AFRICA CARDIOVASCULAR JOURNAL OF AFRICA • SAHS Biennial Congress 16-18 September 2022 34 Submission ID: 1374 Introduction Preclinical evidence suggests that atrial natriuretic peptide (ANP) improves endothelial function through direct effects, but clinical evidence is lacking. We assessed if ANP concentrations in a population with a striking age-related volume overload, and volume-dependent hypertension, are independently associated with endothelial function. Methods Systemic hemodynamics (echocardiography and central arterial pressure), circulating concentrations of ANP and biomarkers of endothelial function (ELISA) were determined in 601 participants from a population with marked age and renal-related increases in systemic flow. Results ANP was independently associated with stroke volume (SV) and cardiac output (CO) derived from both left ventricular outflow tract and dimension measurements (p<0.0001). Beyond blood pressure and additional confounders, ANP, but not systemic flow was independently and inversely associated with asymmetric dimethyl arginine (ADMA) (p<0.0005), but not V-CAM, I-CAM or E-selectin (p>0.24). An interaction between SV and ANP was associated with ADMA (p<0.05), with strong ANP-ADMA relationships noted in those with the highest (p<0.0005), but not the lowest (p=0.11) tertile of SV. Although ANP was independently and inversely associated with systemic vascular resistance (SVR) (p<0.001) and aortic characteristic impedance (Zc) (p<0.01), neither SVR, Zc, nor interactions between ANP and resistance were independently associated with ADMA or alternative indexes of endothelial function. Although ANP was also independently associated with adiponectin (p<0.005), but not pro-inflammatory cytokine concentrations, neither adiponectin, diabetes mellitus, nor insulin resistance (homeostasis model) explained relationships between ANP and ADMA. Conclusion At a population level, independent of metabolic or hemodynamic effects, circulating ANP is independently associated with an improved endothelial function, as indexed by ADMA. Agents that target increases in ANP concentrations in the management of volume-dependent primary hypertension, such as is frequently noted in Africa, may produce cardiovascular benefits beyond BP control. Name: Presenting Author Information Article Category Abstract Title Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. nico.malan@wits.ac.za English Abstract Population Sciences Independent Relationship between Circulating Atrial Natriuretic Peptide Concentrations and Endothelial Function in a Population with AgeRelated Systemic Volume Overload. Author Affiliation: Email: Nico Malan Authors Name & Surname Title Expertise Affiliation Email Country Nico Malan Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg nico.malan@wits.ac.za South Africa Vernice R Peterson Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg vernice.peterson@wits.ac.za South Africa Suraj M Yusuf Mr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg yusufmsuraj@kasu.edu.ng South Africa Monica Gomes Dr Cardiovascular Physiology Cardiovascular Pathophysiology and Genomics Research Unit, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg monica.gomes@wits.ac.za South Africa ORAL PRESENTATION
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