Atrial natriuretic peptide response to unilateral pulmonary artery occlusion.

To test the hypothesis that neural mechanisms evoked by unilateral pulmonary artery occlusion (UPAO) affect the release of atrial natriuretic peptides (ANP) from the heart, hemodynamics and levels of plasma ANP and cyclic guanosine monophosphate (c-GMP) were studied in 11 patients with lung cancer. The UPAO induced a significant rise in heart rate by 5.3 percent, increased mean pulmonary artery pressure by 31 percent without affecting right atrial pressure, and decreased plasma ANP levels in the coronary sinus by 17.4 percent (p < 0.05) from 202.5 +/- 27.1 pg/ml to 167.2 +/- 27.4 pg/ml. Atropine sulfate (0.04 mg/kg) injection increased the heart rate by 38.2 percent (p < 0.01), reduced the stroke volume index by 25.1 percent, decreased coronary sinus ANP levels from 198.5 +/- 16.4 pg/ml to 124.8 +/- 19.6 pg/ml (p < 0.01), and decreased coronary sinus plasma c-GMP levels from 4.6 +/- 0.5 pmol/ml to 3.1 +/- 0.4 pmol/ml (p < 0.05). After atropine pretreatment, UPAO induced a significant (p < 0.05) increase of 34.8 percent in the coronary sinus ANP level. Thus, it is concluded that in UPAO, the secretion of ANP from the heart is modulated partly by the autonomic nervous system.