrial Fibrillation Atrial fibrillation, often called AFib or AF, is the most common type of heart arrhythmia. An arrhythmia is when the ... Atrium Sinoatrial Node (pacemaker) Atrioventricular Node Left Atrium Atrial Fibrillation AFib Facts 1 • An estimated 2.7–6. ...

  9. 低氧诱导因子1α与心房颤动发生和维持的关系%Relationship of hypoxia-inducible factor-1α with occurrence and maintenance of atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    加艳平; 刘玉芝; 韦美玉; 李时乐; 徐延敏

    2013-01-01

    目的 探讨低氧诱导因子1α(HIF-1α)与心房颤动发生和维持的关系.方法 入选 125例临床资料完整的心房颤动患者,其中阵发性心房颤动34例,持续性心房颤动49例,永久性心房颤动42例,窦性心律者38例作为对照组.比较各组患者血清中HIF-1α的表达水平,同时测量左心房内径.结果 永久心房颤动组左心房内径较持续心房颤动组(44.65±6.67) mm vs (41.15±5.53) mm(P0.05).HIF-1α表达水平在永久心房颤动组明显高于阵发心房颤动组及对照组(83.12±26.39) ng/L vs (67.15±31.91) ng/L vs (55.97±18.01) ng/L (P0.05);阵发心房颤动组与对照组比较差异无统计学意义(P>0.05).结论 HIF-1α作为免疫炎症因子参与心房颤动的发生及维持.%Objective To study the relationship of hypoxia-inducible factor-lα(HIF-1α) as immunological and inflammatory factor with the occurrence and maintenance of atrial fibrillation. Methods 125 cases of atrial fibrillation were enrolled, 34 cases were paroxysmal atrial fibrillation and 4 9 cases were persistent atrial fibrillation and 42 cases were permanent atrial fibrillation, besides, 38 sinus rhythm cases were also selected into the control group. HIF-1α levels of different groups were compared and left atrial diameters were measured,respectively. Results Compared with permanent atrial fibrillation group and control group, the left atrial diameter of persistent atrial fibrillation group increased, (44. 65 + 6. 67) mm vs (41. 15 + 5. 53) mm vs (38. 62 + 4. 63) mm vs (38.03 + 3.80) mm( P 0. 05) , HIF-1α levels between paroxysmal atrial fibrillation and control group showed no significant difference( P >0. 05). Conclusion The increase of HIF-la level probably participates in the occurrence of atrial fibrillation, which indicates that the inflammatory reaction may promote the occurrence and maintenance of atrial fibrillation.

  10. Simulation of Daily Snapshot Rhythm Monitoring to Identify Atrial Fibrillation in Continuously Monitored Patients with Stroke Risk Factors.

    Directory of Open Access Journals (Sweden)

    Yuichiro Yano

    Full Text Available New technologies are diffusing into medical practice swiftly. Hand-held devices such as smartphones can record short-duration (e.g., 1-minute ECGs, but their effectiveness in identifying patients with paroxysmal atrial fibrillation (AF is unknown.We used data from the TRENDS study, which included 370 patients (mean age 71 years, 71% men, CHADS2 score≥1 point: mean 2.3 points who had no documentation of atrial tachycardia (AT/AF or antiarrhythmic or anticoagulant drug use at baseline. All were subsequently newly diagnosed with AT/AF by a cardiac implantable electronic device (CIED over one year of follow-up. Using a computer simulation approach (5,000 repetitions, we estimated the detection rate for paroxysmal AT/AF via daily snapshot ECG monitoring over various periods, with the probability of detection equal to the percent AT/AF burden on each day.The estimated AT/AF detection rates with snapshot monitoring periods of 14, 28, 56, 112, and 365 days were 10%, 15%, 21%, 28%, and 50% respectively. The detection rate over 365 days of monitoring was higher in those with CHADS2 scores ≥2 than in those with CHADS2 scores of 1 (53% vs. 38%, and was higher in those with AT/AF burden ≥0.044 hours/day compared to those with AT/AF burden <0.044 hours/day (91% vs. 14%; both P<0.05.Daily snapshot ECG monitoring over 365 days detects half of patients who developed AT/AF as detected by CIED, and shorter intervals of monitoring detected fewer AT/AF patients. The detection rate was associated with individual CHADS2 score and AT/AF burden.ClinicalTrials.gov NCT00279981.

  11. Predictors of left atrial appendage stunning after electrical cardioversion of non-valvular atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    杨沙宁; 黄从新; 胡晓军; 金立军; 李凤翥; 彭水先

    2003-01-01

    Objective To identify predictors of left atrial appendage stunning after the use of electrical cardioversion to restore sinus rhythm in patients with non-valvular atrial fibrillation.Methods A total of 68 consecutive patients (45 men, 23 women, 60.5±8.7 years of age) with non-valvular atrial fibrillation undergoing electrical cardioversion were enlisted in this study. Clinical and echocardiographic variables were analyzed by univariate regression and multivariate logistic regression to investigate the relationship between occurrences of left atrial appendage stunning and these factors. Results Univariate analysis revealed that, in comparing patients without and with left atrial appendage stunning, there were significant differences in the duration of atrial fibrillation > 8 weeks (32.3% vs 75.5%, P 50 mm (29.0% vs 54.1%, P 8 weeks (OR=7.249, 95%CI=1.998-26.304, P 50 mm (OR=3.896, 95%CI=1.105-13.734, P8 weeks, left atrial diameter >50 mm, left ventricular ejection fraction <50%, and cumulative energy of electrical cardioversion are independent predictors of left atrial appendage stunning. Anticoagulation treatment should be individualized for patients undergoing electrical cardioversion to reduce the risk of both cardioversion-related thromboembolic events and hemorrhagic complications caused by warfarin treatment.

  12. 急性脑卒中并发房颤相关临床因素分析%Analysis of related clinical factors of acute stroke combined with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    郭丽; 郭素凤

    2014-01-01

    目的:探讨急性脑卒中并发房颤的相关因素,并据此提出防治措施。方法:2013年9月-2014年9月收治急性脑卒中患者215例,回顾性分析其临床资料,统计发生率和分析相关因素。结果:在215例急性脑卒中患者中发生房颤30例,总发生率14.0%,在发生急性脑卒中后24 h出现房颤16例(53.3%),在发生急性脑卒中后24~48 h出现房颤9例(30%);年龄大、NIHSS评分高者,房颤发生率较高。结论:在急性脑卒中48 h内出现房颤的可能性较高;年龄越大、NIHSS评分越高是急性脑卒中并发房颤的危险因素。%Objective:To explore the related factors of acute stroke combined with atrial fibrillation,and to put forward prevention and control measures.Methods:215 patients with acute stroke were selected from September 2013 to September 2014.The clinical data were retrospectively analyzed.The incidence rate was given statistics and the related factors were analyzed.Results:In 215 patients with acute stroke,30 cases occured atrial fibrillation, and the total incidence rate was 14%.In 24 hours after acute stroke, 16 cases(53.3%) occured atrial fibrillation.In 24~48 hours after acute stroke,9 cases(30%) occured atrial fibrillation.The age was older,the NIHSS score was higher,and the incidence rate of atrial fibrillation was higher.Conclusion:The atrial fibrillation occurs high possibility in 24 hours after acute stroke.The older age,higher NIHSS score are risk factors of acute stroke combined with atrial fibrillation.

  13. Atrial Fibrillation in Congestive Heart Failure

    OpenAIRE

    Lubitz, Steven A.; Benjamin, Emelia J.; Ellinor, Patrick T.

    2010-01-01

    Atrial fibrillation and congestive heart failure are morbid conditions that share common risk factors and frequently coexist. Each condition predisposes to the other, and the concomitant presence of the two identifies individuals at increased risk for mortality. Recent data have emerged which help elucidate the complex genetic and non-genetic pathophysiological mechanisms that contribute to the development of atrial fibrillation in individuals with congestive heart failure. Clinical trial res...

  14. Outcomes after ablation for typical atrial flutter (from the Loire Valley Atrial Fibrillation Project).

    Science.gov (United States)

    Clementy, Nicolas; Desprets, Laurent; Pierre, Bertrand; Lallemand, Bénédicte; Simeon, Edouard; Brunet-Bernard, Anne; Babuty, Dominique; Fauchier, Laurent

    2014-11-01

    Similar predisposing factors are found in most types of atrial arrhythmias. The incidence of atrial fibrillation (AF) among patients with atrial flutter is high, suggesting similar outcomes in patients with those arrhythmias. We sought to investigate the long-term outcomes and prognostic factors of patients with AF and/or atrial flutter with contemporary management using radiofrequency ablation. In an academic institution, we retrospectively examined the clinical course of 8,962 consecutive patients admitted to our department with a diagnosis of AF and/or atrial flutter. After a median follow-up of 934 ± 1,134 days, 1,155 deaths and 715 stroke and/thromboembolic (TE) events were recorded. Patients with atrial flutter undergoing cavotricuspid isthmus ablation (n = 875, 37% with a history of AF) had a better survival rate than other patients (hazard ratio [HR] 0.35, 95% confidence interval [CI] 0.25 to 0.49, p <0.0001). Using Cox proportional hazards model and propensity score model, after adjustment for main other confounders, ablation for atrial flutter was significantly associated with a lower risk of all-cause mortality (HR 0.55, 95% CI 0.36 to 0.84, p = 0.006) and stroke and/or TE events (HR 0.53, 95% CI 0.30 to 0.92, p = 0.02). After ablation, there was no significant difference in the risk of TE between patients with a history of AF and those with atrial flutter alone (HR 0.83, 95% CI 0.41 to 1.67, p = 0.59). In conclusion, in patients with atrial tachyarrhythmias, those with atrial flutter with contemporary management who undergo cavotricuspid isthmus radiofrequency ablation independently have a lower risk of stroke and/or TE events and death of any cause, whether a history of AF is present or not. PMID:25200340

  15. Vascular disease and stroke risk in atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y.H.; Lane, Deirdre A;

    2012-01-01

    Vascular disease (including myocardial infarction and peripheral artery disease) has been proposed as a less well-validated risk factor for stroke in patients with atrial fibrillation. We investigated whether vascular disease is an independent risk factor of stroke/thromboembolism in atrial fibri...

  16. Genetika idiopatske atrijske fibrilacije: Genetics of lone atrial fibrillation:

    OpenAIRE

    Antolič, Bor; Petrovič, Danijel; Šinkovec, Matjaž; Žižek, David

    2010-01-01

    Atrial fibrillation is the most common sustained cardiac dysrhythmia leading to an increased risk of heart failure and thromboembolic stroke. It is a multifactorial disease, the incidence of which increases with age and presenceof other comorbidities. Especially in the young it can develop in the absence of known risk factors, and is called idiopathic or ,loneĆ atrial fibrillation, which in a smaller proportion can occur as a familial form. The familial idiopathic atrial fibrillation is a mon...

  17. How Is Atrial Fibrillation Treated?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Is Atrial Fibrillation Treated? Treatment for atrial fibrillation (AF) depends on ... too much thyroid hormone). Who Needs Treatment for Atrial Fibrillation? People who have AF but don't have ...

  18. How Is Atrial Fibrillation Diagnosed?

    Science.gov (United States)

    ... Atrial Fibrillation » How Is Atrial Fibrillation Diagnosed? Explore Atrial Fibrillation What Is... Types Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Arrhythmia ...

  19. Assessment of right atrial function analysis

    International Nuclear Information System (INIS)

    To assess the potential utility of right atrial function analysis in cardiac disease, reservoir function, pump function, and right atrial peak emptying rate (RAPER) were compared in 10 normal subjects, 32 patients with coronary artery disease, and 4 patients with primary pulmonary hypertension. Right atrial volume curves were obtained using cardiac radionuclide method with Kr-81m. In normal subjects, reservoir function index was 0.41+-0.05; pump function index was 0.25+-0.05. Both types of patients has decreased reservoir funcion and increased pump function. Pump function tended to decrease with an increase of right ventricular end-diastolic pressure. RAPER correlated well with right ventricular peak filling rate, probably reflecting right ventricular diastolic function. Analysis of right atrial function seemed to be of value in evaluating factors regulating right ventricular contraction and diastolic function, and cardiac output. (Namekawa, K)

  20. 房颤患者幽门螺杆菌感染的危险因素分析%Risk factors for Helicobacter py lori infections in atrial fibrillation patients

    Institute of Scientific and Technical Information of China (English)

    谢春; 张燕; 张英延

    2014-01-01

    目的:研究房颤患者幽门螺杆菌(Hp)感染的危险因素及相应的干预措施,以降低房颤患者 Hp的感染率。方法选取2007年1月-2013年1月入院诊治的房颤患者600例,均经14 C-UBT呼气试验检查,应用自拟问卷调查方式及单因素、多因素 logistic回归分析对房颤患者Hp感染的危险因素进行分析。结果600例房颤患者中H p感染358例,感染率为59.67%;经单因素分析,年龄、在外就餐、饭后未刷牙或漱口、未抗 H p治疗是房颤患者Hp感染的影响因素;经多因素 logistic回归分析,年龄>65岁、未接受抗Hp治疗是房颤患者Hp感染的危险因素。结论高龄、未接受抗 Hp治疗的房颤患者易感染Hp;良好的生活饮食习惯是预防房颤患者 Hp感染的重要因素。%OBJECTIVE To explore the risk factors for Helicobacter pylori infections in atrial fibrillation patients and put forward corresponding intervention measures so as to reduce the incidence of H .pylori infections in the at-rial fibrillation patients .METHODS A total of 600 patients with atrial fibrillation who were treated in the hospitals from Jan 2007 to Jan 2013 were enrolled in the study ,then all the patients underwent the breast test ,the self-de-signed questionnaire survey was conducted ,and the univariate and multivariate logistic regression analysis were performed for the risk factors for H .pylori infections in the atrial fibrillation patients .RESULTS The H .pylori infections occurred in 358 of 600 patients with atrial fibrillation ,with the infection rate of 59 .67% .The univariate analysis showed that the age ,eating raw fruits and vegetables ,dining outside ,brushing teeth or gargling after dining ,and anti-H .pylori therapy were the influencing factors for the H .pylori infection in the patients with atri-al fibrillation ;the multivariate logistic regression analysis indicated that the age ,eating raw fruits and vegetables , and anti-H .pylori

  1. Associates of an Elevated Natriuretic Peptide Level in Stable Heart Failure Patients: Implications for Targeted Management

    Directory of Open Access Journals (Sweden)

    Aftab Jan

    2013-01-01

    Full Text Available Background. Persistently elevated natriuretic peptide (NP levels in heart failure (HF patients are associated with impaired prognosis. Recent work suggests that NP-guided therapy can improve outcome, but the mechanisms behind an elevated BNP remain unclear. Among the potential stimuli for NP in clinically stable patients are persistent occult fluid overload, wall stress, inflammation, fibrosis, and ischemia. The purpose of this study was to identify associates of B-type natriuretic peptide (BNP in a stable HF population. Methods. In a prospective observational study of 179 stable HF patients, the association between BNP and markers of collagen metabolism, inflammation, and Doppler-echocardiographic parameters including left ventricular ejection fraction (LVEF, left atrial volume index (LAVI, and E/e prime (E/e′ was measured. Results. Univariable associates of elevated BNP were age, LVEF, LAVI, E/e′, creatinine, and markers of collagen turnover. In a multiple linear regression model, age, creatinine, and LVEF remained significant associates of BNP. E/e′ and markers of collagen turnover had a persistent impact on BNP independent of these covariates. Conclusion. Multiple variables are associated with persistently elevated BNP levels in stable HF patients. Clarification of the relative importance of NP stimuli may help refine NP-guided therapy, potentially improving outcome for this at-risk population.

  2. Plant natriuretic peptides: Systemic regulators of plant homeostasis and defense that can affect cardiomyoblasts

    KAUST Repository

    Gehring, Christoph A

    2010-09-01

    Immunologic evidence has suggested the presence of biologically active natriuretic peptide (NPs) hormones in plants because antiatrial NP antibodies affinity purify biologically active plant NPs (PNP). In the model plant, an Arabidopsis thaliana PNP (AtPNP-A) has been identified and characterized. AtPNP-A belongs to a novel class of molecules that share some similarity with the cell wall loosening expansins but do not contain the carbohydrate-binding wall anchor thus suggesting that PNPs and atrial natriuretic peptides are heterologs. AtPNP-A acts systemically, and this is consistent with its localization in the apoplastic extracellular space and the conductive tissue. Furthermore, AtPNP-A signals via the second messenger cyclic guanosine 3′,5′-monophosphate and modulates ion and water transport and homeostasis. It also plays a critical role in host defense against pathogens. AtPNP-A can be classified as novel paracrine plant hormone because it is secreted into the apoplastic space in response to stress and can enhance its own expression. Interestingly, purified recombinant PNP induces apo-ptosis in a dose-dependent manner and was most effective on cardiac myoblast cell lines. Because PNP is mimicking the effect of ANP in some instances, PNP may prove to provide useful leads for development of novel therapeutic NPs. Copyright © 2013 by The American Federation for Medical Research.

  3. Prevalence of isolated atrial amyloidosis in young patients affected by congestive heart failure.

    Science.gov (United States)

    Millucci, Lia; Ghezzi, Lorenzo; Bernardini, Giulia; Braconi, Daniela; Tanganelli, Piero; Santucci, Annalisa

    2012-01-01

    Atrial natriuretic peptide (ANP), whose amyloid is responsible of isolated atrial amyloidosis (IAA), is known to play an important role in the pathophysiology of congestive heart failure (CHF). We provide here the microscopic examination of atrial biopsies from 36 young (mean 40 years) CHF patients distinguished in idiopathic dilated cardiomyopathy (DC) affected and hypertrophic Cardiomyopathy (HC) affected, endorsing the presumptive association of early CHF with IAA. We utilized a multiple method, using Congo red (CR) staining, CR fluorescence (CRF), and immunohistochemistry to assess the presence of IAA in CHF. Immunostaining showed a moderate deposition of IAA in the atrium surrounding working myocardium with small intracellular deposits. Our findings suggest a monitoring of young CHF cases for the development of IAA. Our study also demonstrated how the concurrent use of immunohistochemistry, CR, and CRF may greatly enhance the detection of low-grade amyloid deposits. PMID:22536133

  4. Antihypertensive action of non-natriuretic doses of furosemide in Dahl salt-sensitive rats

    DEFF Research Database (Denmark)

    Haugan, Ketil; Petersen, Jørgen Søberg; Spannow, Jesper; Shalmi, Michael; Christensen, Sten

    Farmakologi, blood pressure, Dahl rats, furosemide, sodium balance, total body sodium, non-natriuretic......Farmakologi, blood pressure, Dahl rats, furosemide, sodium balance, total body sodium, non-natriuretic...

  5. Hubungan Diameter Vena Cava Inferior Dengan Nilai N-Terminal Pro-Brain Natriuretic Peptide (Nt-Probnp) Pada Pasien Gagal Jantung Kronik Tidak Terkompensasi Akibat Penyakit Jantung Koroner Dan Penyakit Jantung Hipertensi di RSUP H. Adam Malik Medan

    OpenAIRE

    T. Realsyah

    2016-01-01

    The inferior vena cava (IVC) diameter and degree of inspiratory collapse areused as echocardiographic indices in the estimation of right atrial pressure. N-terminal pro-B natriuretic peptide (NT-ProBNP) are established biomarkers of myocardial wall stress. There is no informationavailable regarding the association between the IVC diameterand NT-ProBNPs in patients with Decompensated Chronic heart failure. The purpose of this investigationis to analyse the correlation of inferior vena c...

  6. Embolic Risk in Atrial Fibrillation that Arises from Hyperthyroidism: Review of the Medical Literature

    OpenAIRE

    Traube, Elie; Coplan, Neil L.

    2011-01-01

    Atrial fibrillation, the most common cardiac complication of hyperthyroidism, occurs in an estimated 10% to 25% of overtly hyperthyroid patients. The prevalence of atrial fibrillation increases with age in the general population and in thyrotoxic patients. Other risk factors for atrial fibrillation in thyrotoxic patients include male sex, ischemic or valvular heart disease, and congestive heart failure. The incidence of arterial embolism or stroke in thyrotoxic atrial fibrillation is less cle...

  7. Increased circulating pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP) in patients with cirrhosis: relation to cardiovascular dysfunction and severity of disease

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Gøtze, J P; Fuglsang, Stefan; Christensen, E; Bendtsen, Flemming; Møller, Søren

    2003-01-01

    BACKGROUND AND AIMS: Cardiac dysfunction may be present in patients with cirrhosis. This study was undertaken to relate plasma concentrations of cardiac peptides reflecting early ventricular dysfunction (pro-brain natriuretic peptide (proBNP) and brain natriuretic peptide (BNP)) to markers of...... severity of liver disease, cardiac dysfunction, and hyperdynamic circulation in patients with cirrhosis. PATIENTS AND METHODS: Circulating levels of proBNP and BNP were determined in 51 cirrhotic patients during a haemodynamic investigation. RESULTS: Plasma proBNP and BNP were significantly increased in...... subjects (1.8 v 2.3; NS). Circulating proBNP and BNP were related to severity of liver disease (Child score, serum albumin, coagulation factors 2, 7, and 10, and hepatic venous pressure gradient) and to markers of cardiac dysfunction (QT interval, heart rate, plasma volume) but not to indicators of the...

  8. Determinants of development and preservation of atrial fibrillation at thyrotoxicosis

    Directory of Open Access Journals (Sweden)

    A Yu Babenko

    2013-03-01

    Full Text Available Atrial fibrillation is a frequent violation of a heart rhythm at thyrotoxicosis and it can determine serious complica tions (tromboembolia, stroke and death. The study of factors increasing risk development of atrial fibrillation at thy rotoxicosis is investigating many years but the occurrence of new diagnostic methods and mathematic analysis allows to reveal new determinants of development of atrial fibrillation and its persistence after restoration of euthyreosis. In our research we’ve studied the Echocardiography parameters in 254 normotensive patients with a thyrotoxicosis Graves’ disease without any CVD and 110 patients with a subclinical thyrotoxicosis. We detected new factors of risk of atrial fibrillation: the duration of thyrotoxicosis and the left ventricular concentric hypertrophy. The contribution of different factors in development of atrial fibrillation is defined.

  9. Atrial fibrillation after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Nair Suresh

    2010-01-01

    Full Text Available Once considered as nothing more than a nuisance after cardiac surgery, the importance of postoperative atrial fibrillation (POAF has been realized in the last decade, primarily because of the morbidity associated with the condition. Numerous causative factors have been described without any single factor being singled out as the cause of this complication. POAF has been associated with stroke, renal failure and congestive heart failure, although it is difficult to state whether POAF is directly responsible for these complications. Guidelines have been formulated for prevention of POAF. However, very few cardiothoracic centers follow any form of protocol to prevent POAF. Routine use of prophylaxis would subject all patients to the side effects of anti-arrhythmic drugs, while only a minority of the patients do actually develop this problem postoperatively. Withdrawal of beta blockers in the postoperative period has been implicated as one of the major causes of POAF. Amiodarone, calcium channel blockers and a variety of other pharmacological agents have been used for the prevention of POAF. Atrial pacing is a non-pharmacological measure which has gained popularity in the prevention of POAF. There is considerable controversy regarding whether rate control is superior to rhythm control in the treatment of established atrial fibrillation (AF. Amiodarone plays a central role in both rate control and rhythm control in postoperative AF. Newer drugs like dronedarone and ranazoline are likely to come into the market in the coming years.

  10. Left Atrial Appendage Closure for Stroke Prevention in Patients with Atrial Fibrillation and Hereditary Hemorrhagic Telangiectasia

    OpenAIRE

    Sebastiaan Velthuis; Swaans, Martin J.; Mager, Johannes J.; Rensing, Benno J. W. M.; Lucas V. A. Boersma; Post, Martijn C.

    2012-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting millions of individuals worldwide, and a major risk factor for disabling cerebral embolic stroke. Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant inherited disorder, characterized by vascular abnormalities with high-bleeding tendency and therefore intolerance for oral anticoagulation. We report a case of percutaneous closure of the left atrial appendage, which might be a good alternative strategy in...

  11. Exploiting periodicity to extract the atrial activity in atrial arrhythmias

    OpenAIRE

    Llinares Llopis, Raúl; Igual García, Jorge

    2011-01-01

    [EN] Atrial fibrillation disorders are one of the main arrhythmias of the elderly. The atrial and ventricular activities are decoupled during an atrial fibrillation episode, and very rapid and irregular waves replace the usual atrial P-wave in a normal sinus rhythm electrocardiogram (ECG). The estimation of these wavelets is a must for clinical analysis. We propose a new approach to this problem focused on the quasiperiodicity of these wavelets. Atrial activity is characterized by...

  12. Influence of left ventricular filling pattern on exercise-induced changes of natriuretic peptides in patients with suspected coronary artery disease

    DEFF Research Database (Denmark)

    Møller, Jacob Eifer; Bergeron, S.; Jaffe, A.;

    2008-01-01

    and brain natriuretic peptides (ANP and BNP) with resting and exercise-induced changes of LV systolic function and filling pattern. METHODS: LV function at rest and peak exercise was assessed in 140 patients (mean age 65 years, 78 men) during symptom-limited exercise echocardiography for evaluation......BACKGROUND: Exertional change in brain natriuretic peptide (BNP) has recently been proposed as a biomarker of myocardial ischemia. However, in patients with abnormal left ventricular (LV) filling, BNP is frequently increased. Therefore, we studied the relationship of exertional changes in atrial...... of suspected coronary artery disease. ANP and BNP were measured at rest and 5 min after exercise. RESULTS: ANP and BNP increased with exercise. The increase in BNP was significantly greater in the 65 patients with than in the 76 patients without ischemia [14.7 pg/ml (5.7-19.6) vs. 4.9 pg/ml (2.1-9.2), p

  13. 非瓣膜性心房颤动患者的卒中危险因素分析%Risk factors analysis for stroke in patients with non-valvular atrial fibir llation

    Institute of Scientific and Technical Information of China (English)

    刘立阳; 陈新; 陈晓虹

    2014-01-01

    Stroke is non-valvular atrial fibrillation major complication .Heart failure,advanced age, hypertension , diabetes , history of stroke or transient ischemic attack and stroke in patients with atrial fibrillation associated risks , in addition, the clinical risk factors for other causes of ischemic stroke is also associated with the risk of stroke in patients with atrial fibrillation .Screening patients with atrial fibrillation stroke risk factors,and to take effective way to assess their risks of stroke ,both for anticoagulant therapy to prevent stroke event , or to reduce the risk of bleeding caused by anticoagulant therapy , are of great significance .%卒中是非瓣膜性心房颤动(以下简称为房颤)的主要并发症。心力衰竭、高龄、高血压、糖尿病及卒中或短暂性脑缺血发作史与房颤患者卒中的风险相关,此外,临床上其他原因所致的缺血性卒中的危险因素也与房颤患者的卒中风险相关。筛选房颤患者并发卒中的危险因素,并采取有效方法评估其卒中的危险性,无论是对于抗凝治疗预防卒中事件,还是对于减少抗凝治疗引起的出血风险,都具有十分重要的意义。

  14. Genetics of Atrial Fibrillation and Possible Implications for Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Robin Lemmens

    2011-01-01

    Full Text Available Atrial fibrillation is the most common cardiac arrhythmia mainly caused by valvular, ischemic, hypertensive, and myopathic heart disease. Atrial fibrillation can occur in families suggesting a genetic background especially in younger subjects. Additionally recent studies have identified common genetic variants to be associated with atrial fibrillation in the general population. This cardiac arrhythmia has important public health implications because of its main complications: congestive heart failure and ischemic stroke. Since atrial fibrillation can result in ischemic stroke, one might assume that genetic determinants of this cardiac arrhythmia are also implicated in cerebrovascular disease. Ischemic stroke is a multifactorial, complex disease where multiple environmental and genetic factors interact. Whether genetic variants associated with a risk factor for ischemic stroke also increase the risk of a particular vascular endpoint still needs to be confirmed in many cases. Here we review the current knowledge on the genetic background of atrial fibrillation and the consequences for cerebrovascular disease.

  15. Atrial arrhythmia in ageing spontaneously hypertensive rats: unraveling the substrate in hypertension and ageing.

    Directory of Open Access Journals (Sweden)

    Dennis H Lau

    Full Text Available BACKGROUND: Both ageing and hypertension are known risk factors for atrial fibrillation (AF although the pathophysiological contribution or interaction of the individual factors remains poorly understood. Here we aim to delineate the arrhythmogenic atrial substrate in mature spontaneously hypertensive rats (SHR. METHODS: SHR were studied at 12 and 15 months of age (n = 8 per group together with equal numbers of age-matched normotensive Wistar-Kyoto control rats (WKY. Electrophysiologic study was performed on superfused isolated right and left atrial preparations using a custom built high-density multiple-electrode array to determine effective refractory periods (ERP, atrial conduction and atrial arrhythmia inducibility. Tissue specimens were harvested for structural analysis. RESULTS: COMPARED TO WKY CONTROLS, THE SHR DEMONSTRATED: Higher systolic blood pressure (p<0.0001, bi-atrial enlargement (p<0.05, bi-ventricular hypertrophy (p<0.05, lower atrial ERP (p = 0.008, increased atrial conduction heterogeneity (p = 0.001 and increased atrial interstitial fibrosis (p = 0.006 & CD68-positive macrophages infiltration (p<0.0001. These changes resulted in higher atrial arrhythmia inducibility (p = 0.01 and longer induced AF episodes (p = 0.02 in 15-month old SHR. Ageing contributed to incremental bi-atrial hypertrophy (p<0.01 and atrial conduction heterogeneity (p<0.01 without affecting atrial ERP, fibrosis and arrhythmia inducibility. The limited effect of ageing on the atrial substrate may be secondary to the reduction in CD68-positive macrophages. CONCLUSIONS: Significant atrial electrical and structural remodeling is evident in the ageing spontaneously hypertensive rat atria. Concomitant hypertension appears to play a greater pathophysiological role than ageing despite their compounding effect on the atrial substrate. Inflammation is pathophysiologically linked to the pro-fibrotic changes in the hypertensive atria.

  16. Adaptação de um sistema de ensaio biológico para detecção de fatores relaxantes endoteliais derivados do endocárdio atrial canino Adaptation of bioassay to detect endothelium-derived relaxing factors from the canine atrial endocardium

    Directory of Open Access Journals (Sweden)

    Yeow Leng Chua

    2009-06-01

    Full Text Available OBJETIVO: Estudar a liberação de fatores relaxantes derivados do endotélio (EDRF pelo endocárdio de aurículas de corações caninos. MÉTODOS: Aurículas atriais caninas foram suturadas em forma de tubos e o efluente desses tubos foram submetidos a ensaios biológicos (sistema de perfusão isolada em câmaras de órgãos utilizando artéria coronária canina, para a detecção de EDRFs. RESULTADOS: O efluente da aurícula direita promoveu relaxamento de 58,4 + 10,1% e da aurícula esquerda 74,9 + 8,5% da contração inicial obtida pela ação da prostagladina F2α em artéria coronária. Não houve diferença estatística no relaxamento da artéria coronária induzido pelos efluentes das aurículas direita e esquerda. O relaxamento induzido pelos efluentes das aurículas direita e esquerda foi abolido pelo tratamento das mesmas com Triton X-100. O tratamento das aurículas com L-NMMA, um inibidor competitivo da síntese de óxido nítrico, e com indometacina, um inibidor da via da ciclooxigenase, promoveu redução no relaxamento da artéria coronária induzido pelo efluente auricular, indicando que o endotélio endocárdico libera óxido nítrico e prostanóides. CONCLUSÕES: Esse estudo demonstra, pela primeira vez, a liberação luminal in vitro de EDRF e prostaciclina pelo átrio de coração canino. A habilidade do endotélio endocárdico em produzir esses fatores pode ter um papel importante na prevenção da formação de trombos nas câmaras cardíacas.OBJECTIVE: The aim of this study was to assess the release of endothelium-derived relaxing factors from the endocardium of canine atrial appendage. METHODS: To study the release of endothelium-derived relaxing factor (EDRF from intact atrial endocardial endothelium, tube-shaped sutures of canine atrial appendages were performed and effluents from these tubes were bioassayed (isolated perfused organ chamber system for detection of EDRF in canine coronary artery. RESULTS: Effluent from

  17. 558例心房颤动患者相关危险因素的分析%Clinical analysis of related risk factors in 558 hospitalized cases with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    白玉芝; 张琴; 王晶; 茹静; 安芸; 汤莉莹; 赵霞; 田甜

    2009-01-01

    目的 探讨心房颤动(房颤)患者的相关危险因素,旨在防止房颤的发生.方法 对我院2005年6月至2008年6月558例房颤患者的住院资料进行回顾性分析,并按年龄分组,分析老年人房颤的特点.结果 558例房颤患者中,男298例(53.4%),女260例(46.6%);年龄21~97岁,平均(72.8±10.1)岁,其中21~59岁57例(10.2%),60~97岁501例(89.8 %);同期全院住院患者11 869例,不同年龄组分别为:21~59岁4049例,60~69岁2527例,70~79岁3971例,80~89岁1244例,90~97岁78例.房颤患者占同年龄组住院患者的比例依次为1.4%(57例)、4.2%(107例)、6.6%(262例)、9.5%(118例)、17.9%(14例);558例中,阵发性、持续性、永久性房颤分别为230例(41.2%)、44例(7.9%)、284例(50.9%);基础疾病高血压占首位,其次为冠心病、心功能不全、糖尿病、风湿性心脏病等.结论 房颤的发生随增龄而明显增加.高血压、冠心病、风湿性心脏病、心功能不全、甲状腺功能亢进、糖尿病、慢性肺疾病、肾衰竭均是房颤的危险因素,应早期预防、控制和治疗以防房颤的发生.%Objective To investigate the related risk factors in patients with atrial fibrillation in order to prevent and delay the occurrence of atrial fibrillation.Methods Five hundred and fifty-eight inpatients with atrial fibrillation were retrospectively analyzed from June 2005 to June 2008.They were divided into several groups according to the age and the characteristics of the elder patients with atrial fibrillation were analyzed.Results In the 558 cases with atrial fibrillation, there were 298 males (53.4%) and 260 females (46.6%) aged from 21 to 97 years.The average age was (72.8 ±10.1) years.There were 57 cases aged 21-59 years(10.2 %)and 501 cases aged 60-97 years(89.8 %).The total number of inpatients in our hospital was 11 869, and there were 4049 cases aged90 years.The proportions of the inpatients with atrial fibrillation in the above five age groups

  18. Anticoagulation in atrial fibrillation

    OpenAIRE

    Steinberg, Benjamin A; Piccini, Jonathan P.

    2014-01-01

    Atrial fibrillation increases the risk of stroke, which is a leading cause of death and disability worldwide. The use of oral anticoagulation in patients with atrial fibrillation at moderate or high risk of stroke, estimated by established criteria, improves outcomes. However, to ensure that the benefits exceed the risks of bleeding, appropriate patient selection is essential. Vitamin K antagonism has been the mainstay of treatment; however, newer drugs with novel mechanisms are also availabl...

  19. Atrial fibrillation and the 4P medicine

    Directory of Open Access Journals (Sweden)

    Federica Censi

    2013-09-01

    Full Text Available Although the paradigm of the 4P medicine - Predictive, Personalized, Preemptive, and Participatory - has been suggested several years ago, its application to atrial fibrillation is still far away. Given the increasing prevalence and incidence of this pathology it is the time to promote preventive strategies, by identifying the risk factors associated to life style and by incentivizing innovative diagnostic technologies. The promotion of the correct life style and of the use of diagnostic devices based on innovative and reliable technologies, represent a first step towards the full realization of the revolution of 4P medicine in atrial fibrillation.

  20. Prevention of Recurrent Atrial Fibrillation and Bi-Atrial Resynchronization

    OpenAIRE

    Evrard, P.; Sakalihasan, Natzi; R. Garcia; Van Laere, Anne-Sophie; Patterson, B.

    1999-01-01

    After conversion of atrial fibrillation, it is important to maintain sinus rhythm. In addition antiarrhythmic drugs, biatrial resynchronization seems to prevent recurrences of atrial fibrillation in patients with interatrial conduction block: local experience.

  1. Atrial Fibrosis and the Mechanisms of Atrial Fibrillation

    OpenAIRE

    Everett, Thomas H; Olgin, Jeffrey E.

    2006-01-01

    Atrial fibrillation (AF) is commonly associated with congestive heart failure (CHF), and CHF has been shown to be associated with atrial structural remodeling resulting in fibrosis. This atrial interstitial fibrosis has been seen in patients with CHF and animal models of pacing induced heart failure. With atrial fibrosis, conduction abnormalities result in an increase in AF vulnerability. The mechanism of AF that is associated with CHF is still under debate as both focal and reentrant mechani...

  2. Spontaneous conversion of first onset atrial fibrillation

    DEFF Research Database (Denmark)

    Lindberg, Søren Østergaard; Hansen, Sidsel; Nielsen, Tonny

    2011-01-01

    Background  We studied all patients admitted to hospital with first onset atrial fibrillation (AF) to determine the probability of spontaneous conversion to sinus rhythm and to identify factors predictive of such a conversion. Methods and Results  We retrospectively reviewed charts of 438...

  3. Genetic aspects of lone atrial fibrillation

    DEFF Research Database (Denmark)

    Andreasen, Laura; Nielsen, Jonas B; Olesen, Morten S

    2015-01-01

    Atrial fibrillation (AF) is the most common cardiac arrhythmia. A subgroup of patients presents with AF without traditional risk factors and is diagnosed before the age of 60 years. Such patients are commonly referred as having "lone AF" and comprise 10-20% of all cases. A number of studies have...

  4. Bleeding Risk Assessment in Atrial Fibrillation

    DEFF Research Database (Denmark)

    Lip, Gregory Y H; Lane, Deirdre A

    2016-01-01

    Stroke prevention is central to the management of atrial fibrillation (AF), and effective thromboprophylaxis requires oral anticoagulation (OAC). Even a single stroke risk factor confers excess risk, and the net clinical benefit of treatment is positive for OAC compared to no treatment or aspirin...

  5. CHRONIC KIDNEY DISEASE AND CARDIOVASCULAR DISEASES: FOCUS ON ATRIAL FIBRILLATION

    OpenAIRE

    V N Shishkova

    2015-01-01

    The question of mutual influence of risk factors for cardiovascular and renal diseases with a focus on atrial fibrillation is considered. Modern approaches to the prevention of major macrovascular events in patients with comorbidity are evaluated.

  6. CHRONIC KIDNEY DISEASE AND CARDIOVASCULAR DISEASES: FOCUS ON ATRIAL FIBRILLATION

    Directory of Open Access Journals (Sweden)

    V. N. Shishkova

    2015-09-01

    Full Text Available The question of mutual influence of risk factors for cardiovascular and renal diseases with a focus on atrial fibrillation is considered. Modern approaches to the prevention of major macrovascular events in patients with comorbidity are evaluated.

  7. Can Atrial Fibrillation Be Prevented?

    Science.gov (United States)

    ... page from the NHLBI on Twitter. How Can Atrial Fibrillation Be Prevented? Following a healthy lifestyle and taking ... risk for heart disease may help you prevent atrial fibrillation (AF). These steps include: Following a heart healthy ...

  8. Atrial remodeling, fibrosis, and atrial fibrillation.

    Science.gov (United States)

    Jalife, José; Kaur, Kuljeet

    2015-08-01

    The fundamental mechanisms governing the perpetuation of atrial fibrillation (AF), the most common arrhythmia seen in clinical practice, are poorly understood, which explains in part why AF prevention and treatment remain suboptimal. Although some clinical parameters have been identified as predicting a transition from paroxysmal to persistent AF in some patients, the molecular, electrophysiological, and inflammation changes leading to such a progression have not been described in detail. Oxidative stress, atrial dilatation, calcium overload, inflammation, microRNAs, and myofibroblast activation are all thought to be involved in AF-induced atrial remodeling. However, it is unknown to what extent and at which time points such alterations influence the remodeling process that perpetuates AF. Here we postulate a working model that might open new pathways for future investigation into mechanisms of AF perpetuation. We start from the premise that the progression to AF perpetuation is the result of interplay among manifold signaling pathways with differing kinetics. Some such pathways have relatively fast kinetics (e.g., oxidative stress-mediated shortening of refractory period); others likely depend on molecular processes with slower kinetics (e.g., transcriptional changes in myocyte ion channel protein expression mediated through inflammation and fibroblast activation). We stress the need to fully understand the relationships among such pathways should one hope to identify novel, truly effective targets for AF therapy and prevention. PMID:25661032

  9. Electrophysiological Mechanisms of Atrial Flutter

    OpenAIRE

    2006-01-01

    Atrial flutter (AFL) is a common arrhythmia in clinical practice. Several experimental models such as tricuspid regurgitation model, tricuspid ring model, sterile pericarditis model and atrial crush injury model have provided important information about reentrant circuit and can test the effect of antiarrhythmic drugs. Human atrial flutter has typical and atypical forms. Typical atrial flutter rotates around tricuspid annulus and uses the crista terminalis and sometimes sinus venosa as the ...

  10. Exercise-induced changes in atrial peptides in relation to neuroendocrine responses and fluid balance in the horse.

    Science.gov (United States)

    Kokkonen, U M; Pösö, A R; Hyyppä, S; Huttunen, P; Leppäluoto, J

    2002-04-01

    Previous data show that, in horses, plasma atrial natriuretic peptides (ANP and NT-ANP) remain elevated for a long time after exercise. To study whether exercise-induced changes in hormonal and fluid balance explain this, we measured plasma concentrations of COOH- and NH2-terminal atrial natriuretic peptides (ANP(99-129) and NT-ANP(1-98) together with arginine vasopressin (AVP), adrenocorticotrophin (ACTH), beta-endorphin, cortisol, catecholamines, and indicators of fluid balance in six Finnhorses after a graded submaximal exercise test on a treadmill. After exercise, AVP and catecholamines diminished rapidly; atrial peptides, ACTH, beta-endorphin, and cortisol remained elevated longer. ANP reached its peak value at 5 min and NT-ANP at 30 min post-exercise. At 60 min, ANP was still significantly increased and NT-ANP even above its level at the end of exercise. The different temporal patterns of ANP and NT-ANP are most probably explained by differences in their plasma half-lives. The post-exercise increase in NT-ANP indicates that the release of atrial peptides is stimulated during recovery after exercise. The rapid decrease in AVP and catecholamines suggests that these hormones do not explain the long-lasting increase in atrial peptides. Cortisol remained elevated longer and it may have contributed to some extent. After exercise, the packed cell volume (PCV) decreased more slowly than plasma total protein and electrolytes, which refers to a slow post-exercise return in blood volume. Taken together, the present results show that the long-lasting post-exercise increase in plasma atrial peptides in horses is most probably explained by elevated central blood volume and that the role of vasoactive hormones is small. PMID:12019955

  11. Effectiveness of human atrial natriuretic peptide in patients with chronic kidney disease without dialysis undergoing coronary artery bypass grafting%人心房钠尿肽在患慢性肾病未经透析的患者冠状动脉移植术中的有效性

    Institute of Scientific and Technical Information of China (English)

    Isamu Yoshitake

    2010-01-01

    @@ Chronic kidney disease(CKD)is most important risk factors for cardiac surgery.In this study,the subjects were patients undergoing coronary artery bypass grafting(CABG)with CKD.Not only the early postoperative results but also the renal function including long-term prognosis were examined.

  12. Stroke prevention in atrial fibrillation.

    NARCIS (Netherlands)

    Verheugt, F.W.A.

    2006-01-01

    The only major and potentially fatal risk for patients with atrial fibrillation is the development of systemic thromboembolism. Stroke occurs five times more frequently in patients with atrial fibrillation than in comparable patients in sinus rhythm. The yearly incidence of stroke in atrial fibrilla

  13. Atrial Fibrillation (AF or AFib)

    Science.gov (United States)

    ... Pressure High Blood Pressure Tools & Resources Stroke More Atrial Fibrillation (AF or AFib) Updated:Feb 10,2016 What ... to the Terms and Conditions and Privacy Policy Atrial Fibrillation • Introduction • What is Atrial Fibrillation? • Why AFib Matters • ...

  14. Left atrial appendage occlusion

    Directory of Open Access Journals (Sweden)

    Ahmad Mirdamadi

    2013-01-01

    Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

  15. Natriuretic peptides stimulate the cardiac sodium pump via NPR-C-coupled NOS activation.

    Science.gov (United States)

    William, M; Hamilton, E J; Garcia, A; Bundgaard, H; Chia, K K M; Figtree, G A; Rasmussen, H H

    2008-04-01

    Natriuretic peptides (NPs) and their receptors (NPRs) are expressed in the heart, but their effects on myocyte function are poorly understood. Because NPRs are coupled to synthesis of cGMP, an activator of the sarcolemmal Na(+)-K(+) pump, we examined whether atrial natriuretic peptide (ANP) regulates the pump. We voltage clamped rabbit ventricular myocytes and identified electrogenic Na(+)-K(+) pump current (arising from the 3:2 Na(+):K(+) exchange and normalized for membrane capacitance) as the shift in membrane current induced by 100 micromol/l ouabain. Ten nanomoles per liter ANP stimulated the Na(+)-K(+) pump when the intracellular compartment was perfused with pipette solutions containing 10 mmol/l Na(+) but had no effect when the pump was at near maximal activation with 80 mmol/l Na(+) in the pipette solution. Stimulation was abolished by inhibition of cGMP-activated protein kinase with KT-5823, nitric oxide (NO)-activated guanylyl cyclase with 1H-[1,2,4]oxadiazole[4,3-a]quinoxalin-1-one (ODQ), or NO synthase with N(G)-nitro-L-arginine methyl ester (L-NAME). Since synthesis of cGMP by NPR-A and NPR-B is not NO dependent or ODQ sensitive, we exposed myocytes to AP-811, a highly selective ligand for the NPR-C "clearance" receptor. It abolished ANP-induced pump stimulation. Conversely, the selective NPR-C agonist ANP(4-23) reproduced stimulation. The stimulation was blocked by l-NAME. To examine NO production in response to ANP(4-23), we loaded myocytes with the NO-sensitive fluorescent dye diacetylated diaminofluorescein-2 and examined them by confocal microscopy. ANP(4-23) induced a significant increase in fluorescence, which was abolished by L-NAME. We conclude that NPs stimulate the Na(+)-K(+) pump via an NPR-C and NO-dependent pathway. PMID:18272821

  16. Women Sex Importance in Stroke Patients with Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Cemile Handan Mısırlı

    2014-08-01

    Full Text Available OBJECTIVE: It was shown the differences in age, risk factors and treatment between women and men in stroke patients with atrial fibrillation METHODS: The stroke patients with atrial fibrillation who were hospitalized in our department at the last 2 years were seperated into 2 groups of aged above 75 and below 75, investigated with CHADS2 and CHA2DS2VASc scores and looked at the sex differences of women and men. RESULTS: Stroke ratio according to sex was statistically meaningful especially in women above the age of 75. Risc factors also were founded in elderly women and CHA2DS2VASc scores were higher in women than men so more anticoagulan treatment were begun. No differences were shown between sexes at lone atrial fibrillation and no treatment were begun. CONCLUSION: Women with atrial fibrillation had more risk factors, higher stroke rate and higher anticoagulation treatment.

  17. Effects of radiofrequency catheter ablation of atrial fibrillation on soluble P-selectin, von Willebrand factor and IL-6 in the peripheral and cardiac circulation.

    Directory of Open Access Journals (Sweden)

    Jelena Kornej

    Full Text Available BACKGROUND: Catheter ablation (CA of atrial fibrillation (AF is associated with inflammatory response, endothelial damage and with increased risk of thrombosis. However, whether these processes differ in peripheral and cardiac circulation is unknown. METHODS: Plasma markers (von Willebrand factor (vWf, soluble P-selectin (sPsel and interleukin-6 (IL-6 were measured by ELISA at three time points in 80 patients (62±10 years, 63% males, 41% paroxysmal AF undergoing CA. These were at baseline--from femoral vein (FV and left atrium (LA before ablation; directly after ablation--from the pulmonary vein (PV, LA and FV; and 24 hours after procedure--from a cubital vein (CV. RESULTS: The levels of vWF and IL6--but not sP-sel--increased significantly 24 h after procedure (p<0.001. Baseline vWF was significantly associated with persistent AF (Beta = .303, p = 0.006 and Beta = .300, p = 0.006 for peripheral and cardiac levels, respectively, while persistent AF (Beta = .250, p = 0.031 and LAA flow pattern (Beta = .386, p<0.001 remained associated with vWF in cardiac blood after ablation. Advanced age was significantly associated with IL6 levels at baseline and after ablation in peripheral and cardiac blood. There were no clinical, procedural or anti-coagulation characteristics associated with sP-sel levels in cardiac blood, while peripheral sP-sel levels were associated with hypertension before (Beta = -.307, p = 0.007 and with persistent AF after ablation (Beta = -.262, p = 0.020. CONCLUSIONS: vWF levels are higher in persistent AF and are associated with LAA rheological pattern after AF ablation. Increase of peripheral vWF and IL6 levels after procedure supports current AF ablation management with careful control of post-procedural anticoagulation to avoid ablation-related thromboembolism.

  18. Urodilatin, a natriuretic peptide with clinical implications.

    Science.gov (United States)

    Meyer, M; Richter, R; Forssmann, W G

    1998-02-21

    Natriuretic peptides (NP) constitute hormonal systems of great clinical impact. This report deals with Urodilatin (URO), a renal natriuretic peptide type A. From the gene of NP type A, a message for the preprohormone is transcribed in heart and kidney. The cardiac prohormone CDD/ANP-1-126 is synthesized in the heart atrium and processed during exocytosis forming the circulating hormone CDD/ANP-99-126. URO (CDD/ANP 95-126) is a product from the same gene, but differentially processed in the kidney and detected only in urine. Physiologically, URO acts in a paracrine fashion. After release from distal tubular kidney cells into the tubular lumen, URO binds to luminal receptors (NPR-A) in the collecting duct resulting in a cGMP-dependent signal transduction. cGMP generation is followed by an interaction with the amiloriode-sensitive sodium channel which induces diuresis and natriuresis. In this way, URO physiologically regulates fluid balance and sodium homeostasis. Moreover, URO excretion and natriuresis are in turn dependent on several physiological states, such as directly by sodium homeostasis. Pharmacologically, URO at low dose administered intravenously shows a strong diuretic and natriuretic effect and a low hypotensive effect. Renal, pulmonary, and cardiovascular effects evoked by pharmacological doses indicate that URO is a putative drug for several related diseases. Clinical trials show promising results for various clinical indications. However, the reduction in hemodialysis/hemofiltration in patients suffering from ARF following heart and liver transplantation, derived from preliminary trials recruiting a small number of patients, was not confirmed by a multicenter phase II study. In contrast, data for the prophylactic use of URO in this clinical setting suggest a better outcome for the patients. Furthermore, treatment of asthmatic patients showed a convincingly beneficial effect of URO on pulmonary function. Patients with congestive heart failure may also

  19. 心房颤动影响因素的非匹配病例对照研究%A non-matching case-control study of influence factors for atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    周鑫; 李修德; 李享; 王程成; 仝菲; 张秀军

    2015-01-01

    Objective To investigate the influence factors of atrial fibrillation to provide a scientific basis for the government to make the intervention measures.Methods The patients of atrial fibrillation who had complete information and were hospitalized in department of cardiology of Lu'an People's Hospital from January to May,2014 were viewed as case group.The other patients who did not have atrial fibrilla-tion and were hospitalized in department of cardiology in the same period were randomly selected as the control group.The non-matching case-control study and unconditioned multivariate logistic regression were used to analyze the relative factors of atrial fibrillation.Results A total of 556 participants (number of case group and control group was 278,278,respectively) were included in this analysis.The elder age (OR=1.037,95%CI:1.022~1.052),hypertension (OR=2.395,95%CI:1.361~4.214),diabetes (OR=2.374,95%CI:1.301~4.333),cor-onary heart disease (OR=2.620,95%CI:1.480~4.638),heart disease (OR=3.468,95%CI:1.834 ~6.560),heart failure (OR=3.050,95%CI:1.741 ~5.345),increased uric acid (OR=1.011,95%CI:1.005 ~1.016),and increased left atrial diameter (OR=1.201,95%CI:1.130~1.276) were risk factors for atrial fibrillation;women (OR=0.518,95%CI:0.321~0.837),an increased level of left ventricular ejection fraction (OR=0.097,95%CI:0.021~0.449),triglycerides (OR=0.418,95%CI:0.252~0.693),high density lipoprotein ( OR=0.381,95%CI:0.213~0.683) and low density lipoprotein ( OR=0.230,95%CI:0.127~0.417) were the protective factors for atrial fibrillation.Conclusion Many factors can affect the atrial fibrillation,therefore,relevant departments should make compre-hensive intervention measures for atrial fibrillation.%目的:分析心房颤动患者的影响因素,为制定相关干预措施提供科学依据。方法选取住院治疗资料完整的心房颤动患者作为病例组,并随机从同时期在心内科接受治疗的其他非心房颤动患者中选取同等数量作为

  20. Evaluating the Usability and Perceived Impact of an Electronic Medical Record Toolkit for Atrial Fibrillation Management in Primary Care: A Mixed-Methods Study Incorporating Human Factors Design

    OpenAIRE

    Tran, Kim; Leblanc, Kori; Valentinis, Alissia; Kavanagh, Doug; Zahr, Nina; Ivers, Noah M

    2016-01-01

    Background Atrial fibrillation (AF) is a common and preventable cause of stroke. Barriers to reducing stroke risk through appropriate prescribing have been identified at the system, provider, and patient levels. To ensure a multifaceted initiative to address these barriers is effective, it is essential to incorporate user-centered design to ensure all intervention components are optimized for users. Objective To test the usability of an electronic medical record (EMR) toolkit for AF in primar...

  1. Integrin β1 Participates in Atrial Remodeling in Rapid Atrial Pacing Induced Canine Atrial Fibrillation Model

    Institute of Scientific and Technical Information of China (English)

    Zhang wei; Yang guirong; Zheng zhaotong; Wang sujia; Zhang yun

    2004-01-01

    @@ Objective Integrin β1 regulates cell to cell and cell to extracellualr matrix interaction in heart. however, its pathop hysiological role in atrial fibrillation is unclear. The purpose of t his study was to determine whether atrial structural remodeling during atrial fibrillation is associated with altered integrinβ1.

  2. Pulmonary edema following transcatheter closure of atrial septal defect

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati

    2015-01-01

    Full Text Available We describe an incident of development of acute pulmonary edema after the device closure of a secundum atrial septal defect in a 52-year-old lady, which was treated with inotropes, diuretics and artificial ventilation. Possibility of acute left ventricular dysfunction should be considered after the defect closure in the middle-aged patients as the left ventricular compliance may be reduced due to increased elastic stiffness and diastolic dysfunction. Baseline left atrial pressure may be > 10 mmHg in these patients. Associated risk factors for the left ventricular dysfunction are a large Qp:Qs ratio, systemic hypertension, severe pulmonary hypertension and paroxysmal atrial fibrillation.

  3. B-type natriuretic peptide secretion following scuba diving

    DEFF Research Database (Denmark)

    Passino, Claudio; Franzino, Enrico; Giannoni, Alberto;

    2011-01-01

    To examine the neurohormonal effects of a scuba dive, focusing on the acute changes in the plasma concentrations of the different peptide fragments from the B-type natriuretic peptide (BNP) precursor.......To examine the neurohormonal effects of a scuba dive, focusing on the acute changes in the plasma concentrations of the different peptide fragments from the B-type natriuretic peptide (BNP) precursor....

  4. Exploiting periodicity to extract the atrial activity in atrial arrhythmias

    Science.gov (United States)

    Llinares, Raul; Igual, Jorge

    2011-12-01

    Atrial fibrillation disorders are one of the main arrhythmias of the elderly. The atrial and ventricular activities are decoupled during an atrial fibrillation episode, and very rapid and irregular waves replace the usual atrial P-wave in a normal sinus rhythm electrocardiogram (ECG). The estimation of these wavelets is a must for clinical analysis. We propose a new approach to this problem focused on the quasiperiodicity of these wavelets. Atrial activity is characterized by a main atrial rhythm in the interval 3-12 Hz. It enables us to establish the problem as the separation of the original sources from the instantaneous linear combination of them recorded in the ECG or the extraction of only the atrial component exploiting the quasiperiodic feature of the atrial signal. This methodology implies the previous estimation of such main atrial period. We present two algorithms that separate and extract the atrial rhythm starting from a prior estimation of the main atrial frequency. The first one is an algebraic method based on the maximization of a cost function that measures the periodicity. The other one is an adaptive algorithm that exploits the decorrelation of the atrial and other signals diagonalizing the correlation matrices at multiple lags of the period of atrial activity. The algorithms are applied successfully to synthetic and real data. In simulated ECGs, the average correlation index obtained was 0.811 and 0.847, respectively. In real ECGs, the accuracy of the results was validated using spectral and temporal parameters. The average peak frequency and spectral concentration obtained were 5.550 and 5.554 Hz and 56.3 and 54.4%, respectively, and the kurtosis was 0.266 and 0.695. For validation purposes, we compared the proposed algorithms with established methods, obtaining better results for simulated and real registers.

  5. Management of Atrial Fibrillation in Patients with Heart Failure

    OpenAIRE

    Dr. Andrew E. Darby

    2014-01-01

    Atrial fibrillation (AF) and heart failure (HF) are common conditions that frequently coexist. Both conditions share risk factors, are associated with increased morbidity and mortality, and may worsen the other. The presence of heart failure and symptoms associated with it may influence both the approach to management (i.e., rate versus rhythm control) and the treatment options available for AF patients. The presence of HF increases the stroke risk with atrial fibrillation, and thromboembo...

  6. Stroke Prevention in Atrial Fibrillation: Concepts and Controversies

    OpenAIRE

    Ahmad, Yousif; Lip, Gregory YH

    2012-01-01

    Atrial fibrillation (AF) is the commonest cardiac rhythm disorder worldwide, affecting 1% of the general population. It is estimated that up to 16 million people in the US will suffer from the arrhythmia by 2050. AF is an independent stroke risk factor and associated with more severe strokes. For six decades, warfarin has been the only truly effective therapy to protect against stroke for patients with atrial fibrillation. Despite the proven worth of warfarin, its limitations have seen reluct...

  7. What Is Atrial Fibrillation?

    Science.gov (United States)

    ... regular beat. Certain cells in your heart make electric signals that cause the heart to contract and pump blood. These electrical signals show up on an elec- trocardiogram (ECG) recording. Your doctor can read your ECG to find out if the electric signals are normal. In atrial fibrillation (AFib), the ...

  8. Lesson Five Atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    鲁端; 吴文烈

    2003-01-01

    @@ Atrial fibrillation(AF) may occur in paroxysmaland persistent forms. It may be seen in normal subjects,particularly during emotional stress or follow-ing surgery,exercise, or acute alcoholic intoxication.It also may occur in patients with heart or lungdisease who develop acute hypoxia, hypercapnia,ormetabolic or hemodynamic derangements.

  9. Atrial Arrhythmias in Astronauts - Summary of a NASA Summit

    Science.gov (United States)

    Barr, Yael R.; Watkins, Sharmila D.; Polk, J. D.

    2010-01-01

    Background and Problem Definition: To evaluate NASA s current standards and practices related to atrial arrhythmias in astronauts, Space Medicine s Advanced Projects Section at the Johnson Space Center was tasked with organizing a summit to discuss the approach to atrial arrhythmias in the astronaut cohort. Since 1959, 11 cases of atrial fibrillation, atrial flutter, or supraventricular tachycardia have been recorded among active corps crewmembers. Most of the cases were paroxysmal, although a few were sustained. While most of the affected crewmembers were asymptomatic, those slated for long-duration space flight underwent radiofrequency ablation treatment to prevent further episodes of the arrhythmia. The summit was convened to solicit expert opinion on screening, diagnosis, and treatment options, to identify gaps in knowledge, and to propose relevant research initiatives. Summit Meeting Objectives: The Atrial Arrhythmia Summit brought together a panel of six cardiologists, including nationally and internationally renowned leaders in cardiac electrophysiology, exercise physiology, and space flight cardiovascular physiology. The primary objectives of the summit discussions were to evaluate cases of atrial arrhythmia in the astronaut population, to understand the factors that may predispose an individual to this condition, to understand NASA s current capabilities for screening, diagnosis, and treatment, to discuss the risks associated with treatment of crewmembers assigned to long-duration missions or extravehicular activities, and to discuss recommendations for prevention or management of future cases. Summary of Recommendations: The summit panel s recommendations were grouped into seven categories: Epidemiology, Screening, Standards and Selection, Treatment of Atrial Fibrillation Manifesting Preflight, Atrial Fibrillation during Flight, Prevention of Atrial Fibrillation, and Future Research

  10. Association between familial atrial fibrillation and risk of new-onset atrial fibrillation

    NARCIS (Netherlands)

    Lubitz, Steven A.; Yin, Xiaoyan; Fontes, Joao D.; Magnani, Jared W.; Rienstra, Michel; Pai, Manju; Villalon, Mark L.; Vasan, Ramachandran S.; Pencina, Michael J.; Levy, Daniel; Larson, Martin G.; Ellinor, Patrick T.; Benjamin, Emelia J.

    2010-01-01

    CONTEXT: Although the heritability of atrial fibrillation (AF) is established, the contribution of familial AF to predicting new-onset AF remains unknown. OBJECTIVE: To determine whether familial occurrence of AF is associated with new-onset AF beyond established risk factors. DESIGN, SETTING, AND P

  11. Leptin modulates electrophysiological characteristics and isoproterenol-induced arrhythmogenesis in atrial myocytes

    OpenAIRE

    Lin, Yung-Kuo; Chen, Yao-Chang; Huang, Jen-Hung; Lin, Yenn-Jiang; Huang, Shiang-Suo; Chen, Shih-Ann; Chen, Yi-Jen

    2013-01-01

    Background Obesity is an important risk factor for atrial fibrillation (AF). Leptin is an important adipokine. However, it is not clear whether leptin directly modulates the electrophysiological characteristics of atrial myocytes. Results Whole cell patch clamp and indo-1 fluorescence were used to record the action potentials (APs) and ionic currents in isolated rabbit left atrial (LA) myocytes incubated with and without (control) leptin (100 nM) for 1 h to investigate the role of leptin on a...

  12. C-Type Natriuretic Peptide Analog as Therapy for Achondroplasia.

    Science.gov (United States)

    Legeai-Mallet, Laurence

    2016-01-01

    Fibroblast growth factor receptor 3 (FGFR3) is an important regulator of bone formation. Gain-of-function mutations in the FGFR3 gene result in chondrodysplasias which include achondroplasia (ACH), the most common form of dwarfism, in which skull, appendicular and axial skeletons are affected. The skeletal phenotype of patients with ACH showed defective proliferation and differentiation of the chondrocytes in the growth plate cartilage. Both endochondral and membranous ossification processes are disrupted during development. At cellular level, Fgfr3 mutations induce increased phosphorylation of the tyrosine kinase receptor FGFR3, which correlate with an enhanced activation of its downstream signaling pathways. Potential therapeutic strategies have emerged for ACH. Several preclinical studies have been conducted such as the C-type natriuretic peptide (CNP) analog (BMN111), intermittent parathyroid hormone injections, soluble FGFR3 therapy, and meclozine and statin treatments. Among the putative targets to antagonize FGFR3 signaling, CNP (or BMN111) is one of the most promising strategies. BMN111 acts as a key regulator of longitudinal bone growth by downregulating the mitogen-activated protein kinase pathway, which is activated as a result of a FGFR3 gain-of-function mutation. Preclinical studies showed that BMN111 treatment led to a large improvement in skeletal parameters in Fgfr3Y367C/+ mice mimicking ACH. In 2014, a clinical trial (phase 2) of BMN111 in pediatric patients with ACH has started. This first clinical trial marks the first big step towards real treatment for these patients. PMID:26684019

  13. Distribution and elimination of intravenously administered atrial natriuretic hormone(ANH) to normal and nephrectomized rats

    International Nuclear Information System (INIS)

    The 24 amino acid peptide, ANH(5-28), was N-terminally labeled with I-125 Bolton-Hunter reagent, iodo-N-succinimidyl 3-(4-hydroxyphenyl)propionate. The I-125 peptide plus 1μg/kg of the I-127 Bolton-Hunter peptide was injected into normal and nephrectomized anesthetized (Nembutal) rats. Blood samples were drawn into a cocktail developed to inhibit plasma induced degradation. Radiolabeled peptides were analyzed by HPLC. A biphasic curve of I-125 ANH(5-28) elimination was obtained, the first phase (t 1/2 = 15 sec) representing in vivo distribution and the second phase (t 1/2 = 7-10 min) a measurement of elimination. This biphasic elimination curve was similar in normal and nephrectomized rats. The apparent volumes of distribution were 15-20 ml for the first phase and > 300 ml for the second phase. In order to examine the tissue distribution of the peptide, animals were sacrificed at 2 minutes and the I-125 tissue contents were quantitated. The majority of the label was located in the liver (50%), kidneys (21%) and the lung (5%). The degradative peptides appearing in the plasma and urine of normal rats were identical. No intact radiolabeled ANH(5-28) was found in the urine. In conclusion, iodinated Bolton-Hunter labeled ANH(5-28) is rapidly removed from the circulation by the liver and to a lesser extent by the kidney, but the rate of elimination is not decreased by nephrectomy

  14. Atrial natriuretic peptide (ANP) increases urinary albumin excretion (UAE) in intact and uninephrectomized (UNX) rats

    International Nuclear Information System (INIS)

    Previous experimental observations have suggested that ANP increases the transcapillary shift of water and albumin. The present studies were conducted in anesthetized euvolemic rats 6 weeks after UNX or sham operation. The effect of iv infusion of 103-126 hANP was assessed on GFR and ERPF (99Tc.DTPA and 131I-hippuran clearances), and UAE (nephelemetric method). ANP infusion was associated with no change in mean arterial pressure during the low dose (LD) and a 30 mm Hg decrease during the high dose (HD). ANP induced a dose-dependent and reversible increase in UNaV. Both proximal (as assessed by lithium excretion) and distal reabsorption of sodium were decreased by ANP. GFR was altered whereas ERPF decreased only during HD-AMP; filtration fraction (FF) dose-dependently increased in response to ANP. UAE increased dose-dependently and to a similar extent in both groups in response to ANP. The increase in UAE was readily reversible after discontinuation of ANP. There was a positive correlation between changes in UAE and changes in FF induced by ANP. These results indicate that ANP has a potent albuminuric effect. The simultaneous increase in UAE and FF, which could explain the effect of ANP on proximal tubular handling of sodium, may result from an ANP-induced rise in intraglomerular capillary pressure and/or an increase in glomerular permeability to albumin

  15. Chronic treatment with trimetazidine reduces the upregulation of atrial natriuretic peptide in heart failure

    Science.gov (United States)

    Trimetazidine (TMZ) is effective for the treatment of ischemic cardiomyopathy; however, little is known about the effect of TMZ in established injury-induced heart failure. When rats with established infarct-induced heart failure were treated for 12 weeks with TMZ there was no effect on left ventric...

  16. Truncated atrial natriuretic peptide (ANP) analogs: relationship between receptor binding and cyclic GMP accumulation

    International Nuclear Information System (INIS)

    The authors have shown that cultured bovine aortic smooth muscle (BASM) cells contain high affinity receptor sites for the ANP, auriculin (ANP(4-28)). Furthermore, ANP(4-28) causes cyclic GMP (cGMP) levels to increase in BASM. In the present study, the authors synthesized a series of NH2 and/or COOH truncated ANP(4-28) analogs and examined their ability to compete for 125I-ANP(4-28) binding to BASM and increase cGMP levels. ANP-mediated cGMP responses were reduced when amino acids were deleted from the NH2 and/or COOH termini of ANP(4-28). Removal of the NH2 terminal R, R-S, or R-S-S residues resulted in a 10X decrease in potency for cGMP stimulation. Deletion of the COOH terminal R-Y and F-R-Y residues resulted in a marked decline in potency. ANP's lacking the F-R-Y tripeptide were nearly inactive in stimulating cGMP accumulation. In contrast to the cGMP effects, NH2 and/or COOH truncations of ANP(4-28) did not alter apparent receptor binding affinities (Ki(app)). All of these peptide analogs exhibited Ki(app)'s of 1-5 nM. Furthermore, peptides that bound effectively and failed to elicit cGMP responses did not antagonize ANP(4-28)-mediated cGMP increases. These binding and functional data suggest the presence of a single class of ANP receptors on BASM is insufficient to explain the actions of ANP's in these cells

  17. Effect of atrial natriuretic peptide on lipolysis in the mouse heart

    DEFF Research Database (Denmark)

    Bartels, Emil Daniel; Bisgaard, Line Stattau; Christoffersen, Christina;

    2014-01-01

    (125 or 500 ng/kg/min) or saline to obese leptin-deficient (ob/ob) mice or lean control mice (ob/+) for a week. ANP (500 ng/kg/min) reduced blood pressure but did not affect the cardiac triglyceride stores or mRNA expression of NPR-A and NPR-C. Also, deficiency of NPR-A did not affect the cardiac...... triglyceride content. Finally, addition of ANP to the culture medium (10−7 mol/l) increased cellular cGMP content (P=0.009) but did not affect triglyceride stores in HL-1 cardiac myocyte cultures. Hence, ANP does not affect triglyceride stores in the murine heart....

  18. Atrial natriuretic peptide and renal adaptation to contralateral nephrectomy in healthy man

    DEFF Research Database (Denmark)

    Kamper, A L; Pedersen, E B; Strandgaard, S; Holstein-Rathlou, N H; Leyssac, P P; Skaarup, P; Hemmingsen, L; Holm, J; Munck, O

    1991-01-01

    adaptation to acute reduction in renal mass. Glomerular and tubular function was studied by measurements of the clearances of 51Cr-EDTA, lithium, sodium, potassium, and albumin. ANP was 7.4 +/- 3.1 pmol l-1 (mean +/- SD) before Nx and 8.7 +/- 6.1 pmol l-1 at 5 days after Nx and remained at this level through...... clearance had risen from 13 +/- 2 ml min-1 before Nx to 20 +/- 7 ml min-1 (p less than 0.01), and sodium and water balance was normal. To conclude, plasma ANP, AII, Aldo and AVP do not appear to be responsible for the hyperfiltration and depression of fractional proximal sodium and water reabsorption...... observed in recently uninephrectomized man with normal sodium and water balance....

  19. Effects of felodipine on atrial natriuretic peptide in hypertensive non-insulin dependent diabetes mellitus.

    OpenAIRE

    Jeffrey, R F; Capewell, S; Brown, J.; Collier, A.; Hajducka, C; Lee, M R

    1990-01-01

    Eighteen patients with non-insulin dependent diabetes mellitus and hypertension were treated during two 4 week periods with the calcium antagonist felodipine or placebo in a double-blind, randomised, cross-over study. Mean systemic blood pressure was significantly lower on felodipine, without producing a deleterious effect on diabetic control. Felodipine was associated with an increment in plasma renin concentration but plasma aldosterone and the renal outputs of sodium and dopamine were simi...

  20. Atrial natriuretic peptide and renal adaptation to contralateral nephrectomy in healthy man

    DEFF Research Database (Denmark)

    Kamper, A L; Pedersen, E B; Strandgaard, S;

    1991-01-01

    clearance had risen from 13 +/- 2 ml min-1 before Nx to 20 +/- 7 ml min-1 (p less than 0.01), and sodium and water balance was normal. To conclude, plasma ANP, AII, Aldo and AVP do not appear to be responsible for the hyperfiltration and depression of fractional proximal sodium and water reabsorption...

  1. Characterization of the functional domains of the natriuretic peptide receptor/guanylate cyclase by radiation inactivation

    International Nuclear Information System (INIS)

    Radiation inactivation has been used to evaluate the molecular size of domains responsible for atrial natriuretic peptide (ANP)-binding and cyclase functions of the ANP receptor/guanylate cyclase. Two types of inactivation curves were observed for cyclase function in both adrenal cortex and aortic smooth muscle cells: (1) biphasic with enhanced guanylate cyclase activity after exposure to low radiation doses and (2) linear after preincubation of membrane proteins with 0.5 microM ANP or solubilization with Triton X-100. The existence of an inhibitory component was the simplest model that best explained the types of radiation curves obtained. Activation of guanylate cyclase by ANP or Triton X-100 could occur via the dissociation of this inhibitory component from the catalytic domain. On the other hand, the loss of ANP-binding activity was linear with increasing radiation exposures under basal, ANP treatment, and Triton X-100 solubilization conditions. Radiation inactivation sizes of about 30 kDa for cyclase function, 20 kDa for ANP-binding function, and 90 kDa for inhibitory function were calculated. These studies suggest that the ANP receptor/guanylate cyclase behaves as a multidomain protein. The results obtained by radiation inactivation of the various biological functions of this receptor are compatible with the hypothesis of an intramolecular inhibitory domain repressing the guanylate cyclase catalytic domain within its membrane environment

  2. Management of atrial fibrillation

    OpenAIRE

    Vergara, Pasquale; Della Bella, Paolo

    1997-01-01

    Atrial fibrillation (AF) is associated with increases in the risk of mortality, congestive heart failure, and stroke. Medical treatment is aimed at preventing thrombo-embolic complications and reducing symptoms and consequences related to the arrhythmia. In the first section of this review, we discuss the principles of mainstream oral anticoagulant therapy and the possible advantages of the new oral anticoagulants. In the second section, we review the catheter ablation approaches to paroxysma...

  3. Right atrial lipoma

    Directory of Open Access Journals (Sweden)

    Pêgo-Fernandes Paulo M.

    2003-01-01

    Full Text Available Benign cardiac tumors are rare, and lipomas are among those less frequently found. We report the case of a 48-year-old male complaining of high blood pressure and epistaxis in the last 2 months, with a diagnosis of right atrial lipoma established on echocardiography, magnetic resonance imaging, and anatomicopathological examination. The tumor was successfully removed, and up to 42 months after surgical excision, no evidence of tumor relapse was observed.

  4. Anticoagulation in Atrial Fibrillation

    OpenAIRE

    Ahmad, Yousif; YH Lip, Gregory

    2012-01-01

    Patients with atrial fibrillation (AF) are at increased thromboembolic risk, and they suffer more severe strokes with worse outcomes. Most thromboembolic complications of AF are eminently preventable with oral anticoagulation, and the increasing numbers of AF patients mean antithrombotic therapy is the most crucial management aspect of this common arrhythmia. Despite the proven efficacy of warfarin, a string of limitations have meant that it is underused by physicians and patients alike. This...

  5. Rivaroxaban in atrial fibrillation

    OpenAIRE

    Giorgi MA; Miguel LS

    2012-01-01

    Mariano A Giorgi,1,2 Lucas San Miguel31Cardiology Service, Centro de Educación Médica e Investigaciones Clínicas “Norberto Quirno”, 2Department of Pharmacology, School of Medicine, Universidad Austral, 3Department of Cardiology and Cardiovascular Surgery, FLENI, Buenos Aires, ArgentinaAbstract: Warfarin is the traditional therapeutic option available to manage thromboembolic risk in atrial fibrillation. The hemorrhagic risk with warfarin de...

  6. Evaluation of Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Francis E. Marchlinski

    2008-05-01

    Full Text Available Atrial fibrillation (AF is a supraventricular tachyarrhythmia characterized by uncoordinated atrial activation. On the ECG fibrillatory (f waves (rapid oscillations with variable amplitude, shape and timing replace normal P waves. Ventricular response becomes irregular and rapid depending of the intrinsic electrophysiological properties of the AV node1 and the balance between vagal and sympathetic tone1. The presence of an irregularly pulse is a clinical sign that can be quickly and reliably identified in any healthcare situation and, indicates AF with a high sensitivity and specificity (95% and 75%, respectively. If the irregularity last for more than 20 seconds the specificity reaches 98% 2-4. Identification of AF can be done by using manual pulse palpation in those presenting with a variety of symptoms. It is desirable to check the blood pressure and pulse in all patients who present with breathlessness, dyspnea, palpitations, syncope, dizziness or chest discomfort. Furthermore, many patients presenting with an acute stroke are found to be in AF albeit asymptomatic with respect to non-neurologic complaints. The finding of a sustained irregular wide QRS complex tachycardia may be suspicious of AF conducted with bundle brunch aberrancy or over an accessory pathway, and in patients with A-V sequential pacemakers can reflect an inadequate configuration with ventricular tracking of sensed atrial activity.

  7. Left atrial appendage occlusion for stroke prevention in atrial fibrillation

    DEFF Research Database (Denmark)

    Tzikas, Apostolos; Shakir, Samera; Gafoor, Sameer;

    2015-01-01

    Aims: To investigate the safety, feasibility, and efficacy of left atrial appendage occlusion (LAAO) with the AMPLATZER Cardiac Plug (ACP) for stroke prevention in patients with atrial fibrillation (AF). Methods and results: Data from consecutive patients treated in 22 centres were collected. A...

  8. The Natriuretic Mechanism of γ-Melanocyte-Stimulating Hormone

    OpenAIRE

    Kathpalia, Paru P.; Charlton, Carol; Rajagopal, Madhumitha; Pao, Alan C.

    2011-01-01

    γ-Melanocyte Stimulating Hormone (γ-MSH) regulates sodium (Na+) balance and blood pressure through activation of the melanocortin receptor 3 (MC3-R). The mechanism of the natriuretic effect is proposed to involve binding of MC3-R either in the kidney to directly inhibit tubular Na+ transport or in the brain to inhibit central neural pathways that control renal tubular Na+ absorption. This study aimed to clarify the mechanism involved in the natriuretic effect of γ-MSH on MC3-R in kidney cells...

  9. Persistent atrial fibrillation in a goat model of chronic left atrial overload.

    NARCIS (Netherlands)

    Remes, J.; Brakel, T.J. van; Bolotin, G.; Garber, C.; Jong, MM de; Veen, FH van der; Maessen, J.G.

    2008-01-01

    OBJECTIVES: Atrial dilatation predisposes to atrial fibrillation. Although several animal models focus on the initiating mechanisms of atrial fibrillation in dilated atria, a model of left atrial overload resulting in persistent atrial fibrillation in nonanesthetized animals has not been presented t

  10. Effects of trimetazidine on atrial structural remodeling and platelet activation in dogs with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    HAN Wei; LI Wei-min; ZHOU Hong-yan; HUO Hong; WEI Na; DONG Guo; CAO Yong; ZHOU Guo; YANG Shu-sen

    2009-01-01

    @@ Atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. AF results in electrophysiological alterations which involve increased atrial effective refractory period and atrial effective refractory period dispersion, reduced rate adaptation of atrial effective refractory period, and slowed atrial conduction.

  11. Methods for the development and assessment of atrial fibrillation and heart failure dog models

    Institute of Scientific and Technical Information of China (English)

    Jon F Urban; Renee L Gerhart; Jason R Krzeszak; Corey R Leet; Linnea R Lentz; Carolyn B McClay

    2011-01-01

    Objective To report Medtronic experiences with the development of animal models for atrial fibrillation(AF)and chronic heart failure(CHF)using high-rate pacing for AF and microemboli for CHF.Methods For the AF model,an atrial lead was attached to a Medtronic Synergy neurostimulator,which was programmed to stimulate at 50 Hz in an on-off duty cycle.Atrial natnuretic peptide(ANP),brain natriuretic peptide(BNP)and N-terminal pro brain natriuretic peptide(NT-proBNP)wen; assayed at select time points.For CHF model,a serial injection of 90 μm polystyrene microspheres at 62,400 beads/mL(Polybead,Polysciences,Inc.)was performed to induce global ischemia,either with weekly monitoring and embolization schedule(group 1,n = 25)or with biweekly monitoring and emboliation schedule (group 2,n=36).Echocardiograms were used along with ventriculograms and magnetic resonance imaging scans weekly to assess cardiac function and ANP,BNP and NT-proBNP were monitored.Results For the AF model,the days to sustained AF for four animals following surgery were 7,25,21 and 19,respectively; For the CHF model,the days to meet CHF endpoints were 116 in group 1 and 89 in group 2.For both AF and CHF models,NT-proBNP correlated well with the development of disease states.Conclusion Our experience for the development and assessment of AF and CHF dog models may help researchers who are in search for animal model for assessing the safety and efficacy of a device-based therapy.

  12. Sinus Node and Atrial Arrhythmias.

    Science.gov (United States)

    John, Roy M; Kumar, Saurabh

    2016-05-10

    Although sinus node dysfunction (SND) and atrial arrhythmias frequently coexist and interact, the putative mechanism linking the 2 remain unclear. Although SND is accompanied by atrial myocardial structural changes in the right atrium, atrial fibrillation (AF) is a disease of variable interactions between left atrial triggers and substrate most commonly of left atrial origin. Significant advances have been made in our understanding of the genetic and pathophysiologic mechanism underlying the development and progression of SND and AF. Although some patients manifest SND as a result of electric remodeling induced by periods of AF, others develop progressive atrial structural remodeling that gives rise to both conditions together. The treatment strategy will thus vary according to the predominant disease phenotype. Although catheter ablation will benefit patients with predominantly AF and secondary SND, cardiac pacing may be the mainstay of therapy for patients with predominant fibrotic atrial cardiomyopathy. This contemporary review summarizes current knowledge on sinus node pathophysiology with the broader goal of yielding insights into the complex relationship between sinus node disease and atrial arrhythmias. PMID:27166347

  13. Connexin Remodeling Contributes to Atrial Fibrillation

    OpenAIRE

    Michelle M Jennings; J Kevin Donahue

    2013-01-01

    Atrial fibrillation significantly contributes to mortality and morbidity through increased risk of stroke, heart failure and myocardial infarcts. Investigations of mechanisms responsible for the development and maintenance of atrial fibrillation have highlighted the importance of gap junctional remodeling. Connexins 40 and 43, the major atrial gap junctional proteins, undergo considerable alterations in expression and localization in atrial fibrillation, creating an environment conducive to s...

  14. No incremental benefit of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation

    OpenAIRE

    Levy, T; Walker, S; Rex, S; Rochelle, J; Paul, V.

    2001-01-01

    OBJECTIVE—To evaluate the incremental antifibrillatory effect of multisite atrial pacing compared with right atrial pacing in patients with drug refractory paroxysmal atrial fibrillation paced for arrhythmia prevention alone.
METHODS—In 20 of these patients (mean (SD) age 64 (8) years; 14 female, six male), a single blinded randomised crossover study was performed to investigate the incremental benefit of one month of multisite atrial pacing compared with one month of right atrial pacing. Out...

  15. TRIF promotes angiotensin II-induced cross-talk between fibroblasts and macrophages in atrial fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xiao-Qing; Zhang, Dao-Liang [Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai (China); Zhang, Ming-Jian; Guo, Meng; Zhan, Yang-Yang; Liu, Fang [National Key Laboratory of Medical Immunology, Second Military Medical University, Shanghai (China); Jiang, Wei-Feng; Zhou, Li [Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai (China); Zhao, Liang, E-mail: zhaol_zg@163.com [Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai (China); Wang, Quan-Xing, E-mail: wqxejd@126.com [National Key Laboratory of Medical Immunology, Second Military Medical University, Shanghai (China); Liu, Xu, E-mail: liuxu_xk@163.com [Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai (China)

    2015-08-14

    Aims: Atrial fibroblasts and macrophages have long been thought to participate in atrial fibrillation (AF). However, which specific mediator may regulate the interaction between them remains unclear. Methods and results: We provided the evidence for the involvement of Toll/IL-1 receptor domain-containing adaptor inducing IFN-β (TRIF), an important inflammation-related molecule, in the pathophysiology of AF. Patients with AF showed higher levels of angiotensin II (AngII) and TRIF expression and larger number of macrophages infiltration in left atria appendage than individuals with sinus rhythm (SR). In the cell study, AngII induced chemokines expressions in mouse atrial fibroblasts and AngII-stimulated atrial fibroblasts induced the chemotaxis of macrophages, which were reduced by losartan and TRIF siRNA. Meanwhile, AngII-stimulated atrial fibroblasts proliferation was enhanced by macrophages. Conclusions: Our data demonstrated that TRIF may be a crucial factor promoting the interaction between atrial fibroblasts and macrophages, leading to atrial fibrosis. - Highlights: • Compared with SR, AF showed higher TRIF expression in left atrial appendage. • TRIF siRNA reversed macrophage chemotaxis induced by AngII-treated fibroblast. • TRIF siRNA reversed chemokines expressions induced by AngII in fibroblast. • AngII-stimulated atrial fibroblast proliferation was enhanced by macrophage.

  16. Risk factors of cerebral embolism of elderly patients with nonvalvular atrial fibrillation in Tongchuan city%铜川市老年非瓣膜病心房颤动患者脑栓塞的危险因素

    Institute of Scientific and Technical Information of China (English)

    王成凯; 宋昌鹏; 朱晓娜

    2012-01-01

    目的:调查铜川市老年非瓣膜病心房颤动(nonvalvular atrial fibrillation,NVAF)患者脑栓塞(cerebral embolism,CE)的危险因素.方法:铜川地区非瓣膜病心房纤颤发生脑卒中确诊病例309例,进行1:1配对进行病例对照研究,获得环境暴露等资料,采用EPI-info(6.04)和SPSS(15.0)统计软件进行单因素和多因素Logistic回归分析,计算各因素的调整比值比(0R)和95%可信限(CI).结果:单因素分析发现,老年NVAF患者并发高血压病、糖尿病、心力衰竭、短暂性脑缺血发作(TIA)、肥胖、吸烟、酗酒、高同型半胱氨酸血症等与CE成正相关,而抗凝治疗能降低患CE的危险.多因素分析结果显示,高血压病、糖尿病、TIA、高同型半胱氨酸血症是CE的独立危险因素.结论:铜川市NVAF患者发生CE的独立危险因素是高血压病、糖尿病、TIA和高同型半胱氨酸血症,抗凝治疗是其保护因素.%AIM: To investigate elderly patients in Tongchuan city with nonvalvular atrial fibrillation (NVAF) with cerebral embolism (CE) as a risk factor. METHODS; In Tongchuan city, there were 309 confirmed cases of males and females with nonvalvular atrial fibrillation stroke. This was a 1 : 1 matched case-control study using environmental exposure data with EPI-info (6. 04) and SPSS (15) statistical software for uni- and multivariate logistic regression analysis and the calculation of each factor as adjusted odds ratio (OR) and 95% confidence limit (CI). RESULTS: Single factor analysis revealed that elderly NVAF patients with complications of hypertension, diabetes, heart failure, transient ischemic attack ( TIA ) , obesity, smoking, alcoholism, high homocysteine, and CE were positively correlated, and that anticoagulation therapy may reduce the risk of CE. Multiple factor analysis showed hypertension, diabetes , TIA, and hyperhomocysteinemia as risk factors of CE. CONCLUSION: NVAF patients from Tongchuan city with CE have independent risk

  17. Association between psychological measures and brain natriuretic peptide in heart failure patients

    DEFF Research Database (Denmark)

    Brouwers, Corline; Spindler, Helle; Larsen, Mogens Lytken;

    2012-01-01

    ABSTRACT Objective: Brain natriuretic peptide (BNP) is a promising marker for heart failure diagnosis and prognosis. Although psychological factors also influence heart failure (HF) prognosis, this might be attributed to confounding by BNP. Our aim was to examine the association between multiple ...... findings and examine whether psychological risk markers are independent predictors of prognosis in HF or an artifact that may be attributed to other biological or behavioral mechanisms.......ABSTRACT Objective: Brain natriuretic peptide (BNP) is a promising marker for heart failure diagnosis and prognosis. Although psychological factors also influence heart failure (HF) prognosis, this might be attributed to confounding by BNP. Our aim was to examine the association between multiple...... psychological markers using a prospective study design with repeated NT-proBNP measurements. Design: The sample comprised 94 outpatients with systolic HF (80% men; mean age=62.2±9.32). The psychological markers (i.e., anxiety, depression and Type D personality), assessed with the Hospital Anxiety and Depression...

  18. Atrial Cardiopathy: A Broadened Concept of Left Atrial Thromboembolism Beyond Atrial Fibrillation

    Science.gov (United States)

    Kamel, Hooman; Okin, Peter M.; Longstreth, W. T.; Elkind, Mitchell S.V.; Soliman, Elsayed Z.

    2016-01-01

    Atrial fibrillation (AF) has long been associated with a heightened risk of ischemic stroke and systemic thromboembolism, but recent data require a re-evaluation of our understanding of the nature of this relationship. New findings about the temporal connection between AF and stroke, alongside evidence linking markers of left atrial abnormalities with stroke in the absence of apparent AF, suggest that left atrial thromboembolism may occur even without AF. These observations undermine the hypothesis that the dysrhythmia that defines AF is necessary and sufficient to cause thromboembolism. In this commentary, we instead suggest that the substrate for thromboembolism may often be the anatomic and physiological atrial derangements associated with AF. Therefore, our understanding of cardioembolic stroke may be more complete if we shift our representation of its origin from AF to the concept of atrial cardiopathy. PMID:26021638

  19. Use of Oral Anticoagulation Therapy in Atrial Fibrillation after Stroke

    DEFF Research Database (Denmark)

    Jespersen, Stine Funder; Christensen, Louisa M; Christensen, Anders;

    2013-01-01

    Background. The knowledge is still sparse about patient related factors, influencing oral anticoagulation therapy (OAC) rates, in stroke patients with atrial fibrillation (AF). Aims. To assess the use of OAC in ischemic stroke patients diagnosed with AF and to identify patient related factors...

  20. Prediction of early-onset atrial tachyarrhythmia after successful trans-catheter device closure of atrial septal defect.

    Science.gov (United States)

    Park, Kyoung-Min; Hwang, Jin Kyung; Chun, Kwang Jin; Park, Seung-Jung; On, Young Keun; Kim, June Soo; Park, Seung Woo; Kang, I-Seok; Song, Jinyoung; Huh, June

    2016-08-01

    Atrial tachyarrhythmia is a well-known long-term complication of atrial septal defect (ASD) in adults, even after successful trans-catheter closure. However, the risk factors for early-onset atrial tachyarrhythmia after trans-catheter closure remain unclear. This retrospective study enrolled adults with secundum ASD undergoing trans-catheter closure from January 2000 to March 2014. We analyzed the clinical characteristics of patients and assessed risk factors for new-onset atrial tachyarrhythmia defined as a composite of atrial fibrillation or flutter (AF/AFL) after ASD closure. We enrolled a total of 427 patients; 123 were male (28.8%) and the median age was 37.0 (interquartile range [IQR]: 18.3-49.0). Nineteen (4.4%) patients had documented atrial tachyarrhythmia during the follow-up period (median: 11.4 months [IQR: 5.4-24]). Patients with transient AF/AFL during closure showed a greater incidence of new-onset atrial tachyarrhythmia during the follow-up period than patients with consistent sinus rhythm during closure (27.3% vs 3.8%; P = 0.01). Most new-onset atrial tachyarrhythmias were documented within 6 months (median: 2.6 [IQR: 1.2-4.1] months) of closure. In the multivariate analysis, the risk for new-onset atrial tachyarrhythmia was significant in patients with AF/AFL during closure (hazard ratio [HR]: 9.90, 95% confidence interval [CI]: 2.86-34.20; P < 0.001), deficient posteroinferior rim (HR: 5.48, 95% CI: 1.15-25.72; P = 0.04), and age of closure over 48 years (HR: 3.30, 95% CI: 1.30-8.38; P = 0.01). In conclusion, transient AF/AFL during trans-catheter closure of ASD as well as deficient posteroinferior rim and age of closure over 48 years may be useful for predicting early new-onset atrial tachyarrhythmia after device closure. PMID:27583905

  1. [Antithrombotic management in atrial fibrillation].

    Science.gov (United States)

    Fauchier, Laurent; Taillandier, Sophie; Clementy, Nicolas

    2013-02-01

    There is increasing recognition of the value of oral anticoagulation for stroke prevention in atrial fibrillation (AF), and the availability of new oral anticoagulants that overcome the limitations of vitamin K antagonists (VKA). Stroke risk assessment using the CHA2DS2-Vasc score allows identification of patients who are at truly low risk (score = 0) who should need no antithrombotic therapy, while all others (CHA2DS2-Vasc score > or = 1 with a risk of thromboembolic event > 1% per year) would be considered for oral anticoagulation. The HAS-BLED score has been recently proposed to easily assess bleeding risk in AF patients. A score of > or = 3 indicates "high risk" and some caution and regular review of the patient are needed. It also makes the clinician think of correctable common bleeding risk factors. The direct thrombin inhibitor dabigatran and factor Xa inhibitors rivaroxaban and apixaban are new oral anticoagulants that are at least as efficacious and safe as VKA in non valvular AF. Their advantages are easier use, predictable anticoagulant effects, low propensity for food and drug interactions, and lower rates of intracranial bleeding than with VKA, but they should not be used in patients with kidney disease at the present time. Overall, one may expect that more AF patients will be appropriately treated with oral anticoagulation in the next years. PMID:23513780

  2. Atrial Fibrillation and Heart Failure

    Directory of Open Access Journals (Sweden)

    William G. Stevenson, M.D

    2008-07-01

    Full Text Available Atrial fibrillation is common in heart failure patients and is associated with increased mortality. Pharmacologic trials have not shown any survival benefit for a rhythm control over a rate control strategy. It has been suggested that sinus rhythm is associated with a survival benefit, but that the risks of anti-arrhythmic drug treatment and poor efficacy offset the beneficial effect. Catheter ablation for atrial fibrillation can establish sinus rhythm without the risks of anti-arrhythmic drug therapy. Data from randomized trials demonstrating a survival benefit for patients undergoing an ablation procedure for atrial fibrillation are still lacking. Ablation of the AV junction and permanent pacing remain a treatment alternative in otherwise refractory cases. Placement of a biventricular system may prevent or reduce negative consequences of chronic right ventricular pacing. Current objectives and options for treatment of atrial fibrillation in heart failure patients are reviewed.

  3. Atrial Septal Defect (For Parents)

    Science.gov (United States)

    ... Video) Going to the Hospital Your Heart & Circulatory System Quiz: Heart & Circulatory System EKG (Video) What's It Like to Have Surgery? Atrial Septal Defect Ventricular Septal Defect Heart and Circulatory System Anesthesia Basics Contact Us Print Resources Send to ...

  4. Atrial Fibrillation and Heart Failure

    OpenAIRE

    Jens Seiler; Tedrow, Usha B.; Stevenson, William G

    2008-01-01

    Atrial fibrillation is common in heart failure patients and is associated with increased mortality.  Pharmacologic trials have not shown any survival benefit for a rhythm control over a rate control strategy.  It has been suggested that sinus rhythm is associated with a survival benefit, but that the risks of anti-arrhythmic drug treatment and poor efficacy offset the beneficial effect.  Catheter ablation for atrial fibrillation can establish sinus rhythm without the risks of a...

  5. Atrial Fibrillation and Heart Failure

    OpenAIRE

    William G. Stevenson, M.D; Usha B. Tedrow, M.D; Jens Seiler, M.D

    2008-01-01

    Atrial fibrillation is common in heart failure patients and is associated with increased mortality. Pharmacologic trials have not shown any survival benefit for a rhythm control over a rate control strategy. It has been suggested that sinus rhythm is associated with a survival benefit, but that the risks of anti-arrhythmic drug treatment and poor efficacy offset the beneficial effect. Catheter ablation for atrial fibrillation can establish sinus rhythm without the risks of anti-arrhythmic dru...

  6. Surgical Ablation of Atrial Fibrillation

    OpenAIRE

    Ramlawi, Basel; Abu Saleh, Walid K.

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions...

  7. Antithrombotic therapy in atrial fibrillation.

    OpenAIRE

    Chin, B.; Lip, G. Y.

    1996-01-01

    OBJECTIVE: To review the evidence for antithrombotic therapy in patients with nonrheumatic atrial fibrillation. QUALITY OF EVIDENCE: Five primary prevention trials and one secondary prevention trial compare antithrombotic therapy with placebo or no treatment. Two trials also determine the efficacy and safety of acetylsalicylic acid. MAIN FINDINGS: Warfarin reduces the risk of stroke by 68%. The effect is consistent in all identifiable groups of patients with nonrheumatic atrial fibrillation, ...

  8. Stroke prevention in atrial fibrillation.

    OpenAIRE

    Michael Katsnelson,; Sebastian Koch; Tatjana Rundek

    1997-01-01

    Non-valvular atrial fibrillation is a common and from a neurological perspective the most significant cardiac arrhythmia with a growing world-wide incidence. It also carries a significant associated morbidity and mortality, with cardioembolic strokes arguably being the most disabling sequelae. This brief review will highlight the important studies and the latest treatment modalities available for stroke prevention in patients with non-valvular atrial fibrillation.

  9. Idiopathic giant right atrial aneurysm

    International Nuclear Information System (INIS)

    A 2-year-old boy with an incidental finding of massive cardiomegaly on a chest X-ray was diagnosed with a giant right atrial aneurysm upon further investigation with echocardiography. The patient underwent successful surgical reduction of the right atrium and closure of the patent foramen ovale to prevent thromboembolic complications and to lower the risk of atrial arrhythmias. The resected atrium had paper-thin walls and pathological features of interstitial fibrosis with endocardial thickening

  10. Protective role of heme oxygenase-1 in atrial remodeling.

    Science.gov (United States)

    Yeh, Yung-Hsin; Hsu, Lung-An; Chen, Ying-Hwa; Kuo, Chi-Tai; Chang, Gwo-Jyh; Chen, Wei-Jan

    2016-09-01

    Structural and electrical remodeling in the atrium constitutes the main feature of atrial fibrillation (AF), which is characterized by increased oxidative stress. Heme oxygenase-1 (HO-1) is a potent anti-oxidant system that may provide protection against various oxidative stress-related diseases. The aim of this study is to investigate whether HO-1 has a protective effect on AF-related remodeling. Cultured atrium-derived myocytes (HL-1 cell line) were used to evaluate tachypacing-induced oxidative stress, structural, and electrical remodeling. Transforming growth factor-β (TGF-β) was utilized to assess collagen (a main fibrosis-related protein) expression in atrial fibroblasts. Tachypacing in HL-1 myocytes and treatment of atrial fibroblasts with TGF-β enhanced the expression of HO-1, both of which were mediated by the activation of nuclear factor erythroid-2-related factor 2. Over-expression of HO-1 in HL-1 cells attenuated tachypacing-induced oxidative stress, myofibril degradation, down-regulation of L-type calcium channel, and shortening of action potential duration. Furthermore, HO-1 over-expression in atrial fibroblasts blocked the up-regulation of collagen by TGF-β, implicating a protective role of HO-1 in structural and electrical remodeling in the atrium. In vivo, HO-1(-/-) mice exhibited a higher degree of oxidative stress, myofibril degradation, and collagen deposit in their atria than wild-type mice. Moreover, burst atrial pacing induced a greater susceptibility to AF in HO-1(-/-) mice than in wild-type mice. In conclusion, a negative-feedback regulation of HO-1 in activated atrial myocytes and fibroblasts may provide protection against AF-related remodeling and AF development. PMID:27562817

  11. N-terminal Pro-B-type natriuretic peptide: a measure of significant patent cuctus arteriosus

    LENUS (Irish Health Repository)

    OFarombi-Oghuvbu, IO

    2008-01-24

    Background: B type natriuretic peptide (BNP) is a marker for ventricular dysfunction secreted as a pre-prohormone, Pro-B-type natriuretic peptide (ProBNP), and cleaved into BNP and a biologically inactive fragment, N-terminal pro-B-type natriuretic peptide (NT-proBNP). Little is known about the clinical usefulness of NT-proBNP in preterm infants.\\r\

  12. Giant right atrial myxoma

    International Nuclear Information System (INIS)

    Primary tumors of the heart are rare, their estimated incidence ranging between 0.0017-0.19%, and among them cardiac myxomas are the most common (50%). Right atrial localization is uncommon, occurring only in 15-20% of cases. Their clinical presentation ranges from an asymptomatic status to the presence of constitutional symptoms or symptoms pointing to the presence of cardiac obstruction or pulmonary embolism. A case is presented of a 36-year-old male patient with a history of asthenia, palpitations and reduced functional capacity. Transthoracic echocardiography revealed a large mass in the right atrium which prolapsed into the right ventricle and obstructed the tricuspid valve. The patient underwent cardiopulmonary bypass surgery and the mass (9x9 cm) was removed without any complication. Histological examination confirmed the diagnosis of myxoma.

  13. Post-operative Atrial Fibrillation: Pathophysiology, prevention and treatment

    Directory of Open Access Journals (Sweden)

    E Bidar;

    2013-04-01

    Full Text Available Atrial fibrillation occurring after cardiac surgery has been the subject of intensive research over the past decades. However, the incidence remains high, despite numerous preventive and treatment strategies. In addition, several reports show that the impact of post-operative atrial fibrillation (POAF is high. It is an independent risk factor for mortality after several years. These findings make clear that the fact that the pathophysiology of POAF is not fully understood and POAF-associated risks to some extent might be underestimated. On the one hand, excessive triggers during the acute post operative phase after cardiac surgery might initiate AF even in atria with low vulnerability. On the other hand, many patients undergoing surgery have an atrial substrate at the time of operation promoting AF not only in the post-operative phase but also in the days and weeks thereafter. Progress in our understanding of the AF mechanisms in general has provided valuable insights into processes involved in atrial structural remodeling due to advanced age, hypertension, obesity, and congestive heart failure. These patient characteristics strongly contribute to cardiac disease, predict POAF and likely have an impact on the risk of thrombus formation in the weeks and months after cardiac surgery. For a better understanding of the mechanisms involved, it is important to not only recognize the occurrence of POAF by continuous monitoring after surgery, but also to identity the extent of atrial vulnerability to AF in these patients.

  14. The association between brain natriuretic peptide and tissue Doppler parameters in children with hypertrophic cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Taliha Öner

    2016-01-01

    Full Text Available In this study, we investigated the association between brain natriuretic peptide (BNP levels and tissue Doppler imaging measurements and also screening for deadly mutations in patients with hypertrophic cardiomyopathy (HCM. We enrolled 20 patients diagnosed with HCM (age:10.7±5 years (1-17, 85% male, weight:42.25±23.10 kg, height:141.80±32.45 cm and 20 age, gender and body weight-matched control subjects. We performed electrocardiography, transthoracic echocardiography, and tissue Doppler echocardiography in each group, as well as genetic tests (for Arg403Gln, Arg453Cys, Arg719Trp and Arg719Gln mutations in MYH7 Exons 13, 14, 19 and BNP in the patients. The patients were divided into two groups according to the presence (Group 1 or absence (Group 2 of left ventricular (LV outflow tract obstruction. QTc dispersion and the LV ejection fraction and left atrial (LA volume index were increased in Group 1. The LA volume index and the mitral and septal E/Ea ratio and septum Z-score were increased while the mitral lateral annulus and septal annulus Ea wave velocities and the mitral and tricuspid E/A ratio were decreased in patients with high levels of BNP compared to those with normal BNP levels. There were no mutations that are associated with increased risk of sudden death found in patients included in this study. In the light of our data, we conclude that such parameters BNP levels above the 98 pg/mL, septal thickness Z-score ˃6, and higher mitral and septal E/Ea ratios can be used for management of patients with HCM according to life-threatening conditions.

  15. Genetic Variation in the Natriuretic Peptide System, Circulating Natriuretic Peptide Levels, and Blood Pressure

    DEFF Research Database (Denmark)

    Jeppesen, Jørgen L; Nielsen, Søren J; Torp-Pedersen, Christian; Hansen, Tine W; Olsen, Michael H; Linneberg, Allan; Madsbad, Sten; Fenger, Mogens; Berg, Nikolaj D

    2012-01-01

    BackgroundIn a large collaborative study (n > 50,000), common variants in the natriuretic peptide (NP) genes were found to be associated with circulating NP levels and also with blood pressure (BP) levels based on office BP measurements (OBPMs). It is unknown if determining an individual's BP by 24......-h ambulatory BP measurements (ABPMs) will influence the effect of NP gene variations on BP levels.MethodsWe used rs632793 at the NPPB (NP precursor B) locus to investigate the relationship between genetically determined serum N-terminal pro-brain NP (NT-proBNP) concentrations and BP levels...... participants with the G:G genotype (geometric mean (95% confidence interval (CI)): 34.8 (31.5-38.4) pg/ml vs. 48.1 (41.9-55.3) pg/ml, P = 0.0002), but higher 24-h ambulatory BP levels (mean difference (95% CI): 2.0 (0.1-4.1) mm Hg, P = 0.043, for systolic BP and 1.7 (0.4-3.1) mm Hg, P = 0.011, for diastolic BP...

  16. Edoxaban versus warfarin in patients with atrial fibrillation

    NARCIS (Netherlands)

    Giugliano, R.P.; Ruff, C.T.; Braunwald, E.; Murphy, S.A.; Wiviott, S.D.; Halperin, J.L.; Waldo, A.L.; Ezekowitz, M.D.; Weitz, J.I.; Spinar, J.; Ruzyllo, W.; Ruda, M.; Koretsune, Y.; Betcher, J.; Shi, M.; Grip, L.T.; Patel, S.P.; Patel, I.; Hanyok, J.J.; Mercuri, M.; Antman, E.M.; Verheugt, F.W.A.

    2013-01-01

    BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two

  17. Familial Aggregation of Lone Atrial Fibrillation in Young Persons

    DEFF Research Database (Denmark)

    Oyen, Nina; Ranthe, Mattis F; Carstensen, Lisbeth;

    2012-01-01

    OBJECTIVES: We investigated whether an individual's risk of developing lone atrial fibrillation (AF) before age 60 years is associated with lone AF in relatives. BACKGROUND: Genetic factors may play a role in the development of lone AF. METHODS: Using Danish national registers, a cohort was...

  18. Anticoagulant treatment in patients with atrial fibrillation and ischemic stroke

    DEFF Research Database (Denmark)

    Brunner-Frandsen, Nicole; Dammann Andersen, Andreas; Ashournia, Hamoun;

    2015-01-01

    BACKGROUND: Atrial fibrillation (AF) is the most common cardiac dysrhythmia, with a lifetime risk of 25%, and it is a well-known independent risk factor for ischemic stroke. Over the last 15 years, efforts have been made to initiate relevant treatment in patients with AF. A retrospective study was...

  19. Natriuretic peptides enhance the oxidative capacity of human skeletal muscle

    OpenAIRE

    Engeli, Stefan; Birkenfeld, Andreas L.; Badin, Pierre-Marie; Bourlier, Virginie; Louche, Katie; Viguerie, Nathalie; Thalamas, Claire; Montastier, Emilie; Larrouy, Dominique; Harant, Isabelle; de Glisezinski, Isabelle; Lieske, Stefanie; Reinke, Julia; Beckmann, Bibiana; Langin, Dominique

    2012-01-01

    Cardiac natriuretic peptides (NP) are major activators of human fat cell lipolysis and have recently been shown to control brown fat thermogenesis. Here, we investigated the physiological role of NP on the oxidative metabolism of human skeletal muscle. NP receptor type A (NPRA) gene expression was positively correlated to mRNA levels of PPARγ coactivator-1α (PGC1A) and several oxidative phosphorylation (OXPHOS) genes in human skeletal muscle. Further, the expression of NPRA, PGC1A, and OXPHOS...

  20. Who Is at Risk for Atrial Fibrillation?

    Science.gov (United States)

    ... Who Is at Risk for Atrial Fibrillation? Explore Atrial Fibrillation What Is... Types Other Names Causes Who Is at Risk Signs & Symptoms Diagnosis Treatments Prevention Living With Clinical Trials Links Related Topics Arrhythmia ...

  1. Surgical Ablation of Atrial Fibrillation.

    Science.gov (United States)

    Ramlawi, Basel; Abu Saleh, Walid K

    2015-01-01

    The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality. The Cox-Maze IV is the most currently accepted iteration. It achieves the same lesion set of the Cox- maze III but uses alternative energy sources to create the transmural lesions, potentially in a minimally invasive approach on the beating heart. High-frequency ultrasound, microwave, and laser energy have all been used with varying success in the past. Today, bipolar radiofrequency heat or cryotherapy cooling are the most accepted sources for creating linear lesions with consistent safety and transmurality. The robust and reliable nature of these energy delivery methods has yielded a success rate reaching 90% freedom from atrial fibrillation at 12 months. Such approaches offer a significant long-term advantage over catheter-based ablation, especially in patients having longstanding, persistent atrial fibrillation with characteristics such as dilated left atrial dimensions, poor ejection fraction, and failed catheter ablation. Based on these improved results, there currently is significant interest in developing a hybrid ablation strategy that incorporates the superior transmural robust lesions of surgical ablation, the reliable stroke prevention potential of epicardial left atrial appendage exclusion, and sophisticated mapping and confirmatory catheter-based ablation technology. Such a minimally invasive hybrid strategy for ablation may lead to the development of multidisciplinary "Afib teams" to

  2. Low atrial septum pacing in pacemaker patients

    NARCIS (Netherlands)

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant trea

  3. Obstructive sleep apnea in atrial fibrillation patients.

    Science.gov (United States)

    Arias, Miguel A; Alonso-Fernández, Alberto; García-Río, Francisco; Sánchez, Ana; López, Juana M; Pagola, Carlos

    2006-06-28

    A high prevalence of obstructive sleep apnea has been demonstrated in patients with atrial fibrillation. Our comments want to emphasize the importance of identifying and treating a large proportion of patients with atrial fibrillation who have undiagnosed obstructive sleep apnea as an additional preventive strategy for atrial fibrillation patients. PMID:16309764

  4. A Large Right Atrial Myxoma Associated with Atrial Flutter Rhythm

    Directory of Open Access Journals (Sweden)

    Onursal Buğra

    2010-04-01

    Full Text Available A 22 year-old man presented to the emergency unit with the complaint of difficulty in breathing. In the physical exam, dyspnea and orthopnea were found. In the electocardiographic exam (ECG atrial flutter rhythm was seen. The transthoracic echocardiographic exam revealed a large atrial mass that was originating from interatrial septum. During surgery, complete surgical removal of the right atrial mass was successfully performed under moderate hypothermia. Histological investigations revealed a mass of 15 x 3 cm in diameter and the pathological examination showed that the lesion is a myxoma. Twelve months after surgical excision, clinical and chocardiographicalfollow-up showed a satisfactory exercise tolerance, sinus rhythm in ECG exam, and cardiac functions within normal limits.

  5. Correlation of B-type natriuretic peptide levels and echocardiographic parameters in preterm infants with patent ductus arteriosus

    Science.gov (United States)

    Jeong, Hyun Ah; Shin, Jeonghee; Kim, Eunji; Lee, Eun Hee; Son, Chang Sung; Lee, Joo Won

    2016-01-01

    Purpose This study aimed to evaluate the correlation, according to postnatal age, between plasma B-type natriuretic peptide (BNP) levels and echocardiographic parameters for the assessment of patent ductus arteriosus (PDA) in preterm infants with respiratory distress. Methods We enrolled 42 preterm infants with respiratory distress who underwent serial echocardiographic evaluation with simultaneous plasma BNP measurements until ductal closure. The correlations between BNP levels and the following 4 representative echocardiographic parameters were studied: diameter of the ductus arteriosus (DA), ratio of the left atrial diameter to the aortic diameter (LA/Ao), ratio of the PDA diameter to the infant's left pulmonary artery diameter (PDA/LPA), and the antegrade diastolic flow of LPA (DFLPA). Results BNP levels were significantly correlated to the magnitude of the ductal shunt, comprising the DA diameter, PDA/LPA ratio, LA/Ao ratio, and antegrade DFLPA for the overall study period. The earliest significant correlation, starting from postnatal day 2, was observed between the LA/Ao ratio and BNP levels. The PDA/LPA ratio and the antegrade DFLPA showed significant correlations with BNP levels postnatal day 3 onward, and with the DA diameter, postnatal day 5 onward. Conclusion BNP levels and echocardiographic parameters showed a positive correlation, but the significance of the correlations differed according to the postnatal age, especially during the first few days of life. PMID:27186229

  6. Impact of epitope specificity and precursor maturation in pro-B-type natriuretic peptide measurement

    DEFF Research Database (Denmark)

    Goetze, J.P.; Dahlstrom, U.; Alehagen, U.;

    2008-01-01

    BACKGROUND: Cardiac-derived natriuretic peptides are sensitive plasma markers of cardiac dysfunction. Recent reports have disclosed a more complex molecular heterogeneity of B-type natriuretic peptide precursor (proBNP)-derived peptides than previously suggested. In this study, we examined the im...

  7. Contribution of Kv7 channels to natriuretic peptide mediated vasodilation in normal and hypertensive rats

    DEFF Research Database (Denmark)

    Stott, Jennifer B; Barrese, Vincenzo; Jepps, Thomas Andrew; Leighton, Emma V; Greenwood, Iain A

    2015-01-01

    -cAMP-linked vasodilator pathways has not been investigated. Natriuretic peptides are potent vasodilators, which operate primarily through the activation of a cGMP-dependent signaling pathway. This study investigated the putative role of Kv7 channels in natriuretic peptide-dependent relaxations in the vasculature of...

  8. Effects of C-type natriuretic peptide on rat cardiac contractility

    OpenAIRE

    Brusq, Jean-Marie; Mayoux, Eric; Guigui, Laurent; Kirilovsky, Jorge

    1999-01-01

    Natriuretic peptide receptors have been found in different heart preparations. However, the role of natriuretic peptides in the regulation of cardiac contractility remains largely elusive and was, therefore, studied here.The rate of relaxation of electrically stimulated, isolated rat papillary muscles was enhanced (114.4±1.4%, P

  9. Endurance Sport Practice and Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Naiara Calvo

    2010-10-01

    Full Text Available Atrial fibrillation (AF is the most common cardiac rhythm disorder in clinical practice, with an estimated prevalence of 0.4% to 1% in the general population, increasing with age to 8% in those older than 80 years. The recognized risk factors for developing AF include age, hypertension, structural heart disease, diabetes mellitus, and hyperthyroidism. However, the etiology remains unclear in a significant number of patients younger than age 60 in whom no cardiovascular disease or any other known causal factor is present. This condition is termed lone AF, and may be responsible for as many as 30% of patients with paroxysmal AF seeking medical attention. Although regular physical activity clearly reduces cardiovascular morbidity risk, in recent years long-term endurance sport practice has been recognized as a risk factor for AF. However, the underlying mechanism explaining this association is unclear.

  10. [Measurement of natriuretic peptides in heart failure: the good laboratory and clinical practice].

    Science.gov (United States)

    Kovács, L Gábor; Nyolczas, Noémi; Habon, Tamás; Sepp, Róbert; Piroth, Zsolt; Hajas, Ágota; Boncz, Imre; Tomcsányi, János; Kappelmayer, János; Merkely, Béla

    2015-08-01

    Cardiac natriuretic peptides (BNP, NT-proBNP) play a pivotal role in cardiovascular homeostasis, mainly due to their roles in vasodilatation, natriuresis, diuresis and due to their antiproliferative properties. Proper measurement of the natriuretic peptide levels may help differentiate between respiratory and cardiac forms of dyspnea, diagnose early forms of heart failure, evaluate severity of heart failure (prognosis) and monitor the efficacy of therapy. In many countries natriuretic peptide levels are being used as one of the earliest diagnostics tools to evaluate the involvement of the heart. Current theoretical and clinical data confirm the importance of natriuretic peptides in routine healthcare. These roles are clearly described in international recommendations and guidelines. In the current review the authors discuss the problems of the measurement of natriuretic peptides in Hungary, including several aspects related to laboratory medicine, cardiology and health economy. PMID:26211747

  11. Atrial fibrillation and delayed gastric emptying.

    Directory of Open Access Journals (Sweden)

    Isadora C Botwinick

    Full Text Available BACKGROUND: Atrial fibrillation and delayed gastric emptying (DGE are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7(th postoperative day. METHODS: We performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables. RESULTS: Approximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p = 0.0005. Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p = 0.03. 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p = 0.0007. This association held true when controlling for age. CONCLUSION: Patients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.

  12. Natriuretic peptide receptor-3 underpins the disparate regulation of endothelial and vascular smooth muscle cell proliferation by C-type natriuretic peptide

    OpenAIRE

    Khambata, Rayomand S.; Panayiotou, Catherine M; Hobbs, Adrian J

    2011-01-01

    BACKGROUND AND PURPOSE C-type natriuretic peptide (CNP) is an endothelium-derived vasorelaxant, exerting anti-atherogenic actions in the vasculature and salvaging the myocardium from ischaemic injury. The cytoprotective effects of CNP are mediated in part via the Gi-coupled natriuretic peptide receptor (NPR)3. As GPCRs are well-known to control cell proliferation, we investigated if NPR3 activation underlies effects of CNP on endothelial and vascular smooth muscle cell mitogenesis. EXPERIMENT...

  13. Determinants of left atrial appendage volume in stroke patients without chronic atrial fibrillation.

    Directory of Open Access Journals (Sweden)

    Mikko Taina

    Full Text Available BACKGROUND: Left atrial appendage (LAA volume has been shown to be increased in patients with acute cryptogenic stroke. Atrial fibrillation (AF is a well-recognized risk factor but it is not the only one associated with LAA enlargement. The aim of the study was to clarify the multifactorial etiology of LAA enlargement in cardiogenic stroke/TIA patients without AF. METHODS: Altogether 149 patients with suspected cardioembolic stroke/TIA (47 females; mean age 61 years underwent cardiac CT. Diagnosed AF on admittance was an exclusion criteria but 24-hour Holter ambulatory ECG revealed paroxysmal AF (PAF in 20 patients. Body surface area adjusted LAA volume was evaluated. Eighteen different variables were registered including general characteristics, definite and potential causal risk factors for ischemic stroke/TIA, clinical echoparameters and CT based cardiac volumetric and adipose tissue measurements. A stepwise linear regression analysis was performed to achieve a model adjusted for the number of predictors of LAA volume increase. RESULTS: In linear regression analysis, the best model accounted for 30% of the variability in LAA volume, including PAF (19% and enlarged left atrial volume (6%, enlarged left ventricle end-systolic diameter (3% and decreased pericardial adipose tissue (2%. No multi-colinearity between variables was observed. In addition to PAF, no other definitive or potential causal risk factors could account for the LAA volume in these patients. CONCLUSIONS: LAA volume increase seems to be poorly associated with currently known stroke/TIA risk factors, except for AF. Targeting more comprehensive ECG monitoring for stroke patients with increased LAA volume should be considered.

  14. Determinants of Left Atrial Appendage Volume in Stroke Patients without Chronic Atrial Fibrillation

    Science.gov (United States)

    Taina, Mikko; Sipola, Petri; Muuronen, Antti; Hedman, Marja; Mustonen, Pirjo; Kantanen, Anne-Mari; Jäkälä, Pekka; Vanninen, Ritva

    2014-01-01

    Background Left atrial appendage (LAA) volume has been shown to be increased in patients with acute cryptogenic stroke. Atrial fibrillation (AF) is a well-recognized risk factor but it is not the only one associated with LAA enlargement. The aim of the study was to clarify the multifactorial etiology of LAA enlargement in cardiogenic stroke/TIA patients without AF. Methods Altogether 149 patients with suspected cardioembolic stroke/TIA (47 females; mean age 61 years) underwent cardiac CT. Diagnosed AF on admittance was an exclusion criteria but 24-hour Holter ambulatory ECG revealed paroxysmal AF (PAF) in 20 patients. Body surface area adjusted LAA volume was evaluated. Eighteen different variables were registered including general characteristics, definite and potential causal risk factors for ischemic stroke/TIA, clinical echoparameters and CT based cardiac volumetric and adipose tissue measurements. A stepwise linear regression analysis was performed to achieve a model adjusted for the number of predictors of LAA volume increase. Results In linear regression analysis, the best model accounted for 30% of the variability in LAA volume, including PAF (19%) and enlarged left atrial volume (6%), enlarged left ventricle end-systolic diameter (3%) and decreased pericardial adipose tissue (2%). No multi-colinearity between variables was observed. In addition to PAF, no other definitive or potential causal risk factors could account for the LAA volume in these patients. Conclusions LAA volume increase seems to be poorly associated with currently known stroke/TIA risk factors, except for AF. Targeting more comprehensive ECG monitoring for stroke patients with increased LAA volume should be considered. PMID:24595515

  15. Apixaban and atrial fibrillation: no clear advantage.

    Science.gov (United States)

    2014-02-01

    For the prevention of thromboembolic events in patients with atrial fibrillation and a high thrombotic risk, the standard treatment is warfarin, an anticoagulant. Dabigatran, a thrombin inhibitor, is the alternative when warfarin fails to maintain the INR within the therapeutic range. Patients with a moderate thrombotic risk may receive either warfarin or low-dose aspirin. Apixaban, a factor Xa inhibitor anticoagulant, has been authorised in the European Union for use in patients with non-valvular atrial fibrillation and a moderate or high risk of thrombosis. In a double-blind, randomised non-inferiority trial versus warfarin in 18 201 patients, the incidence of stroke or systemic embolism was lower in the apixaban group (average 1.3 versus 1.6 events per 100 patient-years; p = 0.01). This difference was mainly due to a lower incidence of haemorrhagic stroke and did not result in a clear decline in mortality. In addition, these results are undermined by multiple methodological flaws. Clinical evaluation included no trials comparing apixaban with dabigatran; any indirect comparison would be risky given the poor quality of the clinical assessment of both drugs in atrial fibrillation. A double-blind, randomised trial including 5598 patients compared apixaban with aspirin but provided little information on these options in patients with a moderate risk of thrombosis, as most patients were at high risk. In clinical trials, major bleeding events were less frequent with apixaban than with warfarin (average 2.1 versus 3.1 events per 100 patient-years), but they were more frequent with apixaban than with aspirin (1.4 versus 0.9 events per 100 patient-years). In 2013, there is no way of monitoring the anticoagulant activity of apixaban in routine clinical practice, and there is no antidote in case of overdose; the same is true for dabigatran. Apixaban is a substrate for various cytochrome P450 isoenzymes and for P-glycoprotein, creating a risk of multiple drug

  16. The heart as an endocrine organ

    OpenAIRE

    Ogawa, Tsuneo; Adolfo J. De Bold

    2014-01-01

    The concept of the heart as an endocrine organ arises from the observation that the atrial cardiomyocytes in the mammalian heart display a phenotype that is partly that of endocrine cells. Investigations carried out between 1971 and 1983 characterised, by virtue of its natriuretic properties, a polypeptide referred to atrial natriuretic factor (ANF). Another polypeptide isolated from brain in 1988, brain natriuretic peptide (BNP), was subsequently characterised as a second hormone produced by...

  17. Dexamethasone stimulates expression of C-type Natriuretic Peptide in chondrocytes

    Directory of Open Access Journals (Sweden)

    Beier Frank

    2006-11-01

    Full Text Available Abstract Background Growth of endochondral bones is regulated through the activity of cartilaginous growth plates. Disruption of the physiological patterns of chondrocyte proliferation and differentiation – such as in endocrine disorders or in many different genetic diseases (e.g. chondrodysplasias – generally results in dwarfism and skeletal defects. For example, glucocorticoid administration in children inhibits endochondral bone growth, but the molecular targets of these hormones in chondrocytes remain largely unknown. In contrast, recent studies have shown that C-type Natriuretic Peptide (CNP is an important anabolic regulator of cartilage growth, and loss-of-function mutations in the human CNP receptor gene cause dwarfism. We asked whether glucocorticoids could exert their activities by interfering with the expression of CNP or its downstream signaling components. Methods Primary mouse chondrocytes in monolayer where incubated with the synthetic glucocorticoid Dexamethasone (DEX for 12 to 72 hours. Cell numbers were determined by counting, and real-time PCR was performed to examine regulation of genes in the CNP signaling pathway by DEX. Results We show that DEX does influence expression of key genes in the CNP pathway. Most importantly, DEX significantly increases RNA expression of the gene encoding CNP itself (Nppc. In addition, DEX stimulates expression of Prkg2 (encoding cGMP-dependent protein kinase II and Npr3 (natriuretic peptide decoy receptor genes. Conversely, DEX was found to down-regulate the expression of the gene encoding its receptor, Nr3c1 (glucocorticoid receptor, as well as the Npr2 gene (encoding the CNP receptor. Conclusion Our data suggest that the growth-suppressive activities of DEX are not due to blockade of CNP signaling. This study reveals a novel, unanticipated relationship between glucocorticoid and CNP signaling and provides the first evidence that CNP expression in chondrocytes is regulated by endocrine

  18. Plant natriuretic peptides control of synthesis and systemic effects

    KAUST Repository

    Wang, Yuhua

    2011-10-01

    Plant natriuretic peptides (PNPs) are signaling molecules that are secreted into the apoplast particularly under conditions of biotic and abiotic stress. At the local level, PNPs modulate their own expression via feed forward and feedback loops to enable tuning of the response at the transcript and protein level and to prevent overexpression. PNPs also employ a systemic signal, possibly electrical, to rapidly alter photosynthesis and respiration not only in treated leaves but also in upper and lower leaves thereby modulating and integrating physiological responses at the level of the whole plant. © 2011 Landes Bioscience.

  19. Duration of heart failure and the risk of atrial fibrillation: different mechanisms at different times?

    OpenAIRE

    Rankin, A C; Workman, A.J.

    2009-01-01

    Chronic heart failure increases the risk of atrial fibrillation (AF), with the prevalence of AF paralleling the severity of heart failure.1 Factors that underlie this increased susceptibility to AF may include electrical, structural, and neurohumoral changes.2 In AF, it is recognized that atrial electrophysiological remodelling occurs and contributes to the perpetuation of the arrhythmia, most notably the decrease of effective refractory period (ERP) which predisposes to re-entry by shortenin...

  20. SECONDARY PREVENTION OF STROKE IN PATIENTS WITH NON-VALVULAR ATRIAL FIBRILLATION: THE CLINICIANS’ VIEWPOINT

    Directory of Open Access Journals (Sweden)

    E. A. Drozdova

    2015-09-01

    Full Text Available Atrial fibrillation is one of the main risk factor of ischemic stroke. Current problems of the management of patients with stroke due to non-valvular atrial fibrillation and secondary stroke prevention in these patients are considered. Data of own author’s observation for patients of this type during 6 months after discharge from the hospital are presented. The problems which patients faced with are analyzed. Comparative assessment of warfarin and dabigatran therapies is given.

  1. Surgical Treatment of Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Naghmeh Moshtaghi

    2008-12-01

    Full Text Available Atrial fibrillation is the most prevalent permanent arrhythmia. It may be associated with other cardiac pathologies which need surgical treatment. Various types of surgery including the traditional cut-sew operations and operations using different energy sources are currently in use. In comparison with medical treatment, surgery is safe, effective, and has reliable results.

  2. Atrial Fibrillation and Heart Failure

    Directory of Open Access Journals (Sweden)

    Jens Seiler

    2008-07-01

    Full Text Available Atrial fibrillation is common in heart failure patients and is associated with increased mortality.  Pharmacologic trials have not shown any survival benefit for a rhythm control over a rate control strategy.  It has been suggested that sinus rhythm is associated with a survival benefit, but that the risks of anti-arrhythmic drug treatment and poor efficacy offset the beneficial effect.  Catheter ablation for atrial fibrillation can establish sinus rhythm without the risks of anti-arrhythmic drug therapy.  Data from randomized trials demonstrating a survival benefit for patients undergoing an ablation procedure for atrial fibrillation are still lacking.  Ablation of the AV junction and permanent pacing remain a treatment alternative in otherwise refractory cases.  Placement of a biventricular system may prevent or reduce negative consequences of chronic right ventricular pacing.  Current objectives and options for treatment of atrial fibrillation in heart failure patients are reviewed. 

  3. Personalized management of atrial fibrillation

    DEFF Research Database (Denmark)

    Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne;

    2013-01-01

    The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to de...

  4. Clinical experience with apixaban in atrial fibrillation: implications of AVERROES

    Directory of Open Access Journals (Sweden)

    De Caterina R

    2011-07-01

    Full Text Available Raffaele De CaterinaInstitute of Cardiology and Center of Excellence on Aging, G d’Annunzio University, Chieti, G Monasterio Foundation, Pisa, ItalyAbstract: Atrial fibrillation is an extremely common arrhythmia, which substantially increases the risk of stroke and thromboembolism. Prevention of stroke and thromboembolism is therefore an important part of the management of atrial fibrillation. Guidelines until now have recommended that patients with atrial fibrillation receive some form of antithrombotic therapy, ie, a vitamin K antagonist or aspirin, with a preference for anticoagulants in most cases. However, current treatments are suboptimal, and despite the recommendations, many patients do not receive adequate thromboprophylaxis, because they are considered, for various reasons, “unsuitable” to receive a vitamin K antagonist. In this patient population, apixaban, a new oral anticoagulant inhibiting activated coagulation factor X, administered in fixed doses and without anticoagulation monitoring, has undergone testing against aspirin in the recently published AVERROES trial. This paper addresses the strengths and limitations of this trial and the practical relevance of the new clinical information it provides.Keywords: atrial fibrillation, apixaban, thromboprophylaxis 

  5. What Are the Signs and Symptoms of Atrial Fibrillation?

    Science.gov (United States)

    ... Twitter. What Are the Signs and Symptoms of Atrial Fibrillation? Atrial fibrillation (AF) usually causes the heart's lower ... Chest pain Dizziness or fainting Fatigue (tiredness) Confusion Atrial Fibrillation Complications AF has two major complications— stroke and ...

  6. Natriuretic peptide control of energy balance and glucose homeostasis.

    Science.gov (United States)

    Coué, Marine; Moro, Cedric

    2016-05-01

    Cardiac natriuretic peptides (NP) have recently emerged as metabolic hormones. Physiological stimulation of cardiac NP release as during exercise may contribute to increase fatty acid mobilization from adipose tissue and their oxidation by skeletal muscles. Clinical studies have shown that although very high plasma NP level characterizes cardiac dysfunction and heart failure, a consistently reduced plasma NP level is observed in metabolic diseases such as obesity and type 2 diabetes. A low circulating NP level also predicts the risk of new onset type 2 diabetes. It is unclear at this stage if the "natriuretic handicap" observed in obesity is causally associated with the incidence of type 2 diabetes. Recent work indicates that NP can activate a thermogenic program in brown and white fat, increase energy expenditure and inhibit food intake. Mouse studies also argue for a key role of NP in the regulation of energy balance and glucose homeostasis. This review will focus on recent human and mouse studies to highlight the metabolic roles of NP and their potential relevance in the context of obesity and type 2 diabetes. PMID:26037452

  7. Response of atrial flutter to overdrive atrial pacing and intravenous disopyramide phosphate, singly and in combination.

    OpenAIRE

    Camm, J; Ward, D.; Spurrell, R

    1980-01-01

    Ten patients who suffered spontaneous paroxysms of atrial flutter were investigated by electrophysiological techniques. Two had overt Wolff-Parkinson-White syndrome; three Lown-Ganong-Levine syndrome; and one a concealed accessory atrioventricular connection. Atrial flutter was initiated, at study, by right atrial pacing and electrograms from the right atrium and coronary sinus were observed for at least five minutes to ensure stable flutter in both atria. Atrial flutter was terminated by 2.5...

  8. Atrial fibrillation and its determinants after radiofrequency ablation of chronic common atrial flutter

    OpenAIRE

    2005-01-01

    Aim. Atrial fibrillation (AFib) is a major clinical issue and its occurrence is the main problem after catheter ablation of atrial flutter. The long-term occurrence of AFib after common atrial flutter ablation is still matter of debate as it may influence the therapeutic approach. So, the aim of our study was to analyze the determinants and the time course of AFib after radiofrequency catheter ablation of chronic common atrial flutter. Methods and Results. 89 consecutive patients (67.5 ± ...

  9. Isthmus Dependent Atrial Flutter Cycle Length Correlates with Right Atrial Cross-Sectional Area

    OpenAIRE

    2009-01-01

    Background Right atrial flutter cycle length can prolong in the presence of antiarrhythmic drug therapy. We hypothesized that the cycle length of right atrial isthmus dependent flutter would correlate with right atrial cross-sectional area measurements. Methods 60 patients who underwent ablation for electrophysiologically proven isthmus dependent right atrial flutter, who were not on Class I or Class III antiarrhythmic drugs and had recent 2-dimensional echocardiographic data comprised the st...

  10. Atrial Tachycardias Occurring Late After Open Heart Surgery

    OpenAIRE

    Kohári, Mária; Pap, Róbert

    2015-01-01

    Atrial tachycardias are common after open heart surgery. Most commonly these are macro-reentrant including cavotricuspid isthmus dependent atrial flutter, incisional right atrial flutter and left atrial flutter. Focal atrial tachycardias occur less frequently. The specific type of atrial tachycardia highly depends on the type of surgical incision. Catheter ablation can be very effective, however requires a thorough understanding of anatomy and surgical technique.

  11. Risk of atrial fibrillation in diabetes mellitus

    DEFF Research Database (Denmark)

    Pallisgaard, Jannik L.; Schjerning, Anne-Marie; Lindhardt, Tommi B.;

    2016-01-01

    AIM: Diabetes has been associated with atrial fibrillation but the current evidence is conflicting. In particular knowledge regarding young diabetes patients and the risk of developing atrial fibrillation is sparse. The aim of our study was to investigate the risk of atrial fibrillation in patients...... with diabetes compared to the background population in Denmark. METHODS AND RESULTS: Through Danish nationwide registries we included persons above 18 years of age and without prior atrial fibrillation and/or diabetes from 1996 to 2012. The study cohort was divided into a background population without...... diabetes and a diabetes group. The absolute risk of developing atrial fibrillation was calculated and Poisson regression models adjusted for sex, age and comorbidities were used to calculate incidence rate ratios of atrial fibrillation. The total study cohort included 5,081,087 persons, 4,827,713 (95%) in...

  12. A not so benign atrial flutter: spontaneous 1:1 conduction of atrial flutter

    OpenAIRE

    Murthy, Avinash M A; Jain, Ankit; Tan, Henry

    2013-01-01

    A 1:1 conduction of atrial tachyarrhythmias, although not uncommon, usually is associated with the use of antiarrhythmic drugs; hyperthyroidism etc. Spontaneous 1:1 conduction of atrial flutter is indeed rare. We present a case of a spontaneous 1:1 conduction of a cavotricuspid isthmus-dependent atrial flutter.

  13. Atrial ultrastructural changes during experimental atrial tachycardia depend on high ventricular rate

    NARCIS (Netherlands)

    Schoonderwoerd, BA; Ausma, J; Crijns, HJGM; Van Veldhuisen, DJ; Blaauw, EH; Van Gelder, IC

    2004-01-01

    Atrial Ultrastructural Remodeling. Introduction: Atrial structural and electrophysiologic changes occur during atrial tachycardia. The role of high ventricular rate in these processes remains to be established. Methods and Results: Six goats were subjected to 4 weeks of rapid atrioventricular (AV) p

  14. Left Atrial Appendage Exclusion for Stroke Prevention in Atrial Fibrillation

    OpenAIRE

    Patel, Taral K.; Yancy, Clyde W; Knight, Bradley P.

    2012-01-01

    The public health burden of atrial fibrillation (AF) and associated thromboembolic stroke continues to grow at alarming rates. AF leads to a fivefold increase in the risk of stroke. Therefore, stroke prevention remains the most critical aspect of AF management. Current standard of care focuses on oral systemic anticoagulation, most commonly with warfarin and now with newer agents such as dabigatran, rivaroxaban, and apixaban. However, the challenges and limitations of oral anticoagulation hav...

  15. Low atrial septum pacing in pacemaker patients

    OpenAIRE

    Voogt, Willem Gijsbert de

    2006-01-01

    In patients with an indication for anti bradycardia pacing, atrial fibrillation (AF) is a common arrhythmia (30-50%) even in the absence of atrial tachy arrhythmias before pacemaker implantation. Pace prevention and pace intervention for atrial tachy arrhythmias could be an interesting adjuvant treatment in the prevention of the arrhythmia related complications. These treatment modalities when available in pacemaker systems could come at a relative low cost as the indication for pacemaker imp...

  16. Minimally Invasive Surgical Therapies for Atrial Fibrillation

    OpenAIRE

    Chu, Michael W.A.; Yoshitsugu Nakamura; Bob Kiaii

    2012-01-01

    Atrial fibrillation is the most common sustained arrhythmia and is associated with significant risks of thromboembolism, stroke, congestive heart failure, and death. There have been major advances in the management of atrial fibrillation including pharmacologic therapies, antithrombotic therapies, and ablation techniques. Surgery for atrial fibrillation, including both concomitant and stand-alone interventions, is an effective therapy to restore sinus rhythm. Minimally invasive surgical ablat...

  17. Postoperative atrial fibrillation, oxidative stress, and inflammation

    OpenAIRE

    ÖZAYDIN, Mehmet

    2011-01-01

    Postoperative atrial fibrillation is the most common complication of cardiac surgery. It is associated with increased complication rates. Recent trials have suggested that inflammation and oxidative stress have key roles in the pathophysiology of atrial fibrillation. Current evidence evaluating the use of antiinflammatory and antioxidant agents, including statins, corticosteroids, N-acetylcysteine, vitamin C, and fish oil, to prevent postoperative atrial fibrillation is promising. However, la...

  18. Aspirin Often Wrongly Prescribed for Atrial Fibrillation

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_159459.html Aspirin Often Wrongly Prescribed for Atrial Fibrillation Blood thinners -- not aspirin -- dramatically cut the risk of stroke, researchers say ...

  19. Present treatment options for atrial fibrillation

    OpenAIRE

    Lairikyengbam, S; Anderson, M.,; Davies, A

    2003-01-01

    Atrial fibrillation is the commonest sustained cardiac arrhythmia. It accounts for >35% of all hospital admissions for cardiac arrhythmias in the United States. The presence of atrial fibrillation increases the mortality of a population by up to twofold. The risk of stroke increases from 1.5% in patients with atrial fibrillation from 50–59 years of age to up to 23.5% for such patients aged 80–89 years. Although the diagnosis of atrial fibrillation is usually straightforward, effective treatme...

  20. Relation between epicardial fat tissue and atrial fibrillation

    OpenAIRE

    Enbiya Aksakal; İbrahim Halil Tanboğa; Mustafa Kurt; Süleyman Karakoyun

    2012-01-01

    Objectives: The objective of the study was to evaluatethe relationship of epicardial fat thickness (EFT) assessedby echocardiography with atrial fibrillation (AF) ina clinical setting.Materials and methods: The study consisted of 58 AFpatients who underwent echocardiography and a controlgroup of 22 participants. The EFT thickness was measuredon the free wall of the right ventricle from the parasternallong-axis view. The association between EFT andAF was studied by adjusting the risk factors f...

  1. Effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock

    Institute of Scientific and Technical Information of China (English)

    Xi-Zhou Chen

    2016-01-01

    Objective:To analyze the effect of recombinant human brain natriuretic peptide-assisted interventional treatment on prognosis of acute myocardial infarction patients complicated with cardiogenic shock.Methods: A total of 112 cases of inpatients treated in Cardiology Department of our hospital from March 2013 to March 2015 were selected, all of whom had acute myocardial infarction within 12 hours of onset and received direct PCI treatment. They were divided into observation group and control group according to random number table, each group with 56 cases, control group received conventional interventional treatment and observation group received recombinant human brain natriuretic peptide-assisted interventional treatment. Then differences of regional myocardial deformability, myocardial enzyme spectrum indicators, brain natriuretic peptide and inflammatory factors, blood sugar and stress hormones as well as myocardial infarction prognosis-associated indexes, etc, between two groups after treatment were compared.Results:After treatment, LVEF, SRs, SRe and Sra levels of observation group were higher than those of control group, WMSI level was lower than that of control group; serum myocardial enzyme spectrum indicators CK, CK-MB, AST and LDH values were lower than those of control group; serum BNP, CRP, TNF-α and IL-6 levels were lower than those of control group; serum cortisol, growth hormone and glucagon levels were lower than those of control group, insulin level was higher than that of control group; FT3 and IGF-1 levels were higher than those of control group, sPLA2 and Hcy levels were lower than those of control group.Conclusion: Recombinant human brain natriuretic peptide-assisted interventional treatment for acute myocardial infarction patients complicated with cardiogenic shock can reduce myocardial function injury, protect normal myocardial function and optimize patients' long-term prognosis; it has active clinical significance.

  2. Atrial fibrillation: inflammation in disguise?

    Science.gov (United States)

    Lappegård, K T; Hovland, A; Pop, G A M; Mollnes, T E

    2013-08-01

    Atrial fibrillation is highly prevalent, and affected patients are at an increased risk of a number of complications, including heart failure and thrombo-embolism. Over the past years, there has been increasing interest in the role of inflammatory processes in atrial fibrillation, from the first occurrence of the arrhythmia to dreaded complications such as strokes or peripheral emboli. As the standard drug combination which aims at rate control and anticoagulation only offers partial protection against complications, newer agents are needed to optimize treatment. In this paper, we review recent knowledge regarding the impact of inflammation on the occurrence, recurrence, perpetuation and complications of the arrhythmia, as well as the role of anti-inflammatory therapies in the treatment for the disease. PMID:23672430

  3. The transcription factor MEF2C mediates cardiomyocyte hypertrophy induced by IGF-1 signaling

    Energy Technology Data Exchange (ETDEWEB)

    Munoz, Juan Pablo; Collao, Andres; Chiong, Mario; Maldonado, Carola; Adasme, Tatiana; Carrasco, Loreto; Ocaranza, Paula; Bravo, Roberto; Gonzalez, Leticia; Diaz-Araya, Guillermo [Centro FONDAP Estudios Moleculares de la Celula, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Facultad de Ciencias Quimicas y Farmaceuticas, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Hidalgo, Cecilia [Centro FONDAP Estudios Moleculares de la Celula, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Instituto de Ciencias Biomedicas, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Lavandero, Sergio, E-mail: slavander@uchile.cl [Centro FONDAP Estudios Moleculares de la Celula, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Facultad de Ciencias Quimicas y Farmaceuticas, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile); Instituto de Ciencias Biomedicas, Facultad de Medicina, Universidad de Chile, Santiago 8380492 (Chile)

    2009-10-09

    Myocyte enhancer factor 2C (MEF2C) plays an important role in cardiovascular development and is a key transcription factor for cardiac hypertrophy. Here, we describe MEF2C regulation by insulin-like growth factor-1 (IGF-1) and its role in IGF-1-induced cardiac hypertrophy. We found that IGF-1 addition to cultured rat cardiomyocytes activated MEF2C, as evidenced by its increased nuclear localization and DNA binding activity. IGF-1 stimulated MEF2 dependent-gene transcription in a time-dependent manner, as indicated by increased MEF2 promoter-driven reporter gene activity; IGF-1 also induced p38-MAPK phosphorylation, while an inhibitor of p38-MAPK decreased both effects. Additionally, inhibitors of phosphatidylinositol 3-kinase and calcineurin prevented IGF-1-induced MEF2 transcriptional activity. Via MEF2C-dependent signaling, IGF-1 also stimulated transcription of atrial natriuretic factor and skeletal {alpha}-actin but not of fos-lux reporter genes. These novel data suggest that MEF2C activation by IGF-1 mediates the pro-hypertrophic effects of IGF-1 on cardiac gene expression.

  4. Prevalence, prognostic significance, and treatment of atrial fibrillation in congestive heart failure with particular reference to the DIAMOND-CHF study

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2003-01-01

    failure and the prevalence increases with the severity of the disease. These two conditions seem to be linked together, and congestive heart failure may either be the cause or the consequence of atrial fibrillation. The prognosis of atrial fibrillation is controversial, but studies indicate that atrial...... fibrillation is a risk factor in congestive heart failure patients. In the last 10-15 years, significant advances in the treatment of heart failure have improved survival, whereas effective management of atrial fibrillation in heart failure patients still awaits similar progress. Empirically, two strategies...

  5. Impaired endothelial function in lone atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Polovina Marija

    2013-01-01

    Full Text Available Background/Aim. Impaired endothelial function has been previously documented in patients with atrial fibrillation (AF and underlying comorbidities or older patients with idiopathic AF. The aim of this study was to evaluate systemic endothelial function in younger AF patients (less than 7 days lone AF. The second group comprised of 28 healthy controls in sinus rhythm (the mean age 43 ± 13, 53% male, matched by age, gender and atherosclerotic risk factors. All the participants underwent physical examination, laboratory analysis [including determination of C-reactive protein (CRP], standard echocardiography and exercise-stress testing. Brachial artery FMD and endothelium independent dilation (NMD were assessed with a high-resolution ultrasound probe and arterial diameters taken from 5 consecutive cardiac cycles were averaged for each measurement to accommodate to beat-to-beat flow variations in AF. Results. There were no differences between the 2 groups regarding age, gender and most clinical, laboratory and echocardiographic characteristics (all p > 0.05, apart from the increased heart rate (p = 0.018, body mass index (p = 0.027, CRP levels (p = 0.007 and left atrial anteroposterior dimension (p 0.05. In the multivariate analysis, the independent FMD determinants in our study population were the presence of AF, smoking and total cholesterol levels (all p < 0.001. In patients with AF, the strongest independent FMD determinant was arrhythmia duration (p < 0.001, followed by smoking (p = 0.013 and total cholesterol levels (p = 0.045. Conclusions. Our findings confirm that sustained AF is associated with systemic endothelial dysfunction even in relatively young patients with no cardiovascular disorders or risk factors. AF is an independent contributor to lower FMD and a prolonged arrhythmia duration may confer the risk for more profound endothelial damage.

  6. Mapping Atrial Fibrillation: 2015 Update

    OpenAIRE

    Chirag R. Barbhayia; Saurabh Kumar; Gregory F. Michaud

    2015-01-01

    Atrial fibrillation requires a trigger that initiates the arrhythmia and substrate that favors perpetuation. Cardiac mapping is necessary to locate triggers and substrate so that an ablation strategy can be optimized. The most commonly used cardiac mapping approach is isochronal or activation mapping, which aims to create a spatial model of electrical wavefront propagation. Historically, activation mapping has been successful for mapping point source and single or double wave reentrant arr...

  7. Atrial fibrillation care improvement collaborative

    OpenAIRE

    Robelia, Paul; Kopecky, Stephen; Thacher, Tom

    2015-01-01

    Atrial fibrillation (AF) is an increasingly common cardiac arrhythmia. Many patients with new onset or recurrent AF present to the emergency department and are subsequently admitted to the hospital and seen by cardiology specialists for follow up. In an attempt to address this high utilization of acute health care resources, reduce costs, and improve patient care, our institution instituted a collaborative project between the departments of emergency medicine, cardiology, family medicine, and...

  8. Atrial fibrillation in the elderly

    Institute of Scientific and Technical Information of China (English)

    Roger Kerzner; Michael W. Rich

    2005-01-01

    Atrial fibrillation (AF) is an extremely common condition in the elderly, with increasing prevalence around the world as the population ages. AF may be associated with serious health consequences, including stroke, heart failure, and decreased quality of life, so that careful management of AF by geriatric health care providers is required. With careful attention to anticoagulation therapy, and prudent use of medications and invasive procedures to minimize symptoms, many of the adverse health consequences of AF can be prevented.

  9. Demonstration of natriuretic activity in urine of neurosurgical patients with renal salt wasting [v2; ref status: indexed, http://f1000r.es/1ax

    Directory of Open Access Journals (Sweden)

    Steven J Youmans

    2013-06-01

    Full Text Available We have utilized the persistent elevation of fractional excretion (FE of urate, > 10%, to differentiate cerebral/renal salt wasting (RSW from the syndrome of inappropriate antidiuretic hormone secretion (SIADH, in which a normalization of FEurate occurs after correction of hyponatremia.  Previous studies suggest as well  that an elevated FEurate with normonatremia, without pre-existing hyponatremia, is also consistent with RSW, including studies demonstrating induction of RSW in rats infused with plasma from normonatremic neurosurgical and Alzheimer’s disease patients.  The present studies were designed to test whether precipitates from the urine of normonatremic neurosurgical patients, with either normal or elevated FEurate, and patients with SIADH, display natriuretic activity.   Methods: Ammonium sulfate precipitates from the urine of 6 RSW and 5 non-RSW Control patients were dialyzed (10 kDa cutoff to remove the ammonium sulfate, lyophilized, and the reconstituted precipitate was tested for its effect on transcellular transport of 22Na across LLC-PK1 cells grown to confluency in transwells. Results: Precipitates from 5 of the 6 patients with elevated FEurate and normonatremia significantly inhibited the in vitro transcellular transport of 22Na above a concentration of 3 μg protein/ml, by 10-25%, versus to vehicle alone, and by 15-40% at concentrations of 5-20 μg/ml as compared to precipitates from 4 of the 5 non-RSW patients with either normal FEurate and normonatremia (2 patients or with SIADH (2 patients. Conclusion: These studies provide further evidence that an elevated FEurate with normonatremia is highly consistent with RSW.  Evidence in the urine of natriuretic activity suggests significant renal excretion of the natriuretic factor. The potentially large source of the natriuretic factor that this could afford, coupled with small analytical sample sizes required by the in-vitro bioassay used here, should facilitate future

  10. Demonstration of natriuretic activity in urine of neurosurgical patients with renal salt wasting [v1; ref status: indexed, http://f1000r.es/nu

    Directory of Open Access Journals (Sweden)

    Steven J Youmans

    2013-05-01

    Full Text Available We have utilized the persistent elevation of fractional excretion (FE of urate, > 10%, to differentiate cerebral/renal salt wasting (RSW from the syndrome of inappropriate antidiuretic hormone secretion (SIADH, in which a normalization of FEurate occurs after correction of hyponatremia.  Previous studies suggest as well  that an elevated FEurate with normonatremia, without pre-existing hyponatremia, is also consistent with RSW, including studies demonstrating induction of RSW in rats infused with plasma from normonatremic neurosurgical and Alzheimer’s disease patients.  The present studies were designed to test whether precipitates from the urine of normonatremic neurosurgical patients, with either normal or elevated FEurate, and patients with SIADH, display natriuretic activity.   Methods: Ammonium sulfate precipitates from the urine of 6 RSW and 5 non-RSW Control patients were dialyzed (10 kDa cutoff to remove the ammonium sulfate, lyophilized, and the reconstituted precipitate was tested for its effect on transcellular transport of 22Na across LLC-PK1 cells grown to confluency in transwells. Results: Precipitates from 5 of the 6 patients with elevated FEurate and normonatremia significantly inhibited the in vitro transcellular transport of 22Na above a concentration of 3 μg protein/ml, by 10-25%, versus to vehicle alone, and by 15-40% at concentrations of 5-20 μg/ml as compared to precipitates from 4 of the 5 non-RSW patients with either normal FEurate and normonatremia (2 patients or with SIADH (2 patients. Conclusion: These studies provide further evidence that an elevated FEurate with normonatremia is highly consistent with RSW.  Evidence in the urine of natriuretic activity suggests significant renal excretion of the natriuretic factor. The potentially large source of the natriuretic factor that this could afford, coupled with small analytical sample sizes required by the in-vitro bioassay used here, should facilitate future

  11. Atrial tumors in cardiac MRI

    International Nuclear Information System (INIS)

    Cardiac magnetic resonance imaging (MRI) is an important tool for the diagnosis of cardiac masses. Various cardiac tumors are predisposed to occurring in atrial structures. The aim of this review article is the description of atrial tumors and their morphological features in MRI. In general, cardiac tumors are rare: approximately 0.001-0.03% in autopsy studies. About 75% of them are benign. The most common cardiac tumor is the myxoma. They are predisposed to occur in the atria and show a characteristically strong hyperintense signal on T2-wieghted images in MRI. In other sequences a heterogeneous pattern reflects its variable histological appearance. Lipomas exhibit a signal behavior identical to fatty tissue with a typical passive movement in cine imaging. Fibroelastomas are the most common tumors of the cardiac valves. Consisting of avascular fibrous tissue, they often present with hypointense signal intensities. Thrombi attached to their surface can cause severe emboli even in small tumors. Amongst primary cardiac malignancies, sarcomas are most common and favor the atria. Secondary malignancies of the heart are far more common than primary ones (20-40 times). In case of known malignancies, approximately 10% of patients develop cardiac metastasis at the end of their disease. Lymphogenic metastases favor the pericardium, while hematogenic spread prefers the myocardium. Since they are not real atrial tumors, thrombi and anatomical structures of the atria have to be differentiated from other pathologies. (orig.)

  12. Effects of matrine on collagen proliferation and TNF-α, TGF-β1 and CTGF in atrial tissues of dogs with persistent atrial fibrillation

    Directory of Open Access Journals (Sweden)

    You-ping Dai

    2013-12-01

    Full Text Available Objective:To study the effects of matrine (mat on collagen synthesis and expression of tumor necrosis factoralpha (TNF-α, and transforming growth factor-β1 (TGF-β1 and connective tissue growth factor (CTGF in atrial tissues of dogs with persistent atrial fibrillation (AF. Methods : Ten healthy beagle dogs were randomly divided into two groups: AF group (n=5 and AF/Mat group (n=5, using right ventricular pacing to establish AF model. The collagen volume fraction (CVF in atrial tissue were detected by sirius red staining to determine the level of fabrication. The level of TNF-α, TGF-β1 and CTGF were detected by immunohisto-chemistry. The mRNA expression level of TNF-α, TGF-β1 and CTGF were detected by reverse transcription-polymerase chain reaction (RT-PCR. Results:  Compared with the AF group, the fabriation level of AF/Mat was decreased obviously (P<0.05, the expression levels of TNF-α, TGF-β1 and CTGF were decreased, and the mRNA expression level were decreased significantly in atrial tissues (P<0.05 and P<0.01. Conclusion: Matrine may inhibits fabrosis in atrial tissues through inhibition collagen proliferation and expression of TNF-α, TGF-β1 and CTGF.

  13. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    OpenAIRE

    Wachter Rolf; Pouwels Claudia; Kleta Sibylle; Wetzel Dirk; Kochen Michael M; Lüers Claus; Scherer Martin; Koschack Janka; Herrmann-Lingen Christoph; Pieske Burkert; Binder Lutz

    2008-01-01

    Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, clinical information, and echocardiographic data of left ventricular systolic function wer...

  14. C-type natriuretic peptide modulates permeability of the blood–brain barrier

    OpenAIRE

    BOHARA, Manoj; Kambe, Yuki; Nagayama, Tetsuya; TOKIMURA, Hiroshi; Arita, Kazunori; Miyata, Atsuro

    2014-01-01

    C-type natriuretic peptide (CNP) is abundant in brain and is reported to exert autocrine function in vascular cells, but its effect on blood–brain barrier (BBB) permeability has not been clarified yet. Here, we examined this effect. Transendothelial electrical resistance (TEER) of in vitro BBB model, composed of bovine brain microvascular endothelial cells and astrocytes, was significantly dose dependently decreased by CNP (1, 10, and 100 nmol/L). C-type natriuretic peptide treatment reduced ...

  15. B-Type Natriuretic Peptide: From Posttranslational Processing to Clinical Measurement

    DEFF Research Database (Denmark)

    Goetze, Jens P

    2012-01-01

    BACKGROUND:Plasma cardiac natriuretic peptides and peptide fragments from their molecular precursors are markers of heart disease. Clinical studies have defined the current diagnostic utility of these markers, whereas biochemical elucidation of peptide structure and posttranslational processing has...... revealed new plasma peptide forms of potential clinical use.CONTENT:Natriuretic propeptide structures undergo variable degrees of endo- and exoproteolytic cleavages as well as amino acid modifications, which leave the plasma phase of the peptides highly heterogeneous and dependent on cardiac...

  16. A disulfide-bridged mutant of natriuretic peptide receptor-A displays constitutive activity. Role of receptor dimerization in signal transduction.

    Science.gov (United States)

    Labrecque, J; Mc Nicoll, N; Marquis, M; De Léan, A

    1999-04-01

    Natriuretic peptide receptor-A (NPR-A), a particulate guanylyl cyclase receptor, is composed of an extracellular domain (ECD) with a ligand binding site, a transmembrane spanning, a kinase homology domain (KHD), and a guanylyl cyclase domain. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), the natural agonists, bind and activate the receptor leading to cyclic GMP production. This receptor has been reported to be spontaneously dimeric or oligomeric. In response to agonists, the KHD-mediated guanylate cyclase repression is removed, and it is assumed that ATP binds to the KHD. Since NPR-A displays a pair of juxtamembrane cysteines separated by 8 residues, we hypothesized that the removal of one of those cysteines would leave the other unpaired and reactive, thus susceptible to form an interchain disulfide bridge and to favor the dimeric interactions. Here we show that NPR-AC423S mutant, expressed mainly as a covalent dimer, increases the affinity of pBNP for this receptor by enhancing a high affinity binding component. Dimerization primarily depends on ECD since a secreted NPR-A C423S soluble ectodomain (ECDC423S) also documents a covalent dimer. ANP binding to the unmutated ECD yields up to 80-fold affinity loss as compared with the membrane receptor. However, the ECD C423S mutation restores a high binding affinity. Furthermore, C423S mutation leads to cellular constitutive activation (20-40-fold) of basal catalytic production of cyclic GMP by the full-length mutant. In vitro particulate guanylyl cyclase assays demonstrate that NPR-AC423S displays an increased sensitivity to ATP treatment alone and that the effect of ANP + ATP joint treatment is cumulative instead of synergistic. Finally, the cellular and particulate guanylyl cyclase assays indicate that the receptor is desensitized to agonist stimulation. We conclude the following: 1) dimers are functional units of NPR-A guanylyl cyclase activation; and 2) agonists are inducing dimeric contact

  17. Agonistic induction of a covalent dimer in a mutant of natriuretic peptide receptor-A documents a juxtamembrane interaction that accompanies receptor activation.

    Science.gov (United States)

    Labrecque, J; Deschênes, J; McNicoll, N; De Léan, A

    2001-03-16

    The natriuretic peptide receptor-A (NPR-A) is composed of an extracellular domain with a ligand binding site, a transmembrane-spanning domain, a kinase homology domain, and a guanylyl cyclase domain. In response to agonists (atrial natriuretic peptide (ANP) and brain natriuretic peptide), the kinase homology domain-mediated guanylate cyclase repression is removed, which allows the production of cyclic GMP. Previous work from our laboratory strongly indicated that agonists are exerting their effects through the induction of a juxtamembrane dimeric contact. However, a direct demonstration of this mechanism remains to be provided. As a tool, we are now using the properties of a new mutation, D435C. It introduces a cysteine at a position in NPR-A corresponding to a supplementary cysteine found in NPR-C6, another receptor of this family (a disulfide-linked dimer). Although this D435C mutation only leads to trace levels of NPR-A disulfide-linked dimer at basal state, covalent dimerization can be induced by a treatment with rat ANP or with other agonists. The NPR-A(D435C) mutant has not been subjected to significant structural alterations, since it shares with the wild type receptor a similar dose-response pattern of cellular guanylyl cyclase activation. However, a persistent activation accompanies NPR-A(D435C) dimer formation after the removal of the inducer agonist. On the other hand, a construction where the intracellular domain of NPR-A(D435C) has been truncated (DeltaKC(D435C)) displays a spontaneous and complete covalent dimerization. In addition, the elimination of the intracellular domain in wild type DeltaKC and DeltaKC(D435C) is associated with an increase of agonist binding affinity, this effect being more pronounced with the weak agonist pBNP. Also, a D435C secreted extracellular domain remains unlinked even after incubation with rat ANP. In summary, these results demonstrate, in a dynamic fashion, the agonistic induction of a dimeric contact in the

  18. Brain natriuretic peptide and optimal management of heart failure

    Institute of Scientific and Technical Information of China (English)

    LI Nan; WANG Jian-an

    2005-01-01

    Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease.Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.

  19. Neprilysin and Natriuretic Peptide Regulation in Heart Failure.

    Science.gov (United States)

    Bayes-Genis, Antoni; Morant-Talamante, Nuria; Lupón, Josep

    2016-08-01

    Neprilysin is acknowledged as a key player in neurohormonal regulation, a cornerstone of modern drug therapy in chronic heart failure. In the cardiovascular system, neprilysin cleaves numerous vasoactive peptides, some with mainly vasodilating effects (natriuretic peptides, adrenomedullin, bradykinin) and other with mainly vasoconstrictor effects (angiotensin I and II, endothelin-1). For decades, neprilysin has been an important biotarget. Academia and industry have combined active efforts to search for neprilysin inhibitors (NEPIs) that might be useful in clinical practice. NEPI monotherapy was initially tested with little success due to efficacy issues. Next, combination of NEPI and ACE-inhibiting activity agents were abandoned due to safety concerns. Recently, the combination of NEPI and ARB, also known as ARNI, has shown better than expected results in heart failure with reduced ejection fraction, and multitude of ongoing studies are set to prove its value across the heart failure spectrum. PMID:27260315

  20. Fibrilação atrial e flutter após operação de revascularização do miocárdio: fatores de risco e resultados Atrial fibrillation and flutter following coronary artery bypass graft surgery: risk factors and results

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Vilela Borges LIMA

    2001-09-01

    Full Text Available OBJETIVO: Determinar a incidência de fibrilação atrial e flutter (FAF no pós-operatório de revascularização do miocárdio (RM, bem como os fatores preditivos e a influência destas arritmias sobre o período de internação hospitalar. CASUÍSTICA E MÉTODOS: Foram analisados 275 pacientes submetidos à operação de revascularização do miocárdio isolada ou associada à correção de aneurisma de ventrículo esquerdo. A idade variou de 26 a 83 anos, com média de idade de 58,7 ± 9,5 anos. Cento e noventa e seis pacientes (71,3% eram do sexo masculino. RESULTADOS: A incidência total de fibrilação atrial e flutter pós-operatórios foi 16,4% com pico de incidência ocorrendo no segundo e terceiro dia de pós-operatório. Idade avançada, sexo masculino e história de fibrilação atrial ou flutter no pré-operatório foram identificados como fatores preditivos independentes de fibrilação atrial ou flutter no pós-operatório. Os pacientes que apresentaram FA ou flutter no pós-operatório em média 36 horas a mais na Unidade de Terapia Intensiva (UTI e 4,8 dias a mais hospitalizados. CONCLUSÃO: A FA e flutter são arritmias comuns no pós-operatório de revascularização do miocárdio, tendo efeito significativo sobre os tempos de permanência na UTI e de internação hospitalar.OBJECTIVE: The aim of this study was to determine the overall incidence and predictors of atrial fibrillation and flutter (AFF following CABG, as well as the influence of these arrhythmia on the hospital length of stay. MATERIAL AND METHODS: Two hundred and seventy-five patients, who had undergone coronary artery bypass graft (CABG surgery at the Beneficência Portuguesa Hospital in São Paulo, had their data collected and analyzed. The age range was from 26 to 83 years old with mean age of 58.7 and standard deviation of 9.5 years. One hundred and ninety six patients (71.3% were male. RESULTS: The outcomes of this analysis were: the overall incidence of

  1. Clinical implications of defective B-type natriuretic peptide.

    Science.gov (United States)

    Menon, Santosh G; Mills, Roger M; Schellenberger, Ute; Saqhir, Syed; Protter, Andrew A

    2009-12-01

    Our understanding of the natriuretic peptide system continues to evolve rapidly. B-type natriuretic peptide (BNP), originally thought to be a simple volume-regulating hormone that is produced in response to cardiac stretch, has been shown to also play important roles in modulating bronchodilation, endothelial function, and cardiac remodeling. Recent data demonstrate that elevated levels of BNP in patients with heart failure do not represent a simple ratcheting up of normal production in response to increased stimulus. Instead, we now know that chronic stimulation of BNP synthesis induces a reversion to fetal gene expression, resulting in production of high molecular weight forms of BNP that are functionally deficient. Standard point-of-care BNP assays are immunoassays that will detect any molecule containing the target epitopes. Consequently, these assays cannot distinguish between defective, high molecular weight forms of BNP and normal, physiologically active BNP. In 2 separate evaluations, mass spectroscopy detected little, if any, normal BNP in patients with heart failure, despite the appearance of high circulating levels of immunoreactive BNP (iBNP) using commercial assays. Therefore, these commercial assays should be considered to be only an indication of myocardial stress. They do not measure physiologic BNP activity. This accounts for the "BNP paradox," namely, that administration of exogenous recombinant human BNP (rhBNP, nesiritide) has substantial clinical and hemodynamic impact in the presence of high levels of circulating iBNP using commercial assays. In addition to its short-term hemodynamic impact, rhBNP may have other important effects in this setting, and further investigation is warranted. PMID:20014209

  2. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa; Klausen, Tobias; Jørgensen, Martin Balslev; Nordentoft, Merete

    that patients with depression would have an attenuated N-terminal proANP (NT-proANP) response to acute exercise compared to healthy controls. Secondly, we aimed to assess the effect of antidepressants on NT-proANP response to acute exercise. METHODS: We examined 132 outpatients with mild to moderate...... depression (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60min post-exercise. RESULTS: The NT-proANP response to physical exercise differed between...

  3. Effect of atrial natriuretic peptide on ischemia-reperfusion injury in a porcine total hepatic vascular exclusion model

    Institute of Scientific and Technical Information of China (English)

    Katsumi Kobayashi; Koshi Matsurnoto; Izumi Takeyoshi; Kiyohiro Oshima; Masato Muraoka; Takahiko Akao; Osamu Totsuka; Hisashi Shimizu; Hiroaki Sato; Kazumi Tanaka; Kenjiro Konno

    2007-01-01

    AIM: To evaluate the effect of ANP on warm I/R injury in a porcine THVE model.METHODS: Miniature pigs (mini-pigs) weighing 16-24 kg were observed for 120 min after reperfusion following 120 min of THVE. The animals were divided into two groups. ANP (0.1 μg/kg per min) was administered to the ANP group (n = 7), and vehicle was administered to the control group (n = 7). Either vehicle or ANP was intravenously administered from 30 min before the THVE to the end of the experiment. Arterial blood was collected to measure AST, LDH, and TNF-α. Hepatic tissue blood flow (HTBF) was also measured. Liver specimens were harvested for p38 MAPK analysis and histological study.Those results were compared between the two groups.RESULTS: The AST and LDH levels were lower in the ANP group than in the control group; the AST levels were significantly different between the two groups (60 min: 568.7 ± 113.3 vs 321.6 ± 60.1, P = 0.038 < 0.05,120 min: 673.6 ± 148.2 vs 281.1 ± 44.8, P = 0.004< 0.01). No significant difference was observed in the TNF-α levels between the two groups. HTBF was higher in the ANP group, but the difference was not significant.A significantly higher level of phosphorylated p38 MAPK was observed in the ANP group compared to the control group (0 min: 2.92 ± 1.1 vs 6.38 ± 1.1, P = 0.611 < 0.05).Histological tissue damage was milder in the ANP group than in the control group.CONCLUSION: Our results show that ANP has a protective role in I/R injury with p38 MAPK activation in a porcine THVE model.

  4. N-terminal pro-atrial natriuretic peptide response to acute exercise in depressed patients and healthy controls

    DEFF Research Database (Denmark)

    Krogh, Jesper; Ströhle, Andreas; Westrin, Asa; Klausen, Tobias; Jørgensen, Martin Balslev; Nordentoft, Merete

    depression (ICD-10) and 44 healthy controls, group matched for age, sex, and BMI. We used an incremental bicycle ergometer test as a physical stressor. Blood samples were drawn at rest, at exhaustion, and 15, 30, and 60min post-exercise. RESULTS: The NT-proANP response to physical exercise differed between...

  5. Radiofrequency catheter oblation in atrial flutter

    International Nuclear Information System (INIS)

    Objective: To evaluate the radiofrequency catheter ablation for type I atrial flutter through application of Holo catheter labelling with anatomic imaging localization to ablate the isthmus of IVCTA during complete double-way block. Methods: Eleven cases with type I atrial flutter undergone Holo catheter labelling technique and consecution with conduction time change of coronary venous sinus orifice with-right atrial lower lateral wall pace excitation, were performed with radiofrequency catheter ablation for the isthmus outcoming with complete double-way conduction block. Results: All together 11 cases with 4 of atrial flutter and 7 of sinus rhythm were undergone radiofrequency catheter ablation resulting with double-way conduction block of the isthmus accompanied by prolongation of right atrial conduction time 56.0 ± 2.3 ms and 53.0 ± 4.6 ms respectively. The right atrial excitation appeared to be in clockwise and counter-clockwise of single direction. No recurrence occurred during 3-34 months follow up with only one showing atrial fibrillation. Conclusions: The application of Holo catheter labelling technique with anatomic imaging localization to achieve the double-way conduction block by radiofrequency catheter ablation of TVC-TA isthmus, is a reliable method for treating atrial flutter

  6. A novel and simple atrial retractor.

    Science.gov (United States)

    Kofidis, Theo; Lee, Chuen Neng

    2011-05-01

    Minimally invasive cardiac operations require specialized equipment. Atrial retractors are a frequently used tool to expose heart valves for minimally invasive and open procedures. The models currently available in the market are efficient; however, they may be complex, bulky, or expensive. We introduce a novel, very simple atrial retractor we designed using ubiquitously available materials. PMID:21524488

  7. Refractory atrial fibrillation effectively treated with ranolazine

    OpenAIRE

    Vaishnav, Aditi; Vaishnav, Avani; Lokhandwala, Yash

    2014-01-01

    Atrial fibrillation is the most common sustained cardiac arrhythmia which is often troublesome to manage. Currently, rhythm and rate control medications are the mainstays of therapy. In 2 amiodarone-refractory highly symptomatic patients, an innovative approach using ranolazine, which selectively acts on Na+ channels and delays atrial depolarization, was tried successfully.

  8. PAROXYSMAL ATRIAL FIBRILLATION: CHOICE OF CARDIOVERSION THERAPY

    Directory of Open Access Journals (Sweden)

    B. A. Tatarskii

    2015-12-01

    Full Text Available Characteristics and classification of different patterns of paroxysmal atrial fibrillation are presented. Main indications to restoration of sinus rhythm are discussed. The features of main medications used to terminate of atrial fibrillation are given. The choice of antiarrhythmic drug is considerate. Necessity of individual approach to therapy tactics is proved.

  9. Blocked atrial bigeminy presenting with bradycardia.

    Science.gov (United States)

    Akdeniz, Celal; Tanidir, Ibrahim Cansaran; Tuzcu, Volkan

    2012-01-01

    Blocked premature atrial contractions can cause bradycardia by resetting sinoatrial node and prolonging the RR intervals. Herein, we report the management of a patient with frequent premature atrial contractions in bigeminal pattern. The patient presented with symptomatic bradycardia and was successfully treated with propafenone. PMID:22469245

  10. PREDICTION OF UNEVENTFUL CARDIOVERSION AND MAINTENANCE OF SINUS RHYTHM FROM DIRECT-CURRENT ELECTRICAL CARDIOVERSION OF CHRONIC ATRIAL-FIBRILLATION AND FLUTTER

    NARCIS (Netherlands)

    VANGELDER, IC; CRIJNS, HJ; VANGILST, WH; LIE, KI

    1991-01-01

    The present study was undertaken to reassess prospectively the immediate and long-term results of direct-current electrical cardioversion in chronic atrial fibrillation or atrial flutter, and to determine factors predicting clinical outcome of the arrhthmia after direct-current cardioversion. Two-hu

  11. Noninvasive assessment of filling pressure and left atrial pressure overload in severe aortic valve stenosis: relation to ventricular remodeling and clinical outcome after aortic valve replacement

    DEFF Research Database (Denmark)

    Dahl, Jordi S; Videbæk, Lars; Poulsen, Mikael K;

    2011-01-01

    One of the hemodynamic consequences of aortic valve stenosis is pressure overload leading to left atrial dilatation. Left atrial size is a known risk factor providing prognostic information in several cardiac conditions. It is not known if this is also the case in patients with aortic valve steno...

  12. Left Atrial Thrombus Despite Anticoagulation: The Importance Of Homocystein

    Directory of Open Access Journals (Sweden)

    Dr. J. David Spence

    2013-08-01

    Full Text Available Patients in atrial fibrillation may have left atrial thrombi or strokes despite adequate anticoagulation. It is important to consider elevated plasma total homocysteine (tHcy as a treatable clotting factor that may explain such cases. Metabolic B12 deficiency is common even in patients with a “normal” serum B12. Measurement of holotranscobalamin, methylmalonic acid or, in folate-replete patients, tHcy are necessary to diagnose metabolic B12 deficiency when the serum B12 is below 400 pmol/L. Elevated tHcy quadruples the risk of stroke in atrial fibrillation, and is far more common than the usual clotting factors for which testing is commonly performed: among patients attending a secondary stroke prevention clinic, tHcy > 14 mmol/L is present in 20% at age 40, and in 40% at age 80. B vitamin therapy does reduce the risk of stroke; key issues are renal impairment and adequacy of vitamin B12. This intervention should be considered routinely in patients with AF.

  13. Salinity-dependent in vitro effects of homologous natriuretic peptides on the pituitary-interrenal axis in eels.

    Science.gov (United States)

    Ventura, Albert; Kusakabe, Makoto; Takei, Yoshio

    2011-08-01

    We examined the effects of atrial, B-type, ventricular and C-type natriuretic peptides (ANP, BNP, VNP and CNP1, 3, 4) on cortisol secretion from interrenal tissue in vitro in both freshwater (FW) and seawater (SW)-acclimated eels. We first localized the interrenal and chromaffin cells in the eel head kidney using cell specific markers (cholesterol side-chain cleavage enzyme (P450ssc) and tyrosine hydroxylase (TH), respectively) and established the in vitro incubation system for eel interrenal tissue. Unexpectedly, none of the NPs given alone to the interrenal tissue of FW and SW eels stimulated cortisol secretion. However, ANP and VNP, but not BNP and three CNPs, enhanced the steroidogenic action of ACTH in SW interrenal preparations, while CNP1 and CNP4, but not ANP, BNP, VNP and CNP3, potentiated the ACTH action in FW preparations. These salinity dependent effects of NPs are consistent with the previous in vivo study in the eel where endogenous ACTH can act with the injected NPs. 8-Br-cGMP also enhanced the ACTH action in both FW and SW eel preparations, suggesting that the NP actions were mediated by the guanylyl cyclase-coupled NP receptors (GC-A and B) that were localized in the eel interrenal. Further, ANP and CNP1 stimulated ACTH secretion from isolated pituitary glands of SW and/or FW eels. In summary, the present study revealed complex mechanisms of NP action on corticosteroidogenesis through the pituitary-interrenal axis in eels, thereby providing a deeper insight into the role of the NP family in the acclimation of this euryhaline teleost to diverse salinity environments. PMID:21624369

  14. Galectin-3 in patients undergoing ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Nicolas Clementy

    2014-11-01

    Conclusions: Persistent type of atrial fibrillation is an independent predictor of higher Galectin-3 concentration. This biomarker of fibrosis may be implied in the mechanisms of atrial remodeling and maintenance of atrial fibrillation, and thus be helpful for the design of therapeutic strategy in patients with atrial fibrillation.

  15. Atrial fibrillation and risk of stroke

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Gerds, Thomas A; Olesen, Jonas Bjerring;

    2016-01-01

    AIM: Although the relation between stroke risk factors and stroke in patients with atrial fibrillation (AF) has been extensively examined, only few studies have explored the association of AF and the risk of ischaemic stroke/systemic thromboembolism/transient ischaemic attack (stroke/TE/TIA) in the...... presence of concomitant stroke risk factors. METHODS AND RESULTS: From nationwide registries, all persons who turned 50, 60, 70, or 80 from 1997 to 2011 were identified. Persons receiving warfarin were excluded. The absolute risk of stroke/TE/TIA was reported for a 5-year period, as was the absolute risk...... ratios for AF vs. no AF according to prior stroke and the number of additional risk factors. The study cohort comprised of 3 076 355 persons without AF and 48 189 with AF. For men aged 50 years, with no risk factors, the 5-year risk of stroke was 1.1% (95% confidence interval 1.1-1.1); with AF alone 2...

  16. Transgenic insights linking Pitx2 and atrial arrhythmias

    Directory of Open Access Journals (Sweden)

    DiegoFranco

    2012-06-01

    Full Text Available Pitx2 is a homeobox transcription factor involved in left–right signaling during embryogenesis. Disruption of left–right signaling in mice within its core nodal/lefty cascade, results in impaired expression of the last effector of the left–right cascade, Pitx2, leading in many cases to absence or bilateral expression of Pitx2 in lateral plate mesoderm (LPM. Loss of Pitx2 expression in LPM results in severe cardiac malformations, including right cardiac isomerism. Pitx2 is firstly expressed asymmetrically in the left but not right LPM, before the cardiac crescent forms, and subsequently, as the heart develops, becomes confined to the left side of the linear heart tube. Expression of Pitx2 is remodeled during cardiac looping, becoming localized to the ventral portion of the developing ventricular chambers, while maintaining a distinct left-sided atrial expression. The importance of Pitx2 during cardiogenesis has been illustrated by the complex and robust cardiac defects observed on systemic deletion of Pitx2 in mice. Lack of Pitx2 expression leads to embryonic lethality at mid-term, and Pitx2-deficient embryos display isomeric expression profile resulting in Pitx2 expression within both first and second heart fields during cardiogenesis, hearts and incomplete closure of the body wall. However, whereas the pivotal role of Pitx2 during cardiogenesis is well sustained, its putative role in the foetal and adult heart is largely unexplored. Recent genome-wide association studies have identified several genetic variants highly associated with atrial fibrillation (AF. Among them are genetic variants located on chromosome 4q25 adjacent to PITX2. Since then several transgenic approaches have provided evidences of the role of the homeobox transcription factor PITX2 and atrial arrhythmias. Here, we review new insights into the cellular and molecular links between PITX2 and atrial fibrillation.

  17. Personalized management of atrial fibrillation: Proceedings from the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association consensus conference.

    Science.gov (United States)

    Kirchhof, Paulus; Breithardt, Günter; Aliot, Etienne; Al Khatib, Sana; Apostolakis, Stavros; Auricchio, Angelo; Bailleul, Christophe; Bax, Jeroen; Benninger, Gerlinde; Blomstrom-Lundqvist, Carina; Boersma, Lucas; Boriani, Giuseppe; Brandes, Axel; Brown, Helen; Brueckmann, Martina; Calkins, Hugh; Casadei, Barbara; Clemens, Andreas; Crijns, Harry; Derwand, Roland; Dobrev, Dobromir; Ezekowitz, Michael; Fetsch, Thomas; Gerth, Andrea; Gillis, Anne; Gulizia, Michele; Hack, Guido; Haegeli, Laurent; Hatem, Stephane; Häusler, Karl Georg; Heidbüchel, Hein; Hernandez-Brichis, Jessica; Jais, Pierre; Kappenberger, Lukas; Kautzner, Joseph; Kim, Steven; Kuck, Karl-Heinz; Lane, Deirdre; Leute, Angelika; Lewalter, Thorsten; Meyer, Ralf; Mont, Lluis; Moses, Gregory; Mueller, Markus; Münzel, Felix; Näbauer, Michael; Nielsen, Jens Cosedis; Oeff, Michael; Oto, Ali; Pieske, Burkert; Pisters, Ron; Potpara, Tatjana; Rasmussen, Lars; Ravens, Ursula; Reiffel, James; Richard-Lordereau, Isabelle; Schäfer, Herbert; Schotten, Ulrich; Stegink, Wim; Stein, Kenneth; Steinbeck, Gerhard; Szumowski, Lukasz; Tavazzi, Luigi; Themistoclakis, Sakis; Thomitzek, Karen; Van Gelder, Isabelle C; von Stritzky, Berndt; Vincent, Alphons; Werring, David; Willems, Stephan; Lip, Gregory Y H; Camm, A John

    2013-11-01

    The management of atrial fibrillation (AF) has seen marked changes in past years, with the introduction of new oral anticoagulants, new antiarrhythmic drugs, and the emergence of catheter ablation as a common intervention for rhythm control. Furthermore, new technologies enhance our ability to detect AF. Most clinical management decisions in AF patients can be based on validated parameters that encompass type of presentation, clinical factors, electrocardiogram analysis, and cardiac imaging. Despite these advances, patients with AF are still at increased risk for death, stroke, heart failure, and hospitalizations. During the fourth Atrial Fibrillation competence NETwork/European Heart Rhythm Association (AFNET/EHRA) consensus conference, we identified the following opportunities to personalize management of AF in a better manner with a view to improve outcomes by integrating atrial morphology and damage, brain imaging, information on genetic predisposition, systemic or local inflammation, and markers for cardiac strain. Each of these promising avenues requires validation in the context of existing risk factors in patients. More importantly, a new taxonomy of AF may be needed based on the pathophysiological type of AF to allow personalized management of AF to come to full fruition. Continued translational research efforts are needed to personalize management of this prevalent disease in a better manner. All the efforts are expected to improve the management of patients with AF based on personalized therapy. PMID:23981824

  18. Differential gene expression during atrial structural remodeling in human left and right atrial appendages in atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    Hui Zhu; Wei Zhang; Ming Zhong; Gong Zhang; Yun Zhang

    2011-01-01

    Extracellular matrix (ECM) remodeling increases the vulnerability to atrial fibrillation (AF). Some gene expressions are crucial for the metabolism of ECM. The left atrium plays an important role in maintaining AF.However, most studies investigated only the right atrial tissue. We therefore chose human tissue samples from both the left and right atrial to detect the different gene expressions during structural remodeling in AF. The atrial appendages tissue samples from 24 patients with chronic AF and 12 patients with sinus rhythm were obtained when they were undergoing mitral/aortic valve replacement operation. The mRNA levels of matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinase-1 (TIMP-1), disintegrin, metalloproteases-15, and integrins β1 were determined by reverse transcriptionpolymerase chain reaction (RT-PCR). in AF group, the level of MMP-9 in left atrial appendage (LAA) was increased (P<0.001), while integrin β1 level was decreased (P< 0.05) compared with those expressed in right atrial appendage (RAA) tissue. The levels of disintegrin, metalloproteinases-15, and TIMP-1 genes in the LAA and RAA had no significant differences. The results demonstrated that the gene expressions in the LAA and RAA are different during AF, which implied that the mechanism of atrial structural remodeling in AF is due to multiple sources and is complicated.

  19. Towards Low Energy Atrial Defibrillation.

    Science.gov (United States)

    Walsh, Philip; Kodoth, Vivek; McEneaney, David; Rodrigues, Paola; Velasquez, Jose; Waterman, Niall; Escalona, Omar

    2015-01-01

    A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF) power transmitter (ex vivo) and a passive (battery free) implantable power receiver (in vivo) that enables measurement of the intracardiac impedance (ICI) during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter) and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform). An initial prototype was implemented and tested. In low-power (sense) mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock) mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR) or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR) chronosymmetric (6ms/6ms) amplitude asymmetric (negative phase at 50% magnitude) shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current) power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50-300 V). Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ) = 1.62 Ω), p power transfer and sensing of ICI during cardioversion are evidenced as key to the advancement of low-energy atrial defibrillation. PMID:26404298

  20. Current Issues in Atrial Fibrillation

    OpenAIRE

    Khaykin, Yaariv; Shamiss, Yana

    2012-01-01

    Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It places an enormous burden on the patients, caregivers, and the society at large. While the main themes in the care of an AF patient have not changed over the years and continue to focus on stroke prevention, control of the ventricular, rate and rhythm maintenance, there have been a number of new developments in each of these realms. This paper will discuss the “hot” topics in AF in 2012 including new and upcoming med...

  1. Natriuretic peptide vs. clinical information for diagnosis of left ventricular systolic dysfunction in primary care

    Directory of Open Access Journals (Sweden)

    Wachter Rolf

    2008-02-01

    Full Text Available Abstract Background Screening of primary care patients at risk for left ventricular systolic dysfunction by a simple blood-test might reduce referral rates for echocardiography. Whether or not natriuretic peptide testing is a useful and cost-effective diagnostic instrument in primary care settings, however, is still a matter of debate. Methods N-terminal pro-brain natriuretic peptide (NT-proBNP levels, clinical information, and echocardiographic data of left ventricular systolic function were collected in 542 family practice patients with at least one cardiovascular risk factor. We determined the diagnostic power of the NT-proBNP assessment in ruling out left ventricular systolic dysfunction and compared it to a risk score derived from a logistic regression model of easily acquired clinical information. Results 23 of 542 patients showed left ventricular systolic dysfunction. Both NT-proBNP and the clinical risk score consisting of dyspnea at exertion and ankle swelling, coronary artery disease and diuretic treatment showed excellent diagnostic power for ruling out left ventricular systolic dysfunction. AUC of NT-proBNP was 0.83 (95% CI, 0.75 to 0.92 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.46 (95% CI, 0.41 to 0.50. AUC of the clinical risk score was 0.85 (95% CI, 0.79 to 0.91 with a sensitivity of 0.91 (95% CI, 0.71 to 0.98 and a specificity of 0.64 (95% CI, 0.59 to 0.67. 148 misclassifications using NT-proBNP and 55 using the clinical risk score revealed a significant difference (McNemar test; p Conclusion The evaluation of clinical information is at least as effective as NT-proBNP testing in ruling out left ventricular systolic dysfunction in family practice patients at risk. If these results are confirmed in larger cohorts and in different samples, family physicians should be encouraged to rely on the diagnostic power of the clinical information from their patients.

  2. Relationship between B-type natriuretic peptide levels and echocardiographic indices of left ventricular filling pressures in post-cardiac surgery patients

    Directory of Open Access Journals (Sweden)

    La Carrubba Salvatore

    2009-10-01

    Full Text Available Abstract Background B-type natriuretic peptide (BNP is increased in post-cardiac surgery patients, however the mechanisms underlying BNP release are still unclear. In the current study, we aimed to assess the relationship between postoperative BNP levels and left ventricular filling pressures in post-cardiac surgery patients. Methods We prospectively enrolled 134 consecutive patients referred to our Center 8 ± 5 days after cardiac surgery. BNP was sampled at hospital admission and related to the following echocardiographic parameters: left ventricular (LV diastolic volume (DV, LV systolic volume (SV, LV ejection fraction (EF, LV mass, relative wall thickness (RWT, indexed left atrial volume (iLAV, mitral inflow E/A ratio, mitral E wave deceleration time (DT, ratio of the transmitral E wave to the Doppler tissue early mitral annulus velocity (E/E'. Results A total of 124 patients had both BNP and echocardiographic data. The BNP values were significantly elevated (mean 353 ± 356 pg/ml, with normal value in only 17 patients (13.7%. Mean LVEF was 59 ± 10% (LVEF ≥50% in 108 pts. There was no relationship between BNP and LVEF (p = 0.11, LVDV (p = 0.88, LVSV (p = 0.50, E/A (p = 0.77, DT (p = 0.33 or RWT (p = 0.50. In contrast, BNP was directly related to E/E' (p iLAV (p = 0.026. At multivariable regression analysis, age and E/E' were the only independent predictors of BNP levels. Conclusion In post-cardiac surgery patients with overall preserved LV systolic function, the significant increase in BNP levels is related to E/E', an echocardiographic parameter of elevated LV filling pressures which indicates left atrial pressure as a major determinant in BNP release in this clinical setting.

  3. New-Onset Atrial Fibrillation Is a Predictor of Subsequent Hyperthyroidism

    DEFF Research Database (Denmark)

    Selmer, Christian; Hansen, Morten Lock; Olesen, Jonas Bjerring;

    2013-01-01

    To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism.......To examine the long-term risk of hyperthyroidism in patients admitted to hospital with new-onset AF. Hyperthyroidism is a well-known risk factor for atrial fibrillation (AF), but it is unknown whether new-onset AF predicts later-occurring hyperthyroidism....

  4. The effect of posterior pericardiotomy on pericardial effusion and atrial fibrillation after off-pump coronary artery bypass graft.

    OpenAIRE

    Mahdi Haddadzadeh; Mahtab Motavaselian; Ali Akbar Rahimianfar; Seyed Khalil Forouzannia; Mahmood Emami; Kazem Barzegar

    2015-01-01

    The most common type of arrhythmia following coronary artery bypass graft (CABG) is atrial fibrillation (AF) with an incidence rate of 20-30%. Pericardial effusion is one of the etiologic factors of atrial fibrillation occurring after CABG. Posterior pericardiotomy (PP) causes the drainage of blood and fluids from the pericardial space into the pleural space leading to a decreased pericardial effusion. Most of the studies dealing with the occurrence of AF in the surgical operation of CABG hav...

  5. Acute treatment of atrial fibrillation.

    Science.gov (United States)

    Kowey, P R; Marinchak, R A; Rials, S J; Filart, R A

    1998-03-12

    Atrial fibrillation (AFib) is a common clinical entity, responsible for significant morbidity and mortality, but it also accounts for a large percentage of healthcare dollar expenditures. Efforts to treat this arrhythmia in the past have focused on subacute antithrombotic therapy and eventually use of antiarrhythmic drugs for maintenance of sinus rhythm. However, there has been a growing interest in the concept of acute electrical and pharmacologic conversion. This treatment strategy has a number of benefits, including immediate alleviation of patient symptoms, avoidance of antithrombotic therapy, and prevention of electrophysiologic remodeling, which is thought to contribute to the perpetuation of the arrhythmia. There is also increasing evidence that this is a cost-effective strategy in that it may obviate admission to the hospital and the cost of long-term therapy. This article represents a summary of the treatments that may be used acutely to control the ventricular response to AFib, prevent thromboembolic events, and provide for acute conversion either pharmacologically or electrically. It includes information on modalities that are currently available and those that are under active development. We anticipate that an active, acute treatment approach to AFib and atrial flutter will become the therapeutic norm in the next few years, especially as the benefits of these interventions are demonstrated in clinical trials. PMID:9525568

  6. Extracellular Matrix Remodeling in Atrial Fibrosis: Mechanisms and Implications in Atrial Fibrillation

    OpenAIRE

    Pellman, Jason; Lyon, Robert C.; Sheikh, Farah

    2009-01-01

    Atrial fibrosis has been strongly associated with the presence of heart diseases/arrhythmias, including congestive heart failure (CHF) and atrial fibrillation (AF). Inducibility of AF as a result of atrial fibrosis has been the subject of intense recent investigation, since it is the most commonly encountered arrhythmia in adults and can substantially increase the risk of premature death. Rhythm and rate control drugs as well as surgical interventions are used as therapies for AF; however, in...

  7. Impact of pulmonary vein isolation on atrial vagal activity and atrial electrical remodeling

    Institute of Scientific and Technical Information of China (English)

    Yingxue Dong; Shulong Zhang; Lianjun Gao; Hongwei Zhao; Donghui Yang; Yunlong Xia; Yanzong Yang

    2008-01-01

    Objective Mechanisms of pulmonary vein isolation (PVI) for atrial fibrillation remain controversy.This study aimed to investigate the impact of PVI on vagal modulation to atria.Methods Eighteen adult mongrel dogs under general anesthesia were randomly divided into two groups.Bilateral cervical sympathovagal trunks were decentralized and sympathetic effects was blocked by metoprolol administration.Atrial electrical remodeling (AER) was established by rapid right atrial pacing at the rate of 600 bpm for 30 minutes.PVI was performed in group A.Atrial effective refractory period (ERP),vulnerability window (VW) of atrial fibrillation,and sinus rhythm cycle length (SCL) were measured at baseline and during vagal stimulation before and after atrial rapid pacing with and without PVI at fight atrial appendage (RAA),left atrial appendage (LAA),distal coronary sinus (CSd) and proximal coronary sinus (CSp).Results (1) Effects of PVI on vagal modulation:Shortening of SCL during vagal stimulation decreased significantly after PVI compared with that before PVI in group A (P<0.001).Shortening of ERP during vagal stimulation decreaseed significantly after PVI compared with that before PVI (P<0.05).VW of atrial fibrillation during vagal stimulation decreased significantly after PVI compared with that before PVI (P<0.05).(2) Effects of PVI on AER:shortening of ERP before and after atrial rapid pacing increased significantly at baseline and vagal stimulation in group B compared with that in group A (P<0.05).VW during vagal stimulation increased significantly after atrial rapid pacing in group B (P<0.05).Conclusion PVI attenuates the vagal modulation to the atria,thereby decreases the susceptibility to atrial fibrillation mediated by vagal activity.PVI releases AER,which maybe contributes to the vagal denervation.Our study indicates that PVI not only can eradicate triggered foci but also modify substrates for AF.(J Geriatr Cardiol 2008;5:28-32)

  8. The Atrial Fibrillation Ablation Pilot Study

    DEFF Research Database (Denmark)

    Arbelo, Elena; Brugada, Josep; Hindricks, Gerhard;

    2014-01-01

    AIMS: The Atrial Fibrillation Ablation Pilot Study is a prospective registry designed to describe the clinical epidemiology of patients undergoing an atrial fibrillation (AFib) ablation, and the diagnostic/therapeutic processes applied across Europe. The aims of the 1-year follow-up were to analyse...... left atrial tachycardia, and 4 patients died (1 haemorrhagic stroke, 1 ventricular fibrillation in a patient with ischaemic heart disease, 1 cancer, and 1 of unknown cause). CONCLUSION: The AFib Ablation Pilot Study provided crucial information on the epidemiology, management, and outcomes of catheter...

  9. The totally thoracoscopic left atrial maze procedure for the treatment of atrial fibrillation.

    Science.gov (United States)

    van Laar, Charlotte; Geuzebroek, Guillaume S C; Hofman, Frederik N; Van Putte, Bart P

    2016-01-01

    The totally thoracoscopic left atrial maze (TT-maze) is a recent, minimally invasive surgical procedure for the treatment of atrial fibrillation, with promising results in terms of freedom from atrial fibrillation. The TT-maze consists of a bilateral, epicardial pulmonary vein isolation with the creation of a box using radiofrequency and exclusion of the left atrial appendage (LAA). In addition, the box is connected with the base of the LAA and furthermore with the mitral annulus with the so-called trigonum line. In this report, we describe our surgical approach and short-term results. PMID:26993056

  10. Paroxysmal Atrial Fibrillation and Brain Freeze: A Case of Recurrent Co-Incident Precipitation From a Frozen Beverage

    Science.gov (United States)

    Lugovskaya, Nelya; Vinson, David R.

    2016-01-01

    Patient: Male, 29 Final Diagnosis: Paroxysmal atrial fibrillation • cold-stimulus headache Symptoms: Palpitations • headache Medication: Diltiazem • Ibutilide Clinical Procedure: None Specialty: Emergency Medicine • Internal Medicine Objective: Unknown ethiology • Rare disease Background: Episodes of paroxysmal atrial fibrillation may be precipitated by the rapid ingestion of ice-cold foods and beverages. This condition has received little research attention, and its true prevalence is poorly described. Treating physicians may not identify cold ingestion as a causal factor of paroxysmal atrial fibrillation, thus compromising both history taking and patient education. Case Report: We report a case of a healthy young-adult man who drank a slushed ice beverage that immediately induced atrial fibrillation and a brain freeze headache simultaneously. This occurred on two separate occasions, years apart. During both episodes, the acute brain freeze self-resolved quickly, but the new-onset palpitations occasioned a visit to the emergency department for diagnosis and treatment. The emergency physicians failed to make the causal link between the cold drink and the atrial dysrhythmia. Though the brain freeze headache and paroxysmal atrial fibrillation were both precipitated by rapid ingestion of an ice-cold beverage, the mediating mechanisms are distinct. We review these two cold-induced conditions, their prevalence, and their probable mechanisms. Conclusions: The recurrent simultaneous occurrence of brain-freeze headache with paroxysmal atrial fibrillation identifies the ingestion of a frozen beverage as the precipitant of the atrial dysrhythmia. Increasing physician awareness of cold ingestion as a cause of paroxysmal atrial fibrillation will improve history taking and patient education. PMID:26757615

  11. The influence of anaemia on stroke prognosis and its relation to N-terminal pro-brain natriuretic peptide

    DEFF Research Database (Denmark)

    Nybo, M; Kristensen, S R; Mickley, H;

    2007-01-01

    Anaemia is a negative prognostic factor for patients with heart failure and impaired renal function, but its role in stroke patients is unknown. Furthermore, anaemia has been shown to influence the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), but this is only investigated in...... patients with heart failure, not in stroke patients. Two-hundred-and-fifty consecutive, well-defined ischemic stroke patients were investigated. Mortality was recorded at 6 months follow-up. Anaemia was diagnosed in 37 patients (15%) in whom stroke severity was worse than in the non-anaemic group, whilst...... the prevalence of renal affection, smoking and heart failure was lower. At 6 months follow-up, 23 patients were dead, and anaemia had an odds ratio of 4.7 when adjusted for age, Scandinavian Stroke Scale and a combined variable of heart and/or renal failure and/or elevation of troponin T using...

  12. Brain-natriuretic peptide and cyclic guanosine monophosphate as biomarkers of myxomatous mitral valve disease in dogs

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Falk, Bo Torkel; Teerlink, Tom; Guðmundsdóttir, Halldóra Hrund; Sigurðardóttir, Sif; Rasmussen, Caroline Elisabeth; Olsen, Lisbeth Høier

    2011-01-01

    Elevations in the plasma concentrations of natriuretic peptides correlate with increased severity of myxomatous mitral valve disease (MMVD) in dogs. This study correlates the severity of MMVD with the plasma concentrations of the biomarkers N-terminal fragment of the pro-brain-natriuretic peptide...

  13. C-type natriuretic peptide in prostate cancer

    DEFF Research Database (Denmark)

    Nielsen, Soeren Junge; Iversen, Peter; Rehfeld, Jens F.;

    2009-01-01

    C-type natriuretic peptide (CNP) is expressed in the male reproductive organs in pigs. To examine whether the human prostate also expresses the CNP gene, we measured CNP and N-terminal proCNP in prostate cancer tissue extracts and performed immunohistochemical biopsy staining. Additionally, pro......CNP-derived peptides were quantitated in plasma from patients with prostate cancer. Blood was collected from healthy controls and patients before surgery for localized prostate cancer. Tissue extracts were prepared from tissue biopsies obtained from radical prostatectomy surgery. N-terminal proCNP, proCNP (1-50) and...... CNP were measured in plasma and tissue extracts. Biopsies were stained for CNP-22 and N-terminal proCNP. Tissue extracts from human prostate cancer contained mostly N-terminal proCNP [median 5.3 pmol/g tissue (range 1.0-12.9)] and less CNP [0.14 pmol/g tissue (0.01-1.34)]. Immunohistochemistry...

  14. Diuretic and natriuretic activity of two mistletoe species in rats

    Directory of Open Access Journals (Sweden)

    Namita Jadhav

    2010-01-01

    Full Text Available In different cultural groups, the hemiparasitic plants of the families Loranthaceae and Viscaceae (mistletoes are frequently used in the treatment of hypertension and/or as diuretic agents. However, it remains unclear as to what commonality makes them diuretic agents or a remedy for hypertension. In this article, the diuretic activity of methanol extracts of Viscum articulatum (VA Burm. f. and Helicanthus elastica (HE (Ders. Dans. in rats is reported. The extracts were administered orally at doses of 100, 200 and 400 mg/kg to rats that had been fasted and deprived of water for 18 hours. Investigations were carried out for diuretic, saluretic and natriuretic effects. The polyphenolic and triterpenoid contents were determined quantitatively using chemical assays and high performance liquid chromatography (HPLC analysis, respectively. The extracts of VA and HE demonstrated significant and dose-dependent diuretic activity in rats. It was found that while VA mimics the furosemide pattern, HE demonstrated a dose-dependent increase in diuresis, along with an increase in potassium-sparing effects. Phytochemical analysis revealed that polyphenolics and triterpenoids, such as oleanolic acid and lupeol, are the major phytochemicals involved. It was also found that in different combinations, these phytochemicals differed in the way they influenced the electrolyte excretion. A higher content of polyphenolics in association with lower triterpenoid content was found to favor potassium-sparing effects.

  15. Cardiovascular risk prediction by N-terminal pro brain natriuretic peptide and high sensitivity C-reactive protein is affected by age and sex

    DEFF Research Database (Denmark)

    Olsen, M.H.; Hansen, T.W.; Christensen, M.K.; Gustafsson, F.; Rasmussen, S.; Wachtell, K.; Ibsen, H.; Torp-Pedersen, C.; Hildebrandt, P.R.

    2008-01-01

    BACKGROUND: Previous studies have shown that the urine albumin/creatinine ratio (UACR), high sensitivity C-reactive protein (hsCRP) and N-terminal pro brain natriuretic peptide (Nt-proBNP) predict cardiovascular events in a general population aged 41, 51, 61 or 71 years. This study investigated the...... factors, UACR, hsCRP and Nt-proBNP. The composite cardiovascular endpoint (CEP) of cardiovascular death and non-fatal stroke or myocardial infarction was assessed after 9.5 years. RESULTS: In Cox regression analyses predicting CEP, the effects of log(hsCRP) and log(Nt-proBNP) were modulated by sex (P < 0...

  16. Towards Low Energy Atrial Defibrillation

    Directory of Open Access Journals (Sweden)

    Philip Walsh

    2015-09-01

    Full Text Available A wireless powered implantable atrial defibrillator consisting of a battery driven hand-held radio frequency (RF power transmitter (ex vivo and a passive (battery free implantable power receiver (in vivo that enables measurement of the intracardiac impedance (ICI during internal atrial defibrillation is reported. The architecture is designed to operate in two modes: Cardiac sense mode (power-up, measure the impedance of the cardiac substrate and communicate data to the ex vivo power transmitter and cardiac shock mode (delivery of a synchronised very low tilt rectilinear electrical shock waveform. An initial prototype was implemented and tested. In low-power (sense mode, >5 W was delivered across a 2.5 cm air-skin gap to facilitate measurement of the impedance of the cardiac substrate. In high-power (shock mode, >180 W (delivered as a 12 ms monophasic very-low-tilt-rectilinear (M-VLTR or as a 12 ms biphasic very-low-tilt-rectilinear (B-VLTR chronosymmetric (6ms/6ms amplitude asymmetric (negative phase at 50% magnitude shock was reliably and repeatedly delivered across the same interface; with >47% DC-to-DC (direct current to direct current power transfer efficiency at a switching frequency of 185 kHz achieved. In an initial trial of the RF architecture developed, 30 patients with AF were randomised to therapy with an RF generated M-VLTR or B-VLTR shock using a step-up voltage protocol (50–300 V. Mean energy for successful cardioversion was 8.51 J ± 3.16 J. Subsequent analysis revealed that all patients who cardioverted exhibited a significant decrease in ICI between the first and third shocks (5.00 Ω (SD(σ = 1.62 Ω, p < 0.01 while spectral analysis across frequency also revealed a significant variation in the impedance-amplitude-spectrum-area (IAMSA within the same patient group (|∆(IAMSAS1-IAMSAS3[1 Hz − 20 kHz] = 20.82 Ω-Hz (SD(σ = 10.77 Ω-Hz, p < 0.01; both trends being absent in all patients that failed to cardiovert

  17. Genetics Home Reference: familial atrial fibrillation

    Science.gov (United States)

    ... or Free article on PubMed Central Roberts R. Mechanisms of disease: Genetic mechanisms of atrial fibrillation. Nat Clin Pract Cardiovasc Med. ... with a qualified healthcare professional . About Genetics Home Reference Site Map Contact Us Selection Criteria for Links ...

  18. Atrial Fibrillation - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Atrial Fibrillation URL of this page: https://medlineplus.gov/languages/atrialfibrillation.html Other topics A-Z A B ...

  19. Atrial Fibrillation During an Exploration Class Mission

    Science.gov (United States)

    Lipsett, Mark; Hamilton, Douglas; Lemery, Jay; Polk, James

    2011-01-01

    This slide presentation reviews a possible scenario of an astronaut having Atrial Fibrillation during a Mars Mission. In the case review the presentation asks several questions about the alternatives for treatment, medications and the ramifications of the decisions.

  20. Will sacubitril-valsartan diminish the clinical utility of B-type natriuretic peptide testing in acute cardiac care?

    DEFF Research Database (Denmark)

    Mair, Johannes; Lindahl, Bertil; Giannitsis, Evangelos;

    2016-01-01

    application of B-type natriuretic peptide testing in acute cardiac care is and will be the rapid rule-out of suspected acute heart failure there is no significant impairment to be expected for B-type natriuretic peptide testing in the acute setting. However, monitoring of chronic heart failure patients on......Since the approval of sacubitril-valsartan for the treatment of chronic heart failure with reduced ejection fraction, a commonly raised suspicion is that a wider clinical use of this new drug may diminish the clinical utility of B-type natriuretic peptide testing as sacubitril may interfere with B...... sacubitril-valsartan treatment with B-type natriuretic peptide testing may be impaired. In contrast to N-terminal-proBNP, the current concept that the lower the B-type natriuretic peptide result in chronic heart failure patients, the better the prognosis during treatment monitoring, may no longer be true....

  1. Calpain I Inhibition prevents atrial structural remodeling in a canine model with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    XUE Hong-jie; SHAN Hong-bo; LIU Jie; LI Wei-min; LI Yue; GONG Yong-tai; YANG Bao-feng; JIN Cheng-luo; SHENG Li; CHU Shan; ZHANG Li

    2008-01-01

    Background Atrial fibrillation (AF) is accompanied by atrial structural remodeling. Calpain activity is induced during AR To lest a causal relationship between calpain activation and atrial structural changes, N-acetyl-Leu-Leu-Met (ALLM), a calpain inhibitor, was utilized in a canine AF model.Methods Fifteen dogs were randomly divided into 3 groups: sham-operated group, control group and calpain inhibitor group; each with 5 dogs. Sustained AF was induced by rapid right atrium pacing at 600 beats per minute for 3 weeks. ALLM was administered at a dosage of 1.0 mg-kg-1·d-1 in the calpain inhibitor group. Three weeks later, the proteolysis, protein expression of TnT and myosin, calpain l localization and expression and structural changes were examined in left atrial free walls, right atrial free walls and the interatrial septum respectively. Atrial size and contractile function were also measured by echocardiography.Results Long-term rapid atrial pacing induced marked structural changes such as enlarged atrial volume, myolysis, degradation of TnT and myosin, accumulation of glycogen and changes in mitochondrial shape and size, which were paralleled by an increase in calpain activity. The positive correlation between calpain activity and the degree of myolysis (rs=0.90 961, P<0.0001) was demonstrated. In addition to structural abnormalities, pacing-induced atrial contractile dysfunction was observed in this study. The pacing-induced atrial structural alterations and loss of contractility were partially prevented by the calpain inhibitor ALLM.Conclusions Activation of calpain represents key features in the progression towards overt structural remodeling. Calpain inhibitor, ALLM, suppressed the increased calpain activity and reversed structural remodeling caused by sustained atrial fibrillation in the present model. Calpain Inhibition may therefore provide a possibility for therapeutic Intervention in AF.

  2. Trophic effect of human pericardial fluid on adult cardiac myocytes. Differential role of fibroblast growth factor-2 and factors related to ventricular hypertrophy.

    Science.gov (United States)

    Corda, S; Mebazaa, A; Gandolfini, M P; Fitting, C; Marotte, F; Peynet, J; Charlemagne, D; Cavaillon, J M; Payen, D; Rappaport, L; Samuel, J L

    1997-11-01

    Pericardial fluid (PF) may contain myocardial growth factors that exert paracrine actions on cardiac myocytes. The aims of this study were (1) to investigate the effects of human PF and serum, collected from patients undergoing cardiac surgery, on the growth of cultured adult rat cardiac myocytes and (2) to relate the growth activity of both fluids to the adaptive changes in overloaded human hearts. Both PF and serum increased the rate of protein synthesis, measured by [14C]phenylalanine incorporation in adult rat cardiomyocytes (PF, +71.9 +/- 8.2% [n = 17]; serum, +14.9 +/- 6.5% [n = 13]; both P < .01 versus control medium). The effects of both PF and serum on cardiomyocyte growth correlated positively with the respective left ventricular (LV) mass. However, the magnitude of change with PF was 3-fold greater than with serum (P < .01). These trophic effects of PF were mimicked by exogenous basic fibroblast growth factor (FGF2) and inhibited by anti-FGF2 antibodies and transforming growth factor-beta (TGF-beta), suggesting a relationship to FGF2. In addition, FGF2 concentration in PF was 20 times greater than in serum. On the other hand, the LV mass-dependent trophic effect, present in both fluids, was independent of FGF2 concentration or other factors, such as angiotensin II, atrial natriuretic factor, and TGF-beta. These data suggest that FGF2 in human PF is a major determining factor in normal myocyte growth, whereas unidentified LV mass-dependent factor(s), present in both PF and serum, participates in the development of ventricular hypertrophy. PMID:9351441

  3. The immediate future for the medical treatment of atrial fibrillation

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars;

    2002-01-01

    Atrial fibrillation is the most commonly sustained cardiac arrhythmia and a common reason for mortality and morbidity. Atrial fibrillation causes disease for three reasons: i) the ventricular rate is often high, which leads to symptoms ranging from discomfort to life threatening heart failure; ii......) the rhythm causes loss of atrioventricular synchrony, which reduces diastolic filling and may lead to heart failure; and iii) atrial contraction is lost leading to stagnant blood that again may lead to atrial thrombi and peripheral embolism. Thus, the treatment of atrial fibrillation is focused on the...... are in development, but to the author's knowledge only a single thrombin inhibitor is actively being developed for atrial fibrillation....

  4. The relationship between C-type natriuretic peptide and cognitive impairment in older patients with Type 2 diabetes

    International Nuclear Information System (INIS)

    Objective: To investigate the relationship between C-type natriuretic peptide and cognitive impairment in older patients with type 2 diabetes, and to explore the pathogenesis of diabetic cognitive impairment. Methods: According to the Montreal Cognitive Assessment (MoCA) scores, 80 type 2 diabetic patients over the age of 60 years were divided into two groups, one group including 31 cases with cognitive impairment, the other 49 patients with non-cognitive impairment. And 80 normal participants were selected as the control group. Plasma level of C-type natriuretic peptide was measured by radio-immunity assay in all subjects. The changes and associations of the plasma C-type natriuretic peptide level among three groups was analyzed. Result: In the non-cognitive impairment group, plasma level of C-type natriuretic peptide was higher than that in the control group (P<0.01). But the plasma level of C-type natriuretic peptide in the cognitive impairment group was degraded, significantly deferent with those in the control group and the non-cognitive impairment group (P<0.01). MoCA scores of the cognitive impairment group positively correlated with plasma level of C-type natriuretic peptide (r=0.513, P<0.01). Conclusion: In the early period of type 2 diabetes,the secretion of C-type natriuretic peptide was increased. When diabetic cognitive impairment complicated,the secretion of C-type natriuretic peptide was decompensated. Then plasma level of C-type natriuretic peptide become low. The level of C-type natriuretic peptide closely correlated with diabetic cognitive impairment. It was suggested that diabetic angiopathies may act an important role in the pathogenesis of diabetic cognitive impairment. (authors)

  5. Psychosomatic correlations in atrial fibrillations

    Directory of Open Access Journals (Sweden)

    Vladimir Ernstovich Medvedev

    2011-12-01

    Full Text Available Patients with atrial fibrillations (AF and comorbid mental disorders were examined. Two patient groups differing in the structure of psychosomatic ratios were identified. Group 1 comprised patients with AF and signs of reactivity lability that manifested itself as psychopathological reactions to the primary manifestations of AF; Group 2 included those who had developed mental disorders mainly in end-stage cardiovascular disease (predominantly a permanent form of AF in the presence of such events as chronic heart failure (CHF. The results of the study suggest that the patients with AF have frequently anxiety and hypochondriacal disorders, which agrees with the data available in the literature. In addition, end-stage AF is marked by depressive syndromes caused by the severe course of cardiovascular diseases resulting in CHF.

  6. Spontaneous onset of atrial fibrillation

    Science.gov (United States)

    Zemlin, Christian W.; Mitrea, Bogdan G.; Pertsov, Arkady M.

    2009-06-01

    Most commonly, atrial fibrillation is triggered by rapid bursts of electrical impulses originating in the myocardial sleeves of pulmonary veins (PVs). However, the nature of such bursts remains poorly understood. Here, we propose a mechanism of bursting consistent with the extensive empirical information about the electrophysiology of the PVs. The mechanism is essentially non-local and involves the spontaneous initiation of non-sustained spiral waves in the distal end of the muscle sleeves of the PVs. It reproduces the experimentally observed dynamics of the bursts, including their frequency, their intermittent character, and the unusual shape of the electrical signals in the pulmonary veins that are reminiscent of so-called early afterdepolarizations (EADs).

  7. Thromboembolism Prevention via Transcatheter Left Atrial Appendage Closure with Transeosophageal Echocardiography Guidance

    Directory of Open Access Journals (Sweden)

    John Palios

    2014-01-01

    Full Text Available Atrial fibrillation (AF is an independent risk factor for stroke. Anticoagulation therapy has a risk of intracerebral hemorrhage. The use of percutaneous left atrial appendage (LAA closure devices is an alternative to anticoagulation therapy. Echocardiography has a leading role in LAA closure procedure in patient selection, during the procedure and during followup. A comprehensive echocardiography study is necessary preprocedural in order to identify all the lobes of the LAA, evaluate the size of the LAA ostium, look for thrombus or spontaneous echo contrast, and evaluate atrial anatomy, including atrial septal defect and patent foramen ovale. Echocardiography is used to identify potential cardiac sources of embolism, such as atrial septal aneurysm, mitral valve disease, and aortic debris. During the LAA occlusion procedure transeosophageal echocardiography provides guidance for the transeptal puncture and monitoring during the release of the closure device. Procedure-related complications can be evaluated and acceptable device release criteria such as proper position and seating of the occluder in the LAA, compression, and stability can be assessed. Postprocedural echocardiography is used for followup to assess the closure of the LAA ostium. This overview paper describes the emerging role of LAA occlusion procedure with transeosophageal echocardiography guidance as an alternative to anticoagulation therapy in patients with AF.

  8. Home Screening for Detecting Subclinical Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Renato Pietro Ricci; Taya V. Glotzer

    2015-12-01

    Full Text Available The advent of cardiac implanted electronic devices with accurate atrial arrhythmia diagnostic capabilities has revealed a large burden of “silent “ atrial fibrillation that is present in the cardiac population. Many studies have been completed, and many more are ongoing, to determine the correct treatment course when these atrial arrhythmias are detected. Alongside the development of accurate atrial diagnostics within the devices, has been the growth an entire network of wireless home monitoring capability. It is now possible to see, over the internet, individual patients’ atrial arrhythmia burden on every day. This capability has tremendous promise for patient care, with the possibility of reducing strokes, decreasing heart failure, preventing cardiomyopathies, and likely substantially reducing health care costs. As this innovative diagnostic capability is generating large amounts of data, protocols for what should be done with the plethora of new information are being developed. In the pages that follow, we will present what is known about home monitoring for silent atrial fibrillation, and present the results of recent studies published in this arena.

  9. The relation between brain natriuretic peptide and patent ductus arteriosus in premature infants

    Directory of Open Access Journals (Sweden)

    Selcen Yaroğlu Kazancı

    2012-06-01

    Full Text Available Aim: To compare brain natriuretic peptide level and some of the echocardiographic parameters of premature infants and to search its value for the diagnosis of patent ductus arteriosus.Material and Method: Fifty infants born before the 34th gestational week in the neonatology clinic of Bakırkoy Obstetrics and Children’s Educational Hospital between March 2009 and August 2009 were inspected prospectively. Patients with patent ductus arteriosus constituted Grup 1 (n=20 and patients without patent ductus arteriosus constituted Grup 2 (n=30. The diagnosis of patent ductus arteriosus was made by M-mode and Doppler echocardiography on the 7th day postnatally. Ductus diameter, left atrium aortic root diameter ratio, left ventricular end diastolic diameter, interventricular septum thickness, left ventricular posterior wall thickness, ejection fraction and fractional shortening were evaluated. The infants with hemodynamically significant patent ductus arteriosus were treated.Brain natriuretic peptide was evaluated on the 1st, 3rd and 7th days of postnatal age in all patients and also on the 3rd day after treatment. For statistical analysis SPSS for Windows 15.0 was used. The study was conducted after obtaining informed consent from the patients and was approved with the decision of the ethics commitee (number 231, date 12-6-2009. Results: Sex, gestational age and birth weight were similar in both grups. When brain natriuretic peptide level was compared with ductus diameter, left atrium aortic root diameter ratio and left ventricular end diastolic diameter values, the results were found to be statistically significant (p0.05. Brain natriuretic peptide level decreased significantly after treatment.Conclusions: Brain natriuretic peptide level was found be higher in infants with patent ductus arteriosus compared to infants without patent ductus arteriosus. It was shown that ductus diameter, left atrium aortic root diameter ratio and left ventricular end

  10. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Olesen, Jonas Bjerring; Lip, Gregory Y H; Hansen, Morten Lock;

    2011-01-01

    Objectives To evaluate the individual risk factors composing the CHADS2 (Congestive heart failure, Hypertension, Age=75 years, Diabetes, previous Stroke) score and the CHA2DS2-VASc (CHA2DS2-Vascular disease, Age 65-74 years, Sex category) score and to calculate the capability of the schemes to...... predict thromboembolism. Design Registry based cohort study. Setting Nationwide data on patients admitted to hospital with atrial fibrillation. Population All patients with atrial fibrillation not treated with vitamin K antagonists in Denmark in the period 1997- 2006. Main outcome measures Stroke and...

  11. Left Atrial Sphericity Index Predicts Early Recurrence of Atrial Fibrillation After Direct-Current Cardioversion

    DEFF Research Database (Denmark)

    Osmanagic, Armin; Möller, Sören; Osmanagic, Azra;

    2016-01-01

    BACKGROUND: Attempts to achieve rhythm control using direct-current cardioversion (DCC) are common in those with persistent atrial fibrillation (AF). Although often successful, AF recurs within 1 month in as many as 57% of patients. The aim of this study was to assess whether a baseline left atrial...

  12. Robotic atrial septal defect repair and endoscopic treatment of atrial fibrillation.

    Science.gov (United States)

    Argenziano, Michael; Williams, Mathew R

    2003-04-01

    Computer (robotic) enhancement has emerged as a facilitator of minimally invasive cardiac surgery and has been used to perform portions of intracardiac procedures via thoracotomy incisions. This report describes the use of the da Vinci surgical system in two totally endoscopic ("closed chest") cardiac operations: atrial septal defect closure and pulmonary vein isolation of atrial fibrillation. ASD closure: Fifteen patients underwent repair of a secundum-type atrial septal defect or patent foramen ovale by a totally endoscopic approach, utilizing the da Vinci robotic system. Cardiopulmonary bypass (CPB) was achieved peripherally. Cardioplegia was administered via the distal port of the arterial cannula after endoballoon inflation. Via three port incisions in the right chest, the entire operation including pericardiotomy; bicaval occlusion; atriotomy; atrial septopexy; and atrial closure was performed by a surgeon seated at a computer console. A fourth 15 mm port was utilized for suction and suture passage by a patient-side assistant. In one case, a recurrent shunt was identified and repaired on POD 5. Median ICU length of stay (LOS) was 20 hours, and median hospital LOS was 4 days. Atrial fibrillation surgery: This report also describes the pathway that we have pursued in the development of a totally endoscopic operation for atrial fibrillation. Beginning with animal models, we tested various ablative energy sources; methods of ablation; and minimally invasive approaches. This work has led to the development of a variety of minimally invasive surgical approaches including a totally endoscopic, robotically assisted beating heart procedure for the treatment of atrial fibrillation. PMID:12838483

  13. Intra-atrial endothelial lesion resulting from transseptal puncture for catheter ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Samir M. Said

    2012-06-01

    Full Text Available Thromboembolic events are known complications of left atrial ablation therapy. We describe a complication which may also lead to systemic thromboembolism that has not been reported so far: the formation of a moving structure attached to the fossa ovalis after an attempted transseptal puncture in a 66-year old patient with symptomatic paroxysmal atrial fibrillation.

  14. Percutaneous atrial appendage occlusion for stroke prevention in patients with atrial fibrillation

    DEFF Research Database (Denmark)

    Munkholm-Larsen, Stine; Cao, Christopher; Yan, Tristan D;

    2012-01-01

    This review aims to evaluate systematically the safety and efficacy of percutaneous left atrial appendage occlusion (PLAAO) in stroke prevention for patients with atrial fibrillation (AF). A systematic review of peer-reviewed journals on PLAAO before June 2011 was performed on three electronic...

  15. Symptomatic Bradycardia Caused By Premature Atrial Contractions Originating From Right Atrial Appendage

    OpenAIRE

    Alper, AT; Gungor, B; Turkkan, C; Tekkesin, AI

    2013-01-01

    Premature atrial contraction is a common form of supraventricular arrhythmias. In rare cases, severe symptoms other than palpitation may occur. In this report, we present a patient with symptomatic bradycardia which developed secondary to blocked premature atrial contractions and was successfully treated with radiofrequency ablation.

  16. Symptomatic bradycardia caused by premature atrial contractions originating from right atrial appendage.

    Science.gov (United States)

    Alper, At; Gungor, B; Turkkan, C; Tekkesin, Ai

    2013-05-01

    Premature atrial contraction is a common form of supraventricular arrhythmias. In rare cases, severe symptoms other than palpitation may occur. In this report, we present a patient with symptomatic bradycardia which developed secondary to blocked premature atrial contractions and was successfully treated with radiofrequency ablation. PMID:23840105

  17. Atrial Fibrillation In Athletes: Pathophysiology, Clinical Presentation, Evaluation and Management Abstract

    Directory of Open Access Journals (Sweden)

    Mohit K. Turagam; Greg C. Flaker; Poonam Velagapudi; Sirisha Vadali; Martin A. Alpert

    2015-12-01

    Full Text Available Atrial fibrillation (AF is the most common tachyarrhythmia in athletes. Triggers for AF in athletes include atrial ectopy, sports supplements and sympathomimetic drugs. Substrates for AF in athletes include cardiac (mainly atrial remodeling, fibrosis and inflammation. Autonomic activation, electrolyte abnormalities, and acid reflux disease serve as modulators of AF. Evaluation of AF in athletes consists of classification of the type of AF and assessment for underlying causes and precipitating factors. Management of AF in athletes involve identification and modification of triggers and reductions of physical activity. Rate control strategies may reduce athletic efficiency. Anti-arrhythmic drug therapy of AF in athletes has not been extensively studied. Anticoagulation recommendations are similar to those for non-athletes with AF. Preliminary studies suggest that radiofrequency ablation techniques may be applied successfully in athletes with AF. Credits: Mohit K. Turagam; Greg C. Flaker; Poonam Velagapudi; Sirisha Vadali; Martin A.

  18. Concomitant surgical removal of left atrial myxoma and ablation of paroxysmal atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Revishvili A. Sh.

    2013-03-01

    Full Text Available This article describes a clinical case of a patient with left atrial myxoma combined with paroxysmal atrial fibrillation. General practitioner considered symptoms of left ventricular insufficiency (shortness of breath, cough, palpitation, dizziness, blood spitting as lung pathology. When paroxysms of atrial fibrillation became more frequent the patient was send to cardiologist. Transthoracic echocardiography revealed a tumor (55 × 52 mm arising from the middle third of interatrial septum, floating and partially obstructing left atrioventricular orifice. Patient underwent Maze IV procedure combined with tumor resection. Histological study of the tumor showed typical for heart myxoma structure and cells. This case shows on-time diagnostics and successful surgical treatment of the patient with left atrial myxoma combined with paroxysmal atrial fibrillation.

  19. Effect of age on stroke prevention therapy in patients with atrial fibrillation: the atrial fibrillation investigators

    DEFF Research Database (Denmark)

    van Walraven, Carl; Hart, Robert G; Connolly, Stuart;

    2009-01-01

    BACKGROUND AND PURPOSE: Stroke risk increases with age in patients who have nonvalvular atrial fibrillation. It is uncertain whether the efficacy of stroke prevention therapies in atrial fibrillation changes as patients age. The objective of this study was to determine the effect of age on the...... relative efficacy of oral anticoagulants (OAC) and antiplatelet (AP) therapy (including acetylsalicylic acid and triflusal) on ischemic stroke, serious bleeding, and vascular events in patients with atrial fibrillation. METHODS: This is an analysis of the Atrial Fibrillation Investigators database, which...... contains patient level-data from randomized trials of stroke prevention in atrial fibrillation. We used Cox regression models with age as a continuous variable that controlled for sex, year of randomization, and history of cerebrovascular disease, diabetes, hypertension, and congestive heart failure...

  20. Pathophysiology of cancer therapy-provoked atrial fibrillation.

    Science.gov (United States)

    Cheng, Wan-Li; Kao, Yu-Hsun; Chen, Shih-Ann; Chen, Yi-Jen

    2016-09-15

    Atrial fibrillation (AF) occurs with increased frequency in cancer patients, especially in patients who undergo surgery or chemotherapy. AF disturbs the prognosis of cancer patients and challenges therapeutic outcomes of cancer treatment. Elucidating the mechanisms of cancer-induced AF would help identify specific strategies for preventing AF occurrence. In addition to concurrent risk factors of cancer and AF, cancer surgery, side effects of anticancer agents, and cancer-associated immune responses play critical roles in the genesis of AF. In this review, we provide succinct potential mechanisms of AF genesis in cancer patients. PMID:27327505