AJP - Heart and Circulatory Physiology, Vol 248, Issue 3 396-H402, Copyright © 1985 by American Physiological Society
Plasma vasopressin response to osmotic and hemodynamic stimuli in heart failure
B. F. Uretsky, J. G. Verbalis, T. Generalovich, A. Valdes and P. S. Reddy
Arginine vasopressin (AVP) regulation was studied in 42 patients with
severe heart failure (CHF) and 10 patients without CHF during cardiac
catheterization. Plasma AVP levels were elevated in CHF compared with
non-CHF patients (2.98 +/- 2.48 vs. 1.01 +/- 0.44 pg/ml, P less than 0.01).
In non-CHF patients, osmotic loading with angiographic contrast caused
increases in plasma osmolality (283 +/- 4 to 290 +/- 5 mosmol/l, P less
than 0.05) and AVP (1.01 +/- 0.44 to 1.79 +/- 0.20 pg/ml, P less than
0.001). In 10 CHF patients, similar osmotic loading produced an increase in
plasma osmolality (275 +/- 13 to 288 +/- 17 mosmol/l, P less than 0.05) and
an exaggerated rise in plasma AVP (3.61 +/- 3.17 to 16.30 +/- 12.17 pg/ml,
P less than 0.001). The increase in plasma AVP per unit increase in
osmolality was greater (P less than 0.01) in the CHF patients (1.36 +/-
1.25 pg . mosmol-1 . 1(-1)) than in non-CHF patients (0.18 +/- 0.17). To
determine whether improved cardiac performance would lower AVP levels, 18
CHF patients received the experimental agent MDL 17,043, with improved
cardiac index (1.9 +/- 0.4 to 3.3 +/- 0.7 1 . min-1 . m-2, P less than
0.001). Plasma AVP levels did not change significantly (1.99 +/- 0.74 to
2.81 +/- 2.06 pg/ml), but significant inverse correlations were found
between changes in plasma AVP and changes in mean (r = -0.53) and systolic
(r = -0.65) arterial pressure after MDL 17,043 infusion.(ABSTRACT TRUNCATED
AT 250 WORDS)
