Atrial natriuretic peptide response to postural change and medication in familial dysautonomia

Felicia B. Axelrod, Lewis Krey, Julie S. Glickstein, Deborah Friedman, Jennifer Weider, Linda J. Metakis, Vicki M. Porges, Maria Mineo, Daniel Notterman

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Circulating atrial natriuretic peptide (ANP) was assayed before and after postural change and exercise in 54 patients with familial dysautonomia (FD) and 20 controls. ANP levels were compared with blood pressure, heart rate, plasma catecholamines and parameters of renal function. Compared with controls supine FD subjects had elevated blood pressures, heart rates and ANP levels (39 ± 4 pg/ml vs. 23 ± 3 pg/ml, p < 0.01). With the erect posture and exercise in FD subjects, blood pressure fell below control values, with ANP lowered. In FD subjects, blood pressure was correlated with ANP levels when supine and when erect and with heart rate post exercise. In controls, ANP levels did not correlate with other parameters. In FD patients on metoclopramide, supine and erect blood pressure and ANP levels were higher. FD subjects treated with fludrocortisone, had elevated supine and erect noradrenaline (p < 0.05 and p = 0.06); and those on diazepam had lower erect and post exercise noradrenaline (p < 0.05), but ANP levels were similar. In conclusion, sympathetic denervation may increase FD patients' responsiveness to other regulators of cardiovascular integrity, such as ANP. In addition, circulating ANP and catecholamines in FD subjects appear to be influenced by commonly used medications, such as metoclopramide.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalClinical Autonomic Research
Volume4
Issue number6
DOIs
StatePublished - Dec 1 1994
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Endocrine and Autonomic Systems
  • Clinical Neurology

Keywords

  • Atrial natriuretic peptide
  • Catecholamines
  • Familial dysautonomia
  • Orthostatic hypotension

Fingerprint Dive into the research topics of 'Atrial natriuretic peptide response to postural change and medication in familial dysautonomia'. Together they form a unique fingerprint.

  • Cite this

    Axelrod, F. B., Krey, L., Glickstein, J. S., Friedman, D., Weider, J., Metakis, L. J., Porges, V. M., Mineo, M., & Notterman, D. (1994). Atrial natriuretic peptide response to postural change and medication in familial dysautonomia. Clinical Autonomic Research, 4(6), 311-318. https://doi.org/10.1007/BF01821531