Abstract
This study examines the relationship of ANP to right and left atrial pressures, intracardiac shunts and compares patients with congenital heart disease (N = 11) to a group of normal children (N = 34). During cardiac cath, right and left atrial ANP levels, Intracardiac pressures, and cardiac output were measured and shunt and direction of the shunt were calculated. All ANP results (RIA technique) are in pg/ml (mean ± SD). Of the 11 children, 4 had no intracardiac shunting, 5 had left to right shunts and 2 had right to left shunts. Right and left atrial ANP levels were significantly (p <.005) elevated when compared to the normal control (6.5 ± 4.9). Right atrial ANP (103.9 ± 98.0) was not different from left atrial ANP (101.6 ± 95.4). Seven children with elevated right atrial pressures (RAP ≥ 9 mm Hg) had higher ANP levels than 5 children without elevated RAP (154.9 ± 106.5 vs. 42.6 ± 38.0, p< .03). In patients without shunts (N = 4) RAP and ANP levels were highly correlated (R = 0.930). Left atrial ANP levels were also highly correlated with RAP (R = 0.945). Children with intracardiac shunts had poor correlation between ANP and atrial pressures but significantly (p <.05) higher ANP in the right atrium (166.4 ± 111.5, N = 5) than patients without shunt (40.9 ± 24.6, N = 4). CONCLUSION: These unique data indicate that ANP in children is: (1) primarily produced in the right atrium and is correlated with RAP, (2) elevated in congenital heart disease, and (3) is further elevated in children with left to right shunts.
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Davis, A., Goldstein, D., Shapiro, S. et al. THE ROLE OF ATRIAL NATRIURETIC PEPTIDE (ANP) IN CONGENITAL HEART DISEASE. Pediatr Res 21 (Suppl 4), 189 (1987). https://doi.org/10.1203/00006450-198704010-00137
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DOI: https://doi.org/10.1203/00006450-198704010-00137