Eb. Pedersen et al., Pulsatile secretion of atrial natriuretic peptide and brain natriuretic peptide in healthy humans, CLIN SCI, 97(2), 1999, pp. 201-206
Both atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) a
re involved in sodium and water homoeostasis in healthy humans. The plasma
concentrations of the natriuretic peptides can be used to differentiate bet
ween dyspnoea of cardiac and pulmonary origin, and the degree of elevation
of the peptide levels in the plasma in heart failure is a measure of the se
verity of the disease. However, the patterns of secretion of ANP and BNP ar
e not clear either in healthy humans or in patients. The purpose of the pre
sent study was to test the hypotheses that both ANP and BNP are secreted in
pulses in healthy humans, and that this phenomenon can be revealed by dete
rmination of ANP and BNP in peripheral venous blood samples. In 12 healthy
subjects, blood samples were drawn every 2 min through an intravenously ins
erted plastic needle over a period of 2 h. Plasma concentrations of ANP and
BNP were determined by RIAs, and the results were analysed for pulsatile b
ehaviour by Fourier transformation. Pulsatile secretion of ANP was seen in
10 out of 12 subjects [nu = 0.028 min(-1) (median; range 0.013-0.047 min(-1
)), i.e. a pulse of ANP with an interval of 36 min (range 21-77 min)]. Puls
atile secretion of BNP was seen in nine out of 12 patients [nu = 0.021 min(
-1) (range 0.013-0.042 min(-1)), i.e. a pulse of BNP with an interval of 48
min (range 24-77 min)]. The main conclusion is that the secretion patterns
of both ANP and BNP are pulsatile in most healthy humans. Consequently, it
is important to study whether pulsatile secretion also occurs in heart fai
lure in order to obtain the most informative predictive values both in the
differential diagnosis of dyspnoea and in the evaluation of the severity of
the disease.