Secretion and clinical significance of atrial natriuretic peptide in patients with muscular dystrophy
H. Kawai, K. Adachi, C. Kimura, T. Nishiuchi, Y. Yamasaki, Y. Tsutsui and S. Saito
First Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
The plasma concentration of atrial natriuretic peptide was measured in
patients with muscular dystrophies to study its relationship with
congestive heart failure. In patients with Duchenne muscular dystrophy, the
plasma atrial natriuretic peptide concentration was 35.5 +/- 3.3 pg/mL
(mean +/- SE), which was higher than that in age-matched normal subjects
(9.8 +/- 0.6 pg/mL). It increased with progression of disability and showed
significant correlations with the cardiothoracic ratio and the ratio of the
preejection period to the left ventricular ejection time. In patients with
other types of muscular dystrophy, the plasma atrial natriuretic peptide
concentration showed no significant change. Immunohistochemical examination
demonstrated many atrial natriuretic peptide-positive cells in atrial
muscle of an autopsied patient, indicating preservation of the peptide
until the end stage. These findings suggest that measurement of the plasma
atrial natriuretic peptide concentration is useful for evaluating heart
failure in patients with Duchenne muscular dystrophy.
