To test the hypothesis that atrial natriuetic peptide (ANP) levels could be used as markers of the contractile efficacy of the heart, we analyzed the effect of several rates of pacing under asynchronous ventricular (VVI) and dual chamber (DDD) stimulation on ANP release in 11 patients previously implanted with atrioventricular (AV) sequential multiprogrammable pacemakers. The study design consisted of two successive stages, carried out on the same individual at an interval of three days, during which the right atrial pressure was measured and blood samples were taken from the right atrium for ANP assessment. Our most significant data showed that: (1) Under basic conditions mean ANP levels are significantly higher in VVI stimulation than in DDD pacing mode (P <0.001). (2) While under AV sequential stimulation at various cycle lengths there is a strong correlation between ANP excretion and right atrial pressure (r = .75). This does not happen in VVI mode (r = 34). In conclusion, we can state that VVI, compared with DDD stimulation, can compromise the intrinsic ability of the heart to control the physiologic and pathologic changes in hemodynamic balance by adequate release of ANP.
|Number of pages||6|
|Journal||Current Therapeutic Research|
|Publication status||Published - 1989|
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