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Atrial natriuretic peptide, plasma renin activity, plasma volume, systemic vascular resistance and cardiac output in patients with cirrhosis
Author(s) -
VINEL J. P.,
DENOYEL P.,
VIOSSAT I.,
CALES P.,
CAUCANAS J. P.,
CHABRIER P. E.,
ESQUERRE J. P.,
BRAQUET P.,
PASCAL J. P.
Publication year - 1989
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1989.tb00857.x
Subject(s) - medicine , atrial natriuretic peptide , ascites , plasma renin activity , cirrhosis , endocrinology , vascular resistance , pathogenesis , natriuretic peptide , portal hypertension , heart failure , cardiology , renin–angiotensin system , hemodynamics , blood pressure
The present study aimed to assess relationships between plasma levels of atrial natriuretic peptide (ANP) and plasma volume, systemic vascular resistances, cardiac output and plasma renin activity in patients with cirrhosis. Thirty patients were included: eight with no history of liver disease were used as controls; 22 patients had biopsy‐proven alcoholic cirrhosis without ascites ( n =11) and with ascites ( n =11). Mean ANP plasma level was significantly higher in both groups of cirrhotic patients than in controls ( P <0.05). In the control group, ANP and plasma renin activity were inversely correlated ( P <0.05) but no correlation was found in cirrhotic patients. In the group of patients with ascites, ANP plasma levels were inversely correlated to plasma volume ( P <0.05) and to cardiac output ( P <0.01) and directly correlated to systemic vascular resistances ( P <0.01). Using multiple regression analysis, ANP remained correlated only with systemic vascular resistances ( P <0.05). These results suggest that cirrhotic patients have high plasma levels of ANP whether or not they have ascites. In the light of current knowledge of ANP actions, the relationships between ANP plasma levels and plasma volume, cardiac output, and systemic vascular resistances are paradoxical in cirrhotic patients with ascites. ANP does not seem to play a critical role in the pathogenesis of sodium and water retention observed in these patients.