AUTHOR=Yusuf Suraj M. , Norton Gavin R. , Peterson Vernice R. , Mthembu Nonhlanhla , Libhaber Carlos D. , Tade Grace , Bello Hamza , Bamaiyi Adamu J. , Mmopi Keneilwe N. , Dessein Patrick H. , Peters Ferande , Sareli Pinhas , Woodiwiss Angela J. 

TITLE=Role of atrial natriuretic peptide in the dissociation between flow relations with ventricular mass and function in a community with volume-dependent hypertension

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1175145

DOI=10.3389/fcvm.2023.1175145

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Whether differential effects of volume load on left ventricular mass (LVM) and function occur in sustained volume-dependent primary hypertension, and the impact of atrial natriuretic peptide (ANP) on these effects, is unknown.</p></sec><sec><title>Methods</title><p>From aortic pressure, velocity and diameter measurements and echocardiography, we determined in an African community (<italic>n</italic> = 772), the impact of systemic flow-induced increases in central pulse pressure (PPc) and circulating ANP (ELISA) on LVM and indexes of function.</p></sec><sec><title>Results</title><p>Stroke volume (SV), but not aortic flow (Q), was associated with LVM and mean wall thickness (MWT) beyond stroke work and confounders (<italic>p</italic> &lt; 0.0001). Adjustments for SV markedly decreased the relationships between PPc and LVMI or MWT. However, neither SV, nor Q were independently associated with either myocardial s', e', or E/e' (<italic>p</italic> &gt; 0.14) and adjustments for neither SV nor Q modified relationships between PPc and s', e' or E/e' (<italic>p</italic> &lt; 0.005 to &lt;0.0001). SV was nevertheless strongly and independently associated with ANP (<italic>p</italic> &lt; 0.0001) and ANP was similarly strikingly associated with s' (<italic>p</italic> &lt; 0.0001) and e' (<italic>p</italic> &lt; 0.0005), but not E/e', independent of confounders and several determinants of afterload. Importantly, ANP concentrations were inversely rather than positively associated with LV diastolic dysfunction (DD) (<italic>p</italic> &lt; 0.005) and lower rather than higher ANP concentrations contributed markedly to the ability to detect DD in those with, but not without LV hypertrophy.</p></sec><sec><title>Conclusion</title><p>In populations with sustained volume-dependent hypertension, flow (SV)-related increases in PP have a major impact on LV structure, but not on function, an effect attributed to parallel striking beneficial actions of ANP on myocardial function.</p></sec>