Renal effects of atrial natriuretic peptide in a marine elasmobranch

The effects of atrial natriuretic peptide on the renal function of the spiny dogfish (Squalus acanthias) in seawater were evaluated. A synthetic mammalian peptide, atriopeptin II (2 micrograms/kg), was injected intravascularly into unanesthetized, unrestrained fish prepared for renal clearance studies. The aortic pressure, glomerular filtration rate (GFR), urine flow rate (V), and urinary excretion of sodium, potassium, and total osmolytes were continuously monitored. Atriopeptin II significantly decreased mean aortic pressure (-12%), GFR (-40%), V (-66%), and the absolute excretion rates of sodium (-47%), potassium (-43%), and total osmolytes (-44%). However, the renal effects of atriopeptin II were temporally dissociated from the vasodepressor effect. Mean aortic pressure decreased quickly and returned to control values approximately 2 h after injection, whereas GFR did not decrease significantly until the third hour after injection. The decreases in renal water and solute excretion in response to atriopeptin could be accounted for by the decrease in GFR, since there were no significant changes in fractional water or solute excretion. Similar decreases in GFR were observed during constant infusions of a lower physiological dose of the peptide (80 pg.kg-1.min-1). The observed antidiuretic and antinatriuretic effect of synthetic atriopeptin in the dogfish contrasts with its putative role as a hormone mediating hypervolemic regulation.

Neurohormonal activation and the response to converting enzyme inhibitors in congestive heart failure

The neurohormonal vasoconstrictor systems are frequently activated in patients with congestive heart failure, and they make important contributions to characteristic abnormalities in vasoconstriction. In 177 patients with congestive heart failure, however, there was a widespread distribution of levels of plasma renin activity and plasma norepinephrine, indicating that activation of the renin-angiotensin system and the sympathetic nervous system was not uniform. Furthermore, there were only weak correlations between plasma renin activity and plasma norepinephrine and hemodynamic measurements, age, and renal function, indicating that activation of these systems is complex and determined by many other factors. The converting enzyme inhibitors have beneficial effects on the hemodynamic abnormalities of patients with heart failure, with reductions in arterial tone and preload as well as increases in cardiac output. Their long-term effects on markers of the renin-angiotensin system, however, and their interactions with the sympathetic nervous system and atrial natriuretic factor are less well defined.

Effect of a new angiotensin converting enzyme inhibitor, cilazapril, on circulating atrial natriuretic factor during exercise in patients with essential hypertension

In seven patients with mild to moderate essential hypertension, the effect of a new angiotensin converting enzyme (ACE) inhibitor, cilazapril, on atrial natriuretic factor (ANF) was examined at rest and during exercise. The exercise protocol consisted of three fixed workloads (25, 50 and 75W) every 4 min with the use of a sitting bicycle ergometer. Cilazapril reduced blood pressure without increasing the heart rate, both at rest and during exercise. The resting pre-exercise left ventricular ejection fraction was not altered. The plasma ANF level was increased by exercise, but at the 75-W workload it was decreased by cilazapril; the resting plasma ANF value was not altered. At the 75-W workload the plasma ANF level was inversely correlated to the left ventricular ejection fraction (n = 14, r = -0.64, P less than 0.01). These results suggest that the observed decrease in the plasma ANF level during exercise induced by cilazapril is, in part, related to an improvement in the cardiac overload, and that cilazapril may be effective in physically active hypertensive patients.

Blunting of atrial natriuretic factor response to volume expansion by benazepril in hypertensive patients

To verify the hypothesis that the angiotensin converting enzyme (ACE) level may affect the metabolism of circulating atrial natriuretic factor (ANF), the acute and chronic effects of benazepril on plasma ANF levels were studied in hypertensive patients under basal conditions and in response to acute volume expansion. Ten essential hypertensives entered a double-blind crossover study, and were randomly allocated either to placebo or to 10 mg benazepril orally once a day for 2 days; after a placebo washout period of 2 days the groups were crossed over. On the second day of each crossover period, volume expansion was induced by infusing 1 litre saline in 30 min, and blood samples for ANF measurements were drawn at times -5, 0, 5, 15, 30, 35, 40, 50 and 60 min. Oral benazepril at 10 mg/day was then given to all patients for 4 weeks, and the volume expansion with saline was repeated. After the 2-day acute benazepril treatment, blood pressure fell from 166.1 +/- 3.6/105.1 +/- 0.9 to 140.1 +/- 4.6/85.6 +/- 2.1 mmHg (P less than 0.01 for both systolic and diastolic blood pressure), whereas ANF fell from 29.4 +/- 3.6 to 24.1 +/- 3.7 pg/ml (NS) after the acute benazepril treatment and to 17.7 +/- 3.6 pg/ml (P less than 0.01) after the chronic benazepril treatment. The volume expansion itself did not induce significant changes in mean arterial pressure, either during the placebo treatment or during the acute chronic benazepril treatment. The rise in ANF values in response to saline infusion during placebo was prompt, beginning at min 15 and reaching a maximum at min 40.(ABSTRACT TRUNCATED AT 250 WORDS)

Reciprocal changes in atrial natriuretic factor and aldosterone during angiotensin converting enzyme inhibition in man

To investigate whether aldosterone responses to angiotensin converting enzyme (ACE) inhibition are affected by changes in atrial natriuretic factor, which is known to inhibit aldosterone secretion, we measured blood pressure, plasma renin activity, aldosterone, atrial natriuretic factor and plasma potassium before and after 1 week of treatment with fosenopril, a long-acting ACE inhibitor, in eight normotensive subjects. Fosenopril caused a slight fall in blood pressure and increased plasma renin activity in all subjects. In contrast, aldosterone and atrial natriuretic factor were, on average, unchanged. However, for both these hormones a wide range of individual responses was observed (aldosterone from -254 to +240 pmol/l, atrial natriuretic factor from +9.7 to -16.6 pmol/l) and a significant inverse correlation was found between the changes in aldosterone and those in atrial natriuretic factor (r = -0.73, P less than 0.05). Plasma potassium was unchanged after the fosenopril treatment. These findings suggest an inter-relationship between atrial natriuretic factor and the aldosterone responses to short-term treatment with an ACE inhibitor.

Pharmacological features of the vasodilation induced by tertatolol in isolated perfused rat kidneys

The aim of the studies summarized in the present review was to obtain a pharmacological characterization of the in vitro renal vasodilator action of tertatolol. In isolated Tyrode-perfused rat kidneys, previously constricted with norepinephrine, serotonin or BaCl2, tertatolol evokes vasodilatation. These dilator responses cannot be explained by an interaction of tertatolol with alpha- or beta-adrenoceptors, muscarinic or nicotinic receptors, opioid receptors, dopamine receptors or histamine receptors, and they occur independently of the release of prostaglandins. Since methylene blue, an inhibitor of the soluble form of guanylate cyclase, reduces the renal dilator effect of tertatolol, this action could ultimately depend, at least in part, on the production of cyclic guanosine monophosphate; in this respect, the renal effects of tertatolol and atrial natriuretic factor (ANF) are different. From experiments performed with canine renal arteries and with the perfused rat mesentery, it can be concluded that the effect of tertatolol is more pronounced at the level of the resistance vessels. The in vitro renal dilator response observed with tertatolol may help to explain the beneficial effect on the renal circulation observed in both humans and experimental animals treated with the compound.

[Effect of furosemide on the plasma level of atrial natriuretic peptide (ANP) in healthy persons and in patients with uncomplicated primary arterial hypertension]

The study included 15 healthy individuals aged 37.3 +/- 7.7 years and 27 patients with the primary uncomplicated blood hypertension (stages I and II according to WHO classification) of the comparable age, untreated and given a diet containing 100-120 nM Na+ daily. Plasma ANP concentrations were measured prior to and after 30, 60, and 90 minutes following 40 mg furosemide intravenously. An increase in 1-minute urine output and 1-minute Na+ excretion in the urine were determined during 90 minutes following furosemide administration. A significant decrease in ANP plasma levels was noted in all examined individuals following furosemide administration in all time intervals comparing with baseline values. An increase in 1-minute urine output and 1-minute sodium excretion with the urine significantly correlated with plasma ANP decrease during 90 minutes following furosemide administration. The obtained results suggest that furosemide inhibits ANP secretion in the patients with uncomplicated primary hypertension similarly to healthy individuals.