The plasma atrial natriuretic peptide response to treatment of acute cardiac failure, spontaneous supraventricular tachycardia and induced re-entrant tachycardia in man.

Patients with acute congestive cardiac failure had elevated plasma concentrations of atrial natriuretic peptide (ANP) which fell towards normal levels with successful diuretic therapy. The plasma ANP concentration was closely correlated with the clinical condition of the patients as assessed by serial clinical measurement of the jugular venous pressure and body weight. Plasma ANP concentrations were also raised in patients with a spontaneous acute onset of supraventricular tachycardia but to a lesser extent in patients with chronic tachycardia. Again, successful treatment with d.c. cardioversion returned plasma ANP concentrations towards normal. Induction of atrioventricular re-entrant tachycardia produced an acute and marked rise in plasma ANP concentrations, which rapidly returned to normal when the sinus rhythm was restored. This acute ANP rise probably mediates the known acute natriuretic effect of paroxysmal tachycardia. All the data are consistent with the hypothesis that atrial distension, whatever the cause, releases ANP into plasma.