Plasma level of atrial natriuretic polypeptide during and after cardiopulmonary bypass
Nishimura, K.; Fujiwara, Y.; Matsumoto, M.; Soneda, J.; Konishi, Y.; Okamoto, Y.; Ban, T.
Nihon Kyobu Geka Gakkai 36(10): 2213-2220
1988
ISSN/ISBN: 0369-4739 PMID: 2974856 Document Number: 322944
The potent diuretic hormone, Atrial natriuretic polypeptide (ANP) is released from the heart and circulates in the body. The plasma concentration of ANP was measured in 14 patients during the after cardiopulmonary bypass (CPB), in order to elucidate how ANP associates with water-electrolyte balance under such non-physiological condition. Patients were divided into three groups: 5 ischemic heart disease (IHD), 6 valvular heart disease (VDH), and 3 atrial septal defect (ASD). The basal level of ANP was 83 .+-. 46 pg/ml in IHD, 219 .+-. 90 pg/ml in VHD, and 84 .+-. 22 pg/ml in ASD group respectively. The ANP level decreased significantly after the tracheal intubation (p < 0.01), and returned to near the basal level before CPB. The ANP level during CPB showed essentially similar changes in IHD and VHD groups. It decreased to undetectable level within 30 min after the aortic cross clamp was applied and remained low level during the cross-clamping. After removing the clamp, it rose immediately and reached the maximum level (378 .+-. 66 pg/ml, p < 0.01) within 15 min. During the postoperative course it gradually increased and recovered 24 hours after the operation, and then reached highest level within 2 or 4 days. On the other hand, the ANP level in ASD group was rather higher during CPB than the basal level unlike patients in whom aortic cross clamp was necessitated. Urine volume and urine sodium excretion changed in parallel with the ANP level between 15 hours and 2 days after the operation. These results indicate that a secretion of ANP can be varied by aortic cross clamp or surgical intervention to atrium. Moreover they suggest that ANP has the important role in water-electrolyte balance during and after cardiac surgery.