TY - JOUR
T1 - Atrial natriuretic peptide response to postural change and medication in familial dysautonomia
AU - Axelrod, Felicia B.
AU - Krey, Lewis
AU - Glickstein, Julie S.
AU - Friedman, Deborah
AU - Weider, Jennifer
AU - Metakis, Linda J.
AU - Porges, Vicki M.
AU - Mineo, Maria
AU - Notterman, Daniel
PY - 1994/12
Y1 - 1994/12
N2 - 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.
AB - 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.
KW - Atrial natriuretic peptide
KW - Catecholamines
KW - Familial dysautonomia
KW - Orthostatic hypotension
UR - http://www.scopus.com/inward/record.url?scp=0028582116&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0028582116&partnerID=8YFLogxK
U2 - 10.1007/BF01821531
DO - 10.1007/BF01821531
M3 - Article
C2 - 7711467
AN - SCOPUS:0028582116
SN - 0959-9851
VL - 4
SP - 311
EP - 318
JO - Clinical Autonomic Research
JF - Clinical Autonomic Research
IS - 6
ER -