ATRIAL-NATRIURETIC-PEPTIDE RESPONSE IS BLUNTED IN PATIENTS WITH ACUTEMYOCARDIAL-INFARCTION AND MILD LEFT-VENTRICULAR DYSFUNCTION

Neurohumoral parameters in 45 asymptomatic patients with acute myocard ial infarction were measured. In patients with mild left ventricular d ysfunction (ejection fraction less than or equal to 45% and/or left ve ntricular end-diastolic pressure greater than or equal to 15 mm Hg), a trial natriuretic peptide levels differed significantly from those in patients with normal left ventricular function (127 +/- 74 pg/ml vs. 7 9 +/- 71 pg/ml; p < 0.001). After stimulus an increase in atrial natri uretic peptide levels (79 +/- 71 to 118 +/- 86 pg/ml; p < 0.001) was f ound only in patients with normal hemodynamic parameters. These data s how that in patients with left ventricular dysfunction, the atrial nat riuretic system is activated; however, atrial natriuretic peptide resp onse to stimulus is present only in patients with normal hemodynamics.