Disposal of atrial natriuretic factor (ANF₉₉-₁₂6) in patients with cirrhosis: Effect of beta-adrenergic blockade

Abstract

Bendtsen F, Gerbes A L, Henriksen J H. Disposal of atrial natriuretic factor (ANF₉₉_.₁₂₆) in patients with cirrhosis: effect of beta-adrenergic blockade. Scand J Clin Lab Invest 1993; 53: 547-554.

To test a possible effect of blood flow change on disposal of atrial natriuretic factor: ANF₉₉_₁₂6 (ANF), we determined renal, azygos, hepatic and cubital venous, and arterial plasma concentrations of ANF in 18 patients with cirrhosis before and after ingestion of propranolol 80 mg. Arterial ANF was similar to that of controls (9.4 vs. 10.9pmoll^_1, NS) and was positively correlated to cardiac output (r = 0.49, p < 0.02) and to right atrial pressure (r = 0.44, p < 0.01). All the vascular beds examined extracted ANF significantly. The renal (n = 17), hepato-enteric (n = 16), and splanchnic superior collateral (azygos) beds (n = 13) had significantly higher extraction ratios (0.34-0.39) than that observed in the cubital vein (0.24, n = 15, p < 0.05). Arterial ANF showed no significant change (9.6-ll.Opmoir¹, NS) after reduction of cardiac output (–25%, p < 0.001) by propranolol. Only insignificant changes in ANF extraction and a small decrease in azygos and hepato-enteric clearance occurred during beta-adrenergic blockade. Our results show a substantial extraction of ANF in the kidney, in the splanchnic bed drained through superior portosystemic collaterals, and in the hepato-enteric bed. Only minor effects on ANF extraction were observed after reduction of the blood flow with propranolol.

Key Words:

• atrial natriuretic factor (ANF)
• beta-adrenergic blockade
• cirrhosis
• extraction
• propranolol