Diurnal change of plasma atrial natriuretic peptide concentrations in patients with congestive heart failure

Abstract

Diurnal change of plasma atrial natriuretic peptide (ANP) concentration was observed in 14 patients with congestive heart failure (CHF) and in eight healthy control subjects. Blood pressure, heart rate, and plasma concentration of ANP were obtained at intervals of 4 hours beginning immediately after midnight. In the CHF group, plasma ANP concentrations at the time of blood sampling were all higher than those in the control group. Patients with severe CHF had higher plasma ANP concentrations than those in patients with less severe CHF. Plasma ANP concentration in the control group was highest at 4:00 am and was lowest at 4:00 pm. The percent change of ANP secretion (%ΔANP): [(ANP at 4:00 am — ANP at 4:00 pm)/ANP at 4: pm] × 100% increased in the control group, while it decreased in the CHF group. Moreover, %ΔANP was much lower in patients with severe CHF than it was in patients with less severe CHF. There was a possible relation between the severity of CHF and the increase of ANP secretion associated with the relative diminution of nocturnal ANP secretion. Thus the present data imply that the diurnal change in ANP was lost in patients with CHF.