Cardiac diastolic abnormalities and atrial natriuretic factor in essential hypertension

Cardiac function and plasma levels of atrial natriuretic factor(ANF) were studied in a group of 38 patients with untreatedessential hypertension and in a group of 31 well matched normotensivecontrols. ANF was slightly but significantly higher in hypertensivesand was directly correlated with mean arterial pressure andinversely with plasma renin activity (PRA). Hypertensives showednormal systolic function and higher cardiac mass compared tocontrols. ANF was inversely correlated to echocardiographicindexes of left ventricular performance in the former group.At Doppler echocardiographic evaluation, hypertensives showedan impairment in diastolic function which was correlated tothe increase in ANF levels. Stepwise multiple regression analysisperformed with ANF as the dependent variable and several biohumoraland echocardiographic parameters as the independent variablesshowed that only cardiac diastolic function and PRA significantlyaffect ANF levels in hypertensives. In conclusion, an impairmentin cardiac diastolic function may be responsible together withother factors for the increased ANF levels encountered in essentialhypertension.