Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1994 Dec;72(6):528–533. doi: 10.1136/hrt.72.6.528

Responses of plasma concentrations of A type natriuretic peptide and B type natriuretic peptide to alacepril, an angiotensin-converting enzyme inhibitor, in patients with congestive heart failure.

M Yoshimura 1, H Yasue 1, H Tanaka 1, K Kikuta 1, H Sumida 1, H Kato 1, M Jougasaki 1, K Nakao 1
PMCID: PMC1025637  PMID: 7857734

Abstract

BACKGROUND--Plasma concentrations of A type or atrial natriuretic peptide (ANP) and B type or brain natriuretic peptide (BNP) are increased in patients with congestive heart failure (CHF). OBJECTIVE--To examine the haemodynamic and hormonal responses, especially of ANP and BNP, to oral administration of an angiotensin-converting enzyme (ACE) inhibitor in patients with CHF and in controls. PATIENTS--12 patients with CHF and 11 controls. METHODS--Haemodynamic variables and plasma concentrations of ANP, BNP, and other hormones were serially measured for 24 hours after alacepril (37.5 mg) was given by mouth. RESULTS--Pulmonary capillary wedge pressure and systemic vascular resistance decreased significantly in both groups. The cardiac index increased only in the CHF group. In patients with CHF pulmonary capillary wedge pressure, systemic vascular resistance, and cardiac index were significantly changed from 1 to 12 hours after alacepril administration. Plasma ANP and BNP decreased significantly after alacepril was given to the CHF group: neither concentration changed in the control group. In the CHF group plasma ANP was significantly lower between 1 and 6 hours and was highly significantly correlated with pulmonary capillary wedge pressure. Plasma BNP, however, was significantly lower between 6 and 24 hours after alacepril and was not correlated with pulmonary capillary wedge pressure. CONCLUSIONS--The response of plasma BNP after alacepril administration occurred later and lasted longer than the plasma ANP response. This may indicate that the mechanisms of synthesis, secretion, or degradation of the two peptides are different.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amorim D. S., Dargie H. J., Heer K., Brown M., Jenner D., Olsen E. G., Richardson P., Goodwin J. F. Is there autonomic impairment in congestive (dilated) cardiomyopathy? Lancet. 1981 Mar 7;1(8219):525–527. doi: 10.1016/s0140-6736(81)92863-4. [DOI] [PubMed] [Google Scholar]
  2. Ballermann B. J., Brenner B. M. George E. Brown memorial lecture. Role of atrial peptides in body fluid homeostasis. Circ Res. 1986 May;58(5):619–630. doi: 10.1161/01.res.58.5.619. [DOI] [PubMed] [Google Scholar]
  3. Burnett J. C., Jr, Kao P. C., Hu D. C., Heser D. W., Heublein D., Granger J. P., Opgenorth T. J., Reeder G. S. Atrial natriuretic peptide elevation in congestive heart failure in the human. Science. 1986 Mar 7;231(4742):1145–1147. doi: 10.1126/science.2935937. [DOI] [PubMed] [Google Scholar]
  4. Cody R. J., Atlas S. A., Laragh J. H., Kubo S. H., Covit A. B., Ryman K. S., Shaknovich A., Pondolfino K., Clark M., Camargo M. J. Atrial natriuretic factor in normal subjects and heart failure patients. Plasma levels and renal, hormonal, and hemodynamic responses to peptide infusion. J Clin Invest. 1986 Nov;78(5):1362–1374. doi: 10.1172/JCI112723. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Cohn J. N., Johnson G., Ziesche S., Cobb F., Francis G., Tristani F., Smith R., Dunkman W. B., Loeb H., Wong M. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med. 1991 Aug 1;325(5):303–310. doi: 10.1056/NEJM199108013250502. [DOI] [PubMed] [Google Scholar]
  6. Curtiss C., Cohn J. N., Vrobel T., Franciosa J. A. Role of the renin-angiotensin system in the systemic vasoconstriction of chronic congestive heart failure. Circulation. 1978 Nov;58(5):763–770. doi: 10.1161/01.cir.58.5.763. [DOI] [PubMed] [Google Scholar]
  7. DiCarlo L., Chatterjee K., Parmley W. W., Swedberg K., Atherton B., Curran D., Cucci M. Enalapril: a new angiotensin-converting enzyme inhibitor in chronic heart failure: acute and chronic hemodynamic evaluations. J Am Coll Cardiol. 1983 Nov;2(5):865–871. doi: 10.1016/s0735-1097(83)80233-2. [DOI] [PubMed] [Google Scholar]
  8. Dzau V. J., Colucci W. S., Williams G. H., Curfman G., Meggs L., Hollenberg N. K. Sustained effectiveness of converting-enzyme inhibition in patients with severe congestive heart failure. N Engl J Med. 1980 Jun 19;302(25):1373–1379. doi: 10.1056/NEJM198006193022501. [DOI] [PubMed] [Google Scholar]
  9. Edwards B. S., Ackermann D. M., Lee M. E., Reeder G. S., Wold L. E., Burnett J. C., Jr Identification of atrial natriuretic factor within ventricular tissue in hamsters and humans with congestive heart failure. J Clin Invest. 1988 Jan;81(1):82–86. doi: 10.1172/JCI113314. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Giles T. D., Katz R., Sullivan J. M., Wolfson P., Haugland M., Kirlin P., Powers E., Rich S., Hackshaw B., Chiaramida A. Short- and long-acting angiotensin-converting enzyme inhibitors: a randomized trial of lisinopril versus captopril in the treatment of congestive heart failure. The Multicenter Lisinopril-Captopril Congestive Heart Failure Study Group. J Am Coll Cardiol. 1989 May;13(6):1240–1247. doi: 10.1016/0735-1097(89)90294-5. [DOI] [PubMed] [Google Scholar]
  11. Goldstein R. E., Beiser G. D., Stampfer M., Epstein S. E. Impairment of autonomically mediated heart rate control in patients with cardiac dysfunction. Circ Res. 1975 May;36(5):571–578. doi: 10.1161/01.res.36.5.571. [DOI] [PubMed] [Google Scholar]
  12. Itoh H., Nakao K., Kambayashi Y., Hosoda K., Saito Y., Yamada T., Mukoyama M., Arai H., Shirakami G., Suga S. Occurrence of a novel cardiac natriuretic peptide in rats. Biochem Biophys Res Commun. 1989 Jun 15;161(2):732–739. doi: 10.1016/0006-291x(89)92661-2. [DOI] [PubMed] [Google Scholar]
  13. Itoh H., Nakao K., Yamada T., Shirakami G., Kangawa K., Minamino N., Matsuo H., Imura H. Antidipsogenic action of a novel peptide, 'brain natriuretic peptide', in rats. Eur J Pharmacol. 1988 May 20;150(1-2):193–196. doi: 10.1016/0014-2999(88)90769-8. [DOI] [PubMed] [Google Scholar]
  14. Kambayashi Y., Nakao K., Mukoyama M., Saito Y., Ogawa Y., Shiono S., Inouye K., Yoshida N., Imura H. Isolation and sequence determination of human brain natriuretic peptide in human atrium. FEBS Lett. 1990 Jan 1;259(2):341–345. doi: 10.1016/0014-5793(90)80043-i. [DOI] [PubMed] [Google Scholar]
  15. Laragh J. H. Atrial natriuretic hormone, the renin-aldosterone axis, and blood pressure-electrolyte homeostasis. N Engl J Med. 1985 Nov 21;313(21):1330–1340. doi: 10.1056/NEJM198511213132106. [DOI] [PubMed] [Google Scholar]
  16. Levine T. B., Francis G. S., Goldsmith S. R., Simon A. B., Cohn J. N. Activity of the sympathetic nervous system and renin-angiotensin system assessed by plasma hormone levels and their relation to hemodynamic abnormalities in congestive heart failure. Am J Cardiol. 1982 May;49(7):1659–1666. doi: 10.1016/0002-9149(82)90243-0. [DOI] [PubMed] [Google Scholar]
  17. Levine T. B., Olivari M. T., Garberg V., Sharkey S. W., Cohn J. N. Hemodynamic and clinical response to enalapril, a long-acting converting-enzyme inhibitor, in patients with congestive heart failure. Circulation. 1984 Mar;69(3):548–553. doi: 10.1161/01.cir.69.3.548. [DOI] [PubMed] [Google Scholar]
  18. Matsumoto K., Miyazaki H., Fujii T., Yoshida K., Amejima H., Hashimoto M. Disposition and metabolism of the novel antihypertensive agent alacepril in rats. Arzneimittelforschung. 1986;36(1):40–46. [PubMed] [Google Scholar]
  19. Mettauer B., Rouleau J. L., Bichet D., Kortas C., Manzini C., Tremblay G., Chatterjee K. Differential long-term intrarenal and neurohormonal effects of captopril and prazosin in patients with chronic congestive heart failure: importance of initial plasma renin activity. Circulation. 1986 Mar;73(3):492–502. doi: 10.1161/01.cir.73.3.492. [DOI] [PubMed] [Google Scholar]
  20. Morita E., Yasue H., Yoshimura M., Ogawa H., Jougasaki M., Matsumura T., Mukoyama M., Nakao K. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction. Circulation. 1993 Jul;88(1):82–91. doi: 10.1161/01.cir.88.1.82. [DOI] [PubMed] [Google Scholar]
  21. Mukoyama M., Nakao K., Hosoda K., Suga S., Saito Y., Ogawa Y., Shirakami G., Jougasaki M., Obata K., Yasue H. Brain natriuretic peptide as a novel cardiac hormone in humans. Evidence for an exquisite dual natriuretic peptide system, atrial natriuretic peptide and brain natriuretic peptide. J Clin Invest. 1991 Apr;87(4):1402–1412. doi: 10.1172/JCI115146. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Nakao K., Itoh H., Kambayashi Y., Hosoda K., Saito Y., Yamada T., Mukoyama M., Arai H., Shirakami G., Suga S. Rat brain natriuretic peptide. Isolation from rat heart and tissue distribution. Hypertension. 1990 Jun;15(6 Pt 2):774–778. doi: 10.1161/01.hyp.15.6.774. [DOI] [PubMed] [Google Scholar]
  23. Nakao K., Sugawara A., Morii N., Sakamoto M., Suda M., Soneda J., Ban T., Kihara M., Yamori Y., Shimokura M. Radioimmunoassay for alpha-human and rat atrial natriuretic polypeptide. Biochem Biophys Res Commun. 1984 Nov 14;124(3):815–821. doi: 10.1016/0006-291x(84)91030-1. [DOI] [PubMed] [Google Scholar]
  24. Needleman P., Greenwald J. E. Atriopeptin: a cardiac hormone intimately involved in fluid, electrolyte, and blood-pressure homeostasis. N Engl J Med. 1986 Mar 27;314(13):828–834. doi: 10.1056/NEJM198603273141306. [DOI] [PubMed] [Google Scholar]
  25. Obata K., Yasue H., Okumura K., Matsuyama K., Ogawa H., Kurose M., Saito Y., Nakao K., Imura H., Nobuyoshi M. Atrial natriuretic polypeptide is removed by the lungs and released into the left atrium as well as the right atrium in humans. J Am Coll Cardiol. 1990 Jun;15(7):1537–1543. doi: 10.1016/0735-1097(90)92823-k. [DOI] [PubMed] [Google Scholar]
  26. Ogawa Y., Nakao K., Mukoyama M., Hosoda K., Shirakami G., Arai H., Saito Y., Suga S., Jougasaki M., Imura H. Natriuretic peptides as cardiac hormones in normotensive and spontaneously hypertensive rats. The ventricle is a major site of synthesis and secretion of brain natriuretic peptide. Circ Res. 1991 Aug;69(2):491–500. doi: 10.1161/01.res.69.2.491. [DOI] [PubMed] [Google Scholar]
  27. Ogawa Y., Nakao K., Mukoyama M., Shirakami G., Itoh H., Hosoda K., Saito Y., Arai H., Suga S., Jougasaki M. Rat brain natriuretic peptide--tissue distribution and molecular form. Endocrinology. 1990 Apr;126(4):2225–2227. doi: 10.1210/endo-126-4-2225. [DOI] [PubMed] [Google Scholar]
  28. Raine A. E., Erne P., Bürgisser E., Müller F. B., Bolli P., Burkart F., Bühler F. R. Atrial natriuretic peptide and atrial pressure in patients with congestive heart failure. N Engl J Med. 1986 Aug 28;315(9):533–537. doi: 10.1056/NEJM198608283150901. [DOI] [PubMed] [Google Scholar]
  29. Richards A. M., Rao G., Espiner E. A., Yandle T. Interaction of angiotensin converting enzyme inhibition and atrial natriuretic factor. Hypertension. 1989 Mar;13(3):193–199. doi: 10.1161/01.hyp.13.3.193. [DOI] [PubMed] [Google Scholar]
  30. Riegger G. A., Kochsiek K. Vasopressin, renin and norepinephrine levels before and after captopril administration in patients with congestive heart failure due to idiopathic dilated cardiomyopathy. Am J Cardiol. 1986 Aug 1;58(3):300–303. doi: 10.1016/0002-9149(86)90066-4. [DOI] [PubMed] [Google Scholar]
  31. Saito Y., Nakao K., Arai H., Nishimura K., Okumura K., Obata K., Takemura G., Fujiwara H., Sugawara A., Yamada T. Augmented expression of atrial natriuretic polypeptide gene in ventricle of human failing heart. J Clin Invest. 1989 Jan;83(1):298–305. doi: 10.1172/JCI113872. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Saito Y., Nakao K., Itoh H., Yamada T., Mukoyama M., Arai H., Hosoda K., Shirakami G., Suga S., Minamino N. Brain natriuretic peptide is a novel cardiac hormone. Biochem Biophys Res Commun. 1989 Jan 31;158(2):360–368. doi: 10.1016/s0006-291x(89)80056-7. [DOI] [PubMed] [Google Scholar]
  33. Saito Y., Nakao K., Nishimura K., Sugawara A., Okumura K., Obata K., Sonoda R., Ban T., Yasue H., Imura H. Clinical application of atrial natriuretic polypeptide in patients with congestive heart failure: beneficial effects on left ventricular function. Circulation. 1987 Jul;76(1):115–124. doi: 10.1161/01.cir.76.1.115. [DOI] [PubMed] [Google Scholar]
  34. Shirakami G., Nakao K., Yamada T., Itoh H., Mori K., Kangawa K., Minamino N., Matsuo H., Imura H. Inhibitory effect of brain natriuretic peptide on central angiotensin II-stimulated pressor response in conscious rats. Neurosci Lett. 1988 Aug 15;91(1):77–83. doi: 10.1016/0304-3940(88)90252-2. [DOI] [PubMed] [Google Scholar]
  35. Sudoh T., Kangawa K., Minamino N., Matsuo H. A new natriuretic peptide in porcine brain. Nature. 1988 Mar 3;332(6159):78–81. doi: 10.1038/332078a0. [DOI] [PubMed] [Google Scholar]
  36. Sugawara A., Nakao K., Morii N., Yamada T., Itoh H., Shiono S., Saito Y., Mukoyama M., Arai H., Nishimura K. Synthesis of atrial natriuretic polypeptide in human failing hearts. Evidence for altered processing of atrial natriuretic polypeptide precursor and augmented synthesis of beta-human ANP. J Clin Invest. 1988 Jun;81(6):1962–1970. doi: 10.1172/JCI113544. [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Szatalowicz V. L., Arnold P. E., Chaimovitz C., Bichet D., Berl T., Schrier R. W. Radioimmunoassay of plasma arginine vasopressin in hyponatremic patients with congestive heart failure. N Engl J Med. 1981 Jul 30;305(5):263–266. doi: 10.1056/NEJM198107303050506. [DOI] [PubMed] [Google Scholar]
  38. Yamada T., Nakao K., Itoh H., Shirakami G., Kangawa K., Minamino N., Matsuo H., Imura H. Intracerebroventricular injection of brain natriuretic peptide inhibits vasopressin secretion in conscious rats. Neurosci Lett. 1988 Dec 19;95(1-3):223–228. doi: 10.1016/0304-3940(88)90661-1. [DOI] [PubMed] [Google Scholar]
  39. Yasue H., Obata K., Okumura K., Kurose M., Ogawa H., Matsuyama K., Jougasaki M., Saito Y., Nakao K., Imura H. Increased secretion of atrial natriuretic polypeptide from the left ventricle in patients with dilated cardiomyopathy. J Clin Invest. 1989 Jan;83(1):46–51. doi: 10.1172/JCI113883. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Yoshimura M., Yasue H., Morita E., Sakaino N., Jougasaki M., Kurose M., Mukoyama M., Saito Y., Nakao K., Imura H. Hemodynamic, renal, and hormonal responses to brain natriuretic peptide infusion in patients with congestive heart failure. Circulation. 1991 Oct;84(4):1581–1588. doi: 10.1161/01.cir.84.4.1581. [DOI] [PubMed] [Google Scholar]
  41. Yoshimura M., Yasue H., Okumura K., Ogawa H., Jougasaki M., Mukoyama M., Nakao K., Imura H. Different secretion patterns of atrial natriuretic peptide and brain natriuretic peptide in patients with congestive heart failure. Circulation. 1993 Feb;87(2):464–469. doi: 10.1161/01.cir.87.2.464. [DOI] [PubMed] [Google Scholar]
  42. de Bold A. J., Borenstein H. B., Veress A. T., Sonnenberg H. A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats. Life Sci. 1981 Jan 5;28(1):89–94. doi: 10.1016/0024-3205(81)90370-2. [DOI] [PubMed] [Google Scholar]
  43. de Simone G., Devereux R. B., Chien S., Alderman M. H., Atlas S. A., Laragh J. H. Relation of blood viscosity to demographic and physiologic variables and to cardiovascular risk factors in apparently normal adults. Circulation. 1990 Jan;81(1):107–117. doi: 10.1161/01.cir.81.1.107. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES