PLASMA HUMAN ATRIAL-NATRIURETIC-PEPTIDE UNDER COMPRESSION THERAPY IN PATIENTS WITH CHRONIC VENOUS INSUFFICIENCY WITH OR WITHOUT CARDIAC-INSUFFICIENCY

The influence of a therapy with compression knee stockings on hemodyna mics was investigated; we measured the mean blood pressure (MBP), the heart rate (HR) and the plasma level of the human atrial natriuretic p eptide (hANP) was measured under standardized conditions for a period of three hours. This study comprised three groups of patients; group 1 : five volunteers with a sound heart and healthy venous function (age 72 +/- 9 years); group 2: five patients suffering from II to III stage chronic venous insufficiency (CVI) (age 72 +/- 10 years); Group 3: 5 patients with CVI II-III as well as existing heart insufficiency NYHA II (age 77 +/- 10 years). Whereas the hANP basal values of group 1 and 2 showed no marked differences when compared to each other (58.1 +/- 5.7 pg/ml and 64.8 +/- 22.8 pg/ml), the values of group 3 were almost twice as high (108 +/- 24.2 pg/ml, p < 0.05-0.01). During the course o f the compression therapy no significant plasma hANP changes were obse rved in groups 1 and 2 but there was a significant increase in group 3 after 10 minutes (+ 17.2 +/- 7.2%, p < 0.06) which, however, normaliz ed again. No significant changes of the MBP could be detected in group 1, whereas a significant increase of the MBP values was measured in g roup 2 patients after 10 (+ 4.1 +/- 0.9%, p < 0.001) and 20 minutes ( 3.1 +/- 2.2%, p < 0.05). In the further course of the examination, th e MBP values of group 2 and 3 were not significantly different from th e initial values. There were no marked changes of the HR in all three groups. We can conclude from our study that cardiac stress from a comp ression therapy in patients with CVI and cardiac insufficiency is only a short-term stress and therefore does not represent any risk.