[Relationship between plasma hormones and ventricular premature contractions in extracorporeal shock wave lithotripsy--significance of human atrial natriuretic peptide (hANP)].

Extracorporeal shock wave lithotripsy (ESWL) is a safe and effective treatment for upper urinary tract stones. However, the mechanism by which this treatment may be involved in causing ventricular premature contractions (VPC) is unknown. We evaluated the relationship between VPC and plasma hormones in patients treated by ESWL. Holter monitoring was performed on 61 outpatients undergoing ESWL with electrocardiographic synchronization for upper urinary tract stones. The levels of cathecolamine, plasma renin activity (PRA), plasma aldosterone concentration (PAC), and human atrial natriuretic peptide (hANP) were measured before, immediately after, and 7 days after ESWL. Systolic blood pressure increased significantly immediately after, and decreased 7 days after ESWL. VPC occurred during 23 treatments (37.7%) but during ESWL no significant relationship was observed with the treatment side or location. Epinephrine increased significantly immediately after ESWL. hANP increased significantly immediately after ESWL, and decreased 7 days later. VPC occurred in all patients who had an hANP value above 40 pg/ml before ESWL. These results suggest that VPC is related to hemodynamic changes, and that hANP can predict VPC during ESWL.