Atrial natriuretic peptide ameliorates hypoxic pulmonary vasoconstriction without influencing systemic circulation

Hypoxic pulmonary vasoconstriction (HPV) is encountered during ascent to high altitude. Atrial natriuretic peptide (ANP) could be an option to treat HPV because of its natriuretic, diuretic, and vasodilatory properties. Data on effects of ANP on pulmonary and systemic circulation during HVP are conflicting, partly owing to anesthesia, surgical stress or uncontrolled dietary conditions. Therefore, ten conscious, chronically tracheotomized dogs were studied under standardized dietary conditions. The dogs were trained to breathe spontaneously at a ventilator circuit. Protocol: 30min of normoxia [inspiratory oxygen fraction (FiO2)=0.21] were followed by 30min of hypoxia without ANP infusion (Hypoxia I, FiO2=0.1). While maintaining hypoxia an intravenous infusion of atrial natriuretic peptide was started with 50ng·kg body wt-1·min-1 for 30min (Hypoxia+ANP1=low dose), followed by 1000ng·kg body wt-1·min-1 for 30min (Hypoxia+ANP2=high dose). Thereafter, ANP infusion was stopped and hypoxia maintained for a final 30min (Hypoxia II). Compared to normoxia, mean pulmonary arterial pressure (MPAP) (16±0.7 vs. 26±1.3mmHg) and pulmonary vascular resistance (PVR) (448±28 vs. 764±89dyn·s-1·cm-5) increased during Hypoxia I and decreased during Hypoxia+ANP 1 (MPAP 20±1mmHg, PVR 542±55dyn·s-1·cm-5) (P<0.05). The higher dose of ANP did not further decrease MPAP or PVR, but started to have a tendency to decrease mean arterial pressure and cardiac output. We conclude that low dose ANP is able to reduce HPV without affecting systemic circulation during acute hypoxia.