August 1995
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24 Reads
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7 Citations
Respiratory Medicine
N. PRASAD, C. C. LANG, H. M. MCALPINE, A-M. J. CHOY, T. M. MACDONALD AND A. D. STRUTHERS Department of Clinical Pharmacology and Cardiology, Ninewells Hospital and Medical School, Dundee, UK. Introduction Brain natriuretic peptide (BNP) is a relatively recent addition to the family of natriuretic peptides (1). Although originally isolated from the porcine brain, BNP, like atria1 natriuretic peptide (ANP), is a cardiac hormone which is synthesized and secreted into the circulation by the heart (1,2). Increased cardiac secretion of BNP has been reported in patients with predominant left-sided heart failure (2,3). No information is available for patients with haemodynamic alterations limited to the pulmonary circulation for BNP, although plasma ANP concen- trations have been shown to be elevated in pul- monary hypertension (4,5). We report measurement of plasma BNP concentrations in two patients with pulmonary hypertension undergoing right heart car- diac catheterizations. The patients were maintained on oxygen during the study as hypoxaemia can cause ANP release (6). We also report the effect of nifedipine, a calcium antagonist and potent vaso- dilator, on plasma BNP levels in one of these patients. Case 1 A 57-year-old female was referred to our hospital with a 3-yr history of progressive fatigue and increas- ing dyspnoea with recent onset of ankle swelling. Her medical history was unremarkable. Physical exami- nation revealed peripheral cyanosis, a right ventricu- lar heave and a loud pulmonary component to the second heart sound. Investigations included a normal