Abstract
This study examines the effect of volume overload, atrial heart rate and critical illness on ANP levels in children. ANP levels were measured in 7 children undergoing dialysis(D), 4 children undergoing cardiac catheterization with electrophysiological pacing(EP), and 4 children in the ICU with pulmonary artery (PA) catheters. Thirty-four children were controls. The ANa results (RIA technique) are expressed in pg/ml (mean±SD). ANF levels in all 3 study groups were significantly different from normal (6.5±4.9) as follows: pre D pts, 139.7 ± 71.3 (p <.001); EP, 48.5^20.5 (p<.02); ICU patients, 104.0 ± 44.9 (p<.001). Pre and post D samples were significantly different (139.7±71.3 vs. 90.7±50.6, p<.004)and the change in ANF was correlated with the percent weight loss (R = .733). Pacing increased heart rates (117 ± 17 vs. 157 ± 20, p <.01) and ANP levels correlated with the increase in heart rate (48.5 ± 20.5 vs. 203.0 ± 66.0., p <.005, R = .66). ICU patients had elevated but statistically equivalent ANP levels in central venous, PA and arterial samples. CONCLUSION: ANP levels are increased in children with fluid overload, elevated heart rates and in critical illness. Removal of fluid from volume overloaded patients directly correlated with a decrease in ANP. Pacing of the right atrium in children caused a significant elevation of ANP confirming the association of tachycardia with ANP.
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Davis, A., Goldstein, D., Salcedo, J. et al. ATRIAL NATRIURETIC PEPTIDE (ANP): THE RELATIONSHIP WITH VOLUME, TACHYCARDIA AND CRITICAL ILLNESS. Pediatr Res 21 (Suppl 4), 199 (1987). https://doi.org/10.1203/00006450-198704010-00198
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DOI: https://doi.org/10.1203/00006450-198704010-00198