Central venous pressure--a physiological stimulus for secretion of atrial natriuretic peptide in humans?

Abstract

A sensitive radio-immunoassay (RIA) for the measurement of human alpha-atrial natriuretic peptide (ANP) in extracted plasma was developed and used in a study of the possible effect of posture on the concentration of ANP in plasma. The least detectable quantity was less than 2 pg per tube equivalent to 5 pg ml-1 plasma. In the middle sensitivity range (approximately 50 pg per tube), the within-assay and between-assay coefficients of variation were 4.0 and 2.8%, respectively. The recovery of ANP added to plasma prior to extraction was 95-101%. High pressure liquid chromatography (HPLC) of plasma extracts revealed that endogenous ANP was eluted in the same fractions as synthetic ANP. In order to investigate the effect of posture on the concentration of ANP in plasma six healthy volunteers were exposed to five positions in the following sequence: supine, standing, sitting, supine and 10 degrees head-down tilt on a tilt-table. The concentration of ANP was lower in the standing and sitting position than in the supine and head-down tilted position. In another study six healthy volunteers were subjected to passive tilting on a tilt-table in order to evaluate the effect of tilting on blood pressure (BP), heart rate, central venous pressure (CVP) and the concentration of ANP in plasma. It was found that a fall in CVP was accompanied by a significant decrease in the concentration of ANP and that a rise in CVP was accompanied by a rapid increase in the concentration of ANP in plasma. The results are in agreement with the hypothesis that CVP is a physiological stimulus for the secretion of ANP.