PT  - JOURNAL ARTICLE
AU  - Takahiro Sato
AU  - Ichizo Tsujino
AU  - Hiroshi Ohira
AU  - Noriko Oyama-Manabe
AU  - Masaharu Nishimura
TI  - Atrial natriuretic peptide as a serum marker of right atrial enlargement and function in pulmonary hypertension
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P1504
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P1504.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P1504.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - BackgroundProduction of atrial natriuretic peptide (ANP) increases in response to right atrial (RA) expansion. However, association between serum ANP level and RA volume has been poorly investigated in pulmonary hypertension (PH). Also, no studies have examined the link between serum ANP levels and RA function.Methods and ResultsA total of 51 PH patients were studied. The serum ANP level was 51.6 pg/ml [median, IQR: 31.7 – 121, normal range 0 - 43]. Volumetric analysis by cardiac magnetic resonance imaging (CMRI) showed greater RA volume in PH patients (58 ± 23 ml/m2) than in 22 controls (40 ± 11 ml/m2) (p<0.001). Analysis of RA function by CMRI indicated similar RA ejection fraction (RAEF) between the two groups; however, fractional emptying and reservoir volume were reduced in PH patients than in controls (p<0.001 for both). Correlation analysis showed significant association between serum ANP levels and RA volume (r=0.45, p<0.001). Serum ANP levels also correlated with CMRI indices of RA function [RAEF (r=-0.66, p<0.001), fractional emptying (r=-0.75, p<0.001) and RA reservoir volume (r=-0.42, p=0.01)].ConclusionsSerum ANP level increases in response to RA enlargement. Importantly, the level is also a marker of reduced systolic and reservoir function of the right atrium in PH.