European Journal of Cardio-Thoracic Surgery, Vol 5, 205-210, Copyright © 1991 by European Association for Cardio-thoracic Surgery
Time course of human atrial natriuretic factor release during cardiopulmonary bypass in mitral valve and coronary artery diseased patients
S Curello, C Ceconi, F De Giuli, A Cargnoni, O Alfieri, A Pardini, P Marzollo, R Mastropiero and R Ferrari
Division of Cardiology, University of Brescia, Italy.
We determined the time-course of the release of atrial natriuretic factor
(ANF) during cardiopulmonary bypass (CPB) in six patients undergoing
coronary artery bypass (CAD) and eight patients undergoing valve
replacement for mitral stenosis (MS). Before CPB, the arterial ANF was
significantly higher in MS patients than in CAD patients (243 +/- 38 and 29
+/- 5.8 pg/ml respectively, P less than 0.01). With the onset of CPB, the
acute pressure unloading of the atria induced a significant, rapid decrease
of ANF only in MS patients (-64% of pre-CPB value at 5 min) and no major
changes in CAD patients. Clamping of the aorta induced a further
progressive reduction of ANF release to almost zero in both groups.
Readmission of coronary flow to the empty atria with declamping resulted in
an increase in the plasma level of ANF in both groups to reach the
concentration present in MS patients before CPB. After CPB, the ANF levels
decreased in CAD patients while remaining elevated in MS patients. These
data suggest that ANF release from human atria depends on atrial filling
pressure and other unknown factors.
