The effect of water deprivation on the expression of atrial natriuretic pepide and its receptors in the spinifex hopping mouse, Notomys alexis

This study investigated the mRNA expression of the atrial natriuretic peptide (ANP) system (peptide and receptors) during water deprivation in the spinifex hopping mouse, Notomys alexis, a native of central and western Australia that is well adapted to survive in arid environments. Initially, ANP, NPR-A and NPR-C cDNAs (partial for receptors) were cloned and sequenced, and were shown to have high homology with those of rat and mouse. Using a semi-quantitative multiplex PCR technique, the expression of cardiac ANP mRNA and renal ANP, NPR-A, and NPR-C mRNA was determined in 7- and 14-day water-deprived hopping mice, in parallel with control mice (access to water). The levels of ANP mRNA expression in the heart remained unchanged, but in the kidney ANP mRNA levels were increased in the 7-day water-deprived mice, and were significantly decreased in the 14-day water-deprived mice. NPR-A mRNA levels were significantly higher in 7-day water-deprived mice while no change for NPR-A mRNA expression was observed in 14-day water-deprived mice. No variation in NPR-C mRNA levels was observed. This study shows that water deprivation differentially affects the expression of the ANP system, and that renal ANP expression is more important than cardiac ANP in the physiological adjustment to water deprivation.

Toad atrial natriuretic peptide : cDNA cloning and functional analysis in isolated perfused kidneys

Complementary DNA (cDNA) encoding Bufo marinus (toad) preproatrial natriuretic peptide (preproANP) was isolated by reverse-transcription polymerase chain reaction. Sequence analysis of toad preproANP cDNA revealed an open reading frame of 150 amino acid residues, which shared 72% and 66% identity with Rana catesbeiana and Xenopus laevis preproANP, respectively. The deduced amino acid sequence of toad ANP that corresponded to ANP 1–24 of R. catesbeiana and Rana ridibunda was identical, but it differed by four residues from that of X. laevis. ANP mRNA transcripts were also shown to be expressed in the toad kidney. Subsequently, the effect of frog ANP (1–24) on renal function in toad was examined using a perfused kidney preparation. The arterial infusion of frog ANP caused a dose-dependent decrease in the arterial perfusion pressure that was associated with an increase in the glomerular filtration rate (GFR) and a renal natriuresis and diuresis. The renal natriuresis and diuresis resulted predominantly from an increased GFR rather than from direct tubular effects. This study demonstrates that ANP can regulate renal function, which suggests it may be involved in overall fluid volume regulation.

Expression of natriuretic peptide receptor mRNA and functional response to atrial natriuretic peptide and C-type natriuretic peptide in rainbow trout (Oncorhynchus mykiss) head kidney leucocytes

The stimulatory effect of vasomodulatory natriuretic peptide hormones on macrophages and peripheral blood leucocytes in mammals is well-established. However, the relationship in lower vertebrates has not been characterised. Expression of atrial natriuretic peptide, ventricular natriuretic peptide and C-type natriuretic peptide-1, and the guanylyl cyclase-linked (GC) natriuretic peptide receptor-A and -B-type receptors (NPR-A and NPR-B, respectively) was determined by PCR from the mRNA of rainbow trout head kidney leucocytes yielding gene fragments with 100% homology to the same respective natriuretic peptide and NPR-A and -B sequences obtained from other rainbow trout tissues. A mixed population of isolated rainbow trout head kidney leucocytes was stimulated in vitro with trout atrial natriuretic peptide (specific NPR-A agonist) and trout C-type natriuretic peptide (NPR-A and -B agonist) as well as the cGMP agonist 8-bromo-cGMP or the GC inhibitor 8-bromo-phenyl-eutheno-cGMP. Respiratory burst was stimulated by trout atrial natriuretic peptide, trout C-type natriuretic peptide-1 and 8-bromo-cGMP in a dose dependant manner with the highest activity as a result of stimulation with trout C-type natriuretic peptide-1 in excess of that achieved by phorbol myristate acetate (PMA). Equimolar concentrations of the inhibitor, inhibited the respiratory burst caused by the natriuretic peptides and 8-bromo-cGMP. The natriuretic peptide receptors on rainbow trout head kidney leucocytes appear to have a stimulatory function with regard to respiratory burst that is activated through a cGMP second messenger pathway and the natriuretic peptides expressed in the head kidney leucocytes may well act in a paracrine/autocrine manner.

Amiodarone, anticoagulation, and clinical events in patients with atrial fibrillation: insights from the ARISTOTLE trial

Amiodarone is an effective medication in preventing atrial fibrillation (AF), but it interferes with the metabolism of warfarin.

An international observational prospective survey assessing the control of atrial fibrillation in Asia-Pacific: results of the record-AFAP registry

A prospective 1-year observational survey was designed to assess the management and control of atrial fibrillation (AF) in eight countries within the Asia-Pacific region. Patients (N = 2,604) with recently diagnosed AF or a history of AF ≤1 year were included. Clinicians chose the treatment strategy (rhythm or rate control) according to their standard practice and medical discretion. The primary endpoint was therapeutic success. At baseline, rhythm- and rate-control strategies were applied to 35.7% and 64.3% of patients, respectively. At 12 months, therapeutic success was 43.2% overall. Being assigned to rhythm-control strategy at baseline was associated with a higher therapeutic success (46.5% vs 41.4%; P = 0.0214) and a lower incidence of clinical outcomes (10.4% vs 17.1% P < 0.0001). Patients assigned to rate-control strategies at baseline had higher cardiovascular morbidities (history of heart failure or valvular heart disease). Cardiovascular outcomes may be less dependent on the choice of treatment strategy than cardiovascular comorbidities.

Avaliação do apêndice atrial esquerdo pela ecocardiografia transtorácica com imagem harmônica após evento neurológico agudo

Introdução: Embora a imagem com segunda harmônica esteja largamente disponível na maioria dos aparelhos de ultra-sonografia, sua acurácia para avaliar a morfologia e a função do apêndice atrial esquerdo (AAE) permanece precariamente caracterizada. Objetivos: Explorar o desempenho diagnóstico da ecocardiografia transtorácica com segunda harmônica (ETTsh) na avaliação do AAE após eventos neurológicos agudos. Métodos: Realizamos um estudo transversal em pacientes com eventos neurológicos isquêmicos agudos, encaminhados para realização de ETTsh e Ecocardiografia Transesofágica (ETE). As análises da área longitudinal máxima e do pico da velocidade de esvaziamento de fluxo do AAE foram realizadas por observadores cegos. Resultados: Foram avaliados 51 pacientes (49% femininas, 62 ± 12 anos) com eventos neurológicos isquêmicos agudos. Contraste ecocardiográfico espontâneo foi observado em 11 (22%) pacientes no AE, em 7(14%) no AAE e em 3 (6%) na aorta torácica descendente. Trombo no AAE foi identificado em apenas 2 (4%) pacientes. O mapeamento e a análise do AAE foi factível na maioria dos casos (98%), tanto para o estudo com Doppler quanto para avaliação da área do AAE. Observamos uma associação positiva e significativa entre o ETTsh e o ETE, tanto para a avaliação das velocidades máximas de esvaziamento do AAE (r=0,63; p<0,001) quanto para a área longitudinal máxima do AAE (r=0,73; p<0,001). Ademais, todos os pacientes com trombos no AAE ou contraste espontâneo (n=7) tiveram velocidade de esvaziamento inferior a 50 cm/s no mapeamento transtorácico (valor preditivo negativo de 100%). Na análise multivariada ajustada para diversos potenciais preditores transtorácicos de risco, a velocidade máxima de esvaziamento do AAE permaneceu independentemente associada com trombos no AAE ou contraste espontâneo. Conclusão: ETTsh pode fornecer informações relevantes a respeito da morfologia e dinâmica do AAE. Em particular, pacientes com velocidades altas de esvaziamento do AAE podem não necessitar de avaliação adicional com ETE.

Peptídeo natriurético tipo-B como ferramento no manejo de insuficiência cardíaca e fibrilação atrial persistente

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Cerebral ischemia as initial neurological manifestation of atrial myxoma: case report

Infartos cerebrais de etiologia cardíaca são observados em cerca de 20% dos pacientes com acidente vascular cerebral isquêmico. Infarto cerebral ocorre como manifestação clínica inicial em um terço dos casos de mixoma atrial. Embora quase metade dos pacientes com mixoma atrial apresente alteração ao exame neurológico, infarto cerebral não hemorrágico é visto na tomografia computadorizada em praticamente todos os casos. Os autores apresentam o caso de uma paciente, cuja primeira manifestação clínica do mixoma atrial foi um acidente vascular cerebral isquêmico e chamam a atenção para a possibilidade de infarto cerebral silencioso em pacientes portadores de mixoma atrial.