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Edvinsson ML, Uddman E, Edvinsson L, et al. Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients. J Geriatr Cardiol. 2014;11(1):50-6doi: 10.3969/j.issn.1671-5411.2014.01.004.
Edvinsson, M. L., Uddman, E., Edvinsson, L., & Andersson, S. E. (2014). Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients. Journal of geriatric cardiology : JGC, 11(1), 50-6. https://doi.org/10.3969/j.issn.1671-5411.2014.01.004
Edvinsson, Marie-Louise, et al. "Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients." Journal of geriatric cardiology : JGC vol. 11,1 (2014): 50-6. doi: https://doi.org/10.3969/j.issn.1671-5411.2014.01.004
Edvinsson ML, Uddman E, Edvinsson L, Andersson SE. Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients. J Geriatr Cardiol. 2014 Mar;11(1):50-6. doi: 10.3969/j.issn.1671-5411.2014.01.004. PMID: 24748882; PMCID: PMC3981984.
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J Geriatr Cardiol. 2014 Mar;11(1):50-6. doi: 10.3969/j.issn.1671-5411.2014.01.004.

Brain natriuretic peptide is a potent vasodilator in aged human microcirculation and shows a blunted response in heart failure patients.

Journal of geriatric cardiology : JGC

Marie-Louise Edvinsson, Erik Uddman, Lars Edvinsson, Sven E Andersson

Affiliations

  1. Department of Emergency and Internal Medicine, Institute of Clinical Sciences Lund University, Lund University Hospital, SE- 221 85 Lund, Sweden.

PMID: 24748882 PMCID: PMC3981984 DOI: 10.3969/j.issn.1671-5411.2014.01.004

Abstract

BACKGROUND: Brain natriuretic peptide (BNP) is normally present in low levels in the circulation, but it is elevated in parallel with the degree of congestion in heart failure subjects (CHF). BNP has natriuretic effects and is a potent vasodilator. It is suggested that BNP could be a therapeutic alternative in CHF. However, we postulated that the high levels of circulating BNP in CHF may downregulate the response of microvascular natriuretic receptors. This was tested by comparing 15 CHF patients (BNP > 3000 ng/L) with 10 matched, healthy controls.

METHODS: Cutaneous microvascular blood flow in the forearm was measured by laser Doppler Flowmetry. Local heating (+44°C, 10 min) was used to evoke a maximum local dilator response.

RESULTS: Non-invasive iontophoretic administration of either BNP or acetylcholine (ACh), a known endothelium-dependent dilator, elicited an increase in local flow. The nitric oxide synthase inhibitor, l-N-Arginine- methyl-ester (L-NAME), blocked the BNP response (in controls). Interestingly, responses to BNP in CHF patients were reduced to about one third of those seen in healthy controls (increase in flow: 251% in CHF vs. 908% in controls; P < 0.001). In contrast, the vasodilator responses to ACh and to local heating were only somewhat attenuated in CHF patients. Thus, dilator capacity and nitric oxide signalling were not affected to the same extent as BNP-mediated dilation, indicating a specific downregulation of the latter response.

CONCLUSIONS: The findings show for the first time that microvascular responses to BNP are markedly reduced in CHF patients. This is consistent with the hypothesis of BNP receptor function is downregulated in CHF.

Keywords: Acetylcholine, Brain natriuretic peptide; Cutaneous microcirculation; Endothelial responses; Heart failure; Nitric oxide

References

  1. J Cardiovasc Pharmacol. 2013 May;61(5):361-8 - PubMed
  2. Clin Chem. 2005 Aug;51(8):1420-31 - PubMed
  3. JAMA. 2010 Jun 2;303(21):2141-7 - PubMed
  4. JAMA. 2002 Mar 27;287(12):1531-40 - PubMed
  5. J Appl Physiol (1985). 2008 Jul;105(1):381; author reply 389 - PubMed
  6. N Engl J Med. 2000 Jul 27;343(4):246-53 - PubMed
  7. Am J Geriatr Cardiol. 2008 Jan-Feb;17(1):13-20 - PubMed
  8. Clin Pharmacol Ther. 2013 Jan;93(1):57-67 - PubMed
  9. JAMA. 2012 Nov 28;308(20):2108-17 - PubMed
  10. Endocr Rev. 2006 Feb;27(1):47-72 - PubMed
  11. N Engl J Med. 2011 Jul 7;365(1):32-43 - PubMed
  12. Clin Sci (Lond). 2003 Dec;105(6):699-707 - PubMed
  13. Circulation. 2013 Oct 15;128(16):e240-327 - PubMed
  14. Cardiovasc Res. 2004 Nov 1;64(2):308-14 - PubMed
  15. Eur Heart J. 2013 Feb;34(7):529-39 - PubMed
  16. Fundam Clin Pharmacol. 2005 Aug;19(4):411-9 - PubMed
  17. J Geriatr Cardiol. 2011 Jun;8(2):82-7 - PubMed
  18. Basic Clin Pharmacol Toxicol. 2005 Nov;97(5):306-10 - PubMed

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