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Influence of β-Blockade on Ejection Fraction, ANP, and cGMP in Patients After Myocardial Infarction

Susanne Hauptlorenz, MD; Bernd Puschendorf, MD; Franz Dienstl, MD
JAMA. 1989;262(21):2996-2997. doi:10.1001/jama.1989.03430210034016.
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To the Editor. —  Atrial natriuretic peptide (ANP) is a peptide concerned with the homeostasis of blood volume produced by cardiomyocytes. Atrial stretch, for example in arrhythmias1 and congestive heart failure,2 leads to a release of ANP into the plasma followed by an intracellular and intravascular increase of cyclic 3′,5′—guanosine monophosphate (cGMP), its second messenger.3 The question arises whether ANP and cGMP are useful tools to quantify slight congestive heart failure or to control medical therapy. We therefore investigated the ejection fraction and ergometric workload and compared these with the biochemical markers ANP and cGMP. In addition, we studied the influence of β-blockade on these factors.

Study.—  Nine patients who had a myocardial infarction 6 to 8 months previously gave informed consent and entered the study. All patients went through two cycles of 2 weeks' length. The first was a control period, in which all medication except

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