ATRIAL-NATRIURETIC-PEPTIDE AND HEMODYNAMIC-RESPONSE TO PERICARDIECTOMY FOR CHRONIC CONSTRICTIVE PERICARDITIS

A trial compliance, intraluminal pressure, transmural pressure and atrial stretch have been suggested as major stimuli for the production of atrial natriuretic peptide (ANP). These assumptions are mainly based on observations showing good correlations between pressures and ANP levels in heart failure due to heart diseases of various etiology.1 Increasing pressure in the left and/or right atrium is followed by an increased stretch of the atrial wall in most heart diseases, except in cardiac tamponade and constrictive pericarditis. In an experiment with dogs, the rise of ANP during rapid volume expansion was decreased in the presence of cardiac tamponade, even if the right atrial pressure and the left end-diastolic pressure increased during the induced tamponade.2 This indicates that pressure is not the only determinant, as has been presumed previously. To investigate this relation, we studied the relation between ANP and some important hemodynamic parameters in a patient during exercise before and after pericardiectomy. © 1990.