The Changes of Concentration of Atrial Natriuretic Peptide and Haemodynamic Correlates in Patients With Supraventricular Tachycardias

To investigate the changes of concentration of atrial natriuretic peptide(ANP) and haemodynamic correlates in patients with supraventricular tachycardias.Forty patients were divided into atrioventricular nodal reentrant tachycardias (AVNRT) group (n=17) and atrioventricular reentrant tachycardias (AVRT) group(n=23). The levels of ANP in femoral artery(FA) , femoral vein(FV), right atria(RA) ,and coronary sinus(CS) with the peak right atrial pressure( peak RAP), and FA pressure were measured before and 5 min after onset of tachycardia. Results:During tachycardias, the plasma levels of ANP significantly increased both in AVNRT and AVRT groups (P 0.001). The values of ANP levels in the AVNRT group after 5 min onset of tachycardia had more significant increases than those of the AVRT group(P0.05). Before and 5 min after onset of tachycardia the peak RAP of each group had a marked increase(P 0.001). After onset of tachycardia the higher values of peak RAP in AVNRT groups had more significant increases than those of the AVRT group(P 0.01). Following tachycardia, significant correlations were found between the changes in plasma levels of ANP and peak RAP or amount of increase values( P0.01). There was a marked fall in FA pressure in both groups at the onset of tachycardias(P0.001). There were significant correlations among the plasma levels of ANP , the change in peak RAP, and the fall of blood press(BP)(P0.001). Conclusion: During onset of tachycardias of AVNRT and AVRT , the plasma levels of ANP significantly increased. This study demonstrates that the release of ANP during tachycardia(both AVRT and AVNRT) is primarily dependent on increased atrial pressure. The ANP levels in patients with AVNRT have also more significant increases than those of patients with AVRT . The different plasma levels of ANP between AVRT and AVNRT are mainly caused by the change in value of peak RAP. There are significant negative correlations between the plasma levels of ANP and the fall of BP.