Chest ACCP Member Benefits
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wilkins, M. A.
Right arrow Articles by Kryger, M. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wilkins, M. A.
Right arrow Articles by Kryger, M. H.
(Chest. 1995;107:909-915.)
© 1995 American College of Chest Physicians

The Effects of Posture Change and Continuous Positive Airway Pressure on Cardiac Natriuretic Peptides in Congestive Heart Failure

Michael A. Wilkins BSc (Hons)1; Xiao-Ling Su MD1; Mark D. Palayew MD1; Yoshihiro Yamashiro MD1; Peter Bolli MD2; John K. McKenzie MD2; and Meir H. Kryger MD, FCCP1

1 From the Department of Respiratory Medicine, University of Manitoba, Winnipeg, Canada
2 From the Department of Nephrology, University of Manitoba, Winnipeg, Canada

We studied changes in the peripheral plasma levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in seven patients with congestive heart failure (CHF) during four 1-h protocols during which patients maintained either an upright or a supine posture with or without nasal continuous positive airway pressure therapy (N-CPAP) at a pressure of 10 cm H20 (FIo2=0.21). The mean plasma ANP concentration of patients increased significantly from baseline at the end of 1 h of recumbency (65.9±5.8 to 82.6±8.3 pg/mL (mean ± standard error); p<0.05). This increase was prevented by concomitant N-CPAP therapy (72.1±8.0 to 61.0±8.8 pg/mL; p=NS). The mean level of ANP decreased significantly (71.9±9.0 to 62.5±8.0 pg/mL; p<0.05) while patients simply maintained an upright posture. A significant reduction was also observed when patients remained upright with accompanying N-CPAP (72.6±10.9 to 54.6±4.3 pg/mL; p<0.05). There were no significant changes observed in the mean level of BNP for any of the protocols undertaken. We conclude that in patients with chronic CHF, (1) an increase in ANP concentration occurs with recumbency, and this can be prevented by N-CPAP therapy; (2) a decrease in ANP occurs with maintenance of an upright posture, and that this reduction may be augmented by N-CPAP; and (3) no net change in BNP concentration occurs with either posture change or N-CPAP.

Key Words: congestive heart failure • continuous positive airway pressure • natriuretic peptide

Submitted on December 2, 1993
Accepted on July 29, 1994




This article has been cited by other articles:


Home page
 ChestHome page
M. R. Pinsky
Cardiovascular Issues in Respiratory Care
Chest, November 1, 2005; 128(5_suppl_2): 592S - 597S.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. MEHTA, P. P. LIU, F. S. FITZGERALD, Y. K. ALLIDINA, and T. DOUGLAS BRADLEY
Effects of Continuous Positive Airway Pressure on Cardiac Volumes in Patients with Ischemic and Dilated Cardiomyopathy
Am. J. Respir. Crit. Care Med., January 1, 2000; 161(1): 128 - 134.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1995 by the American College of Chest Physicians.