Exercise and posture-related changes of atrial natriuretic factor and cardiac function in diabetes

Exercise and posture-related changes of atrial natriuretic factor and cardiac function in diabetes. J E Donckier , P M De Coster , M Buysschaert , D P Pieters , F M Cauwe , A Robert , C M Brichant , A C Berbinschi and J M Ketelslegers Division of Endocrinology, University of Louvain, Belgium. Abstra...

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Published in:	Diabetes care Vol. 12; no. 7; pp. 475 - 480
Main Authors:	Donckier, J E, De Coster, P M, Buysschaert, M, Pieters, D P, Cauwe, F M, Robert, A, Brichant, C M, Berbinschi, A C, Ketelslegers, J M
Format:	Journal Article
Language:	English
Published:	United States American Diabetes Association 01-07-1989
Subjects:	Adult Atrial Natriuretic Factor - blood Blood Pressure Diabetes Mellitus - physiopathology Diabetes Mellitus, Type 1 - physiopathology Diabetes Mellitus, Type 2 - physiopathology Diabetic Neuropathies - physiopathology Female Heart - physiopathology Heart Conduction System - physiopathology Heart Rate Humans Male Physical Exertion Posture Reference Values Valsalva Maneuver
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Summary:	Exercise and posture-related changes of atrial natriuretic factor and cardiac function in diabetes. J E Donckier , P M De Coster , M Buysschaert , D P Pieters , F M Cauwe , A Robert , C M Brichant , A C Berbinschi and J M Ketelslegers Division of Endocrinology, University of Louvain, Belgium. Abstract To study whether the release of atrial natriuretic factor (ANF) was altered in diabetic cardiac autonomic neuropathy (CAN), we determined plasma ANF concentrations during exercise and changes of posture in three groups of age- and sex-matched subjects (9 healthy subjects, 7 diabetic patients with CAN, and 7 diabetic patients without CAN). During exercise, plasma ANF concentrations rose threefold (P less than .001), and this increase was similar in the three groups. However, heart-rate response to exercise was impaired in the two groups of diabetic patients (P less than .004 vs. healthy subjects) but was more severely impaired in patients with CAN (P less than .03 vs. patients without CAN). In healthy subjects and patients without CAN, the increases of ANF during exercise correlated significantly with those of heart rate, systolic blood pressure, and rate-pressure product (P less than .01). In patients with CAN, the correlation was found exclusively with heart rate (P less than .01). An increase of ventricular ejection fraction occurred in all groups (P less than .001) but without showing statistical differences between groups. After 30 min of standing, a similar postural drop of plasma ANF concentrations (P less than .002) was observed in all subjects, reflecting preserved sympathetic control of vessels. In conclusion, exercise induces an increase of plasma ANF in diabetic patients with CAN. This increase, occurring similarly to healthy subjects, indicates that autonomic activation plays a minor role in ANF release during exercise. Impaired heart-rate response to exercise in patients without CAN suggests early damage of autonomic function, undetected by conventional rest tests.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0149-5992 1935-5548
DOI:	10.2337/diacare.12.7.475