SHORT-TERM EFFECTS OF EATING ON VASOACTIVE HORMONES AND HEMODYNAMICS IN PATIENTS WITH HEART-FAILURE

Objectives, To investigate if eating can influence the measurements of vasoactive hormones or their relationship to important haemodynamic variables. Design. Haemodynamic variables and plasma concentrations of atrial natriuretic peptide (ANP), arginine vasopressin and angiotensin enzyme (ACE) activity were measured. During the 24-h study period the patients ate ordinary hospital meals and thus were studied both in the absorptive and postabsorptive phases. Setting. Two university hospitals in Sweden participated in the study. Subjects. Ten patients with heart failure, due to ischaemic heart disease. Intervention. Eating. Main outcome measures. Change in haemodynamic variables and plasma concentrations of vasoactive hormones related to eating. Results. After a meal (absorptive phase) pulmonary capillary wedge pressure and plasma concentrations of ANP were significantly lower compared to the postabsorptive phase, 13 +/- 1.7 vs. 16 +/- 1.9 mmHg and 57 +/- 9.5 vs. 72 +/- 12.2 pmol l(-1), respectively. The relationship between ANP and its main predictor, pulmonary capillary wedge pressure, was not altered during the study period. Plasma concentration of arginine vasopressin, ACE activity and mean right atrial pressure decreased with time and the cardiac index increased with time over the study period. Conclusions. A meal may significantly influence plasma concentrations of ANP. Studies on vasodilator treatment and its interactions with ANP should take account of these basal fluctuations. The present data confirm previous reports on haemodynamic improvement during the first 24 h of supine cardiac catheterization in patients with heart failure, and add new information about decreasing concentrations of arginine vasopressin and ACE.