Atrial natriuretic factor and catecholamine levels during exercise in patients with and without coronary artery disease.

To investigate the effects of exercise-induced ischemia on the release of atrial natriuretic factor (ANF), we measured peripheral plasma ANF, epinephrine and norepinephrine in 18 male patients with and without coronary artery disease. The patients underwent tomographic thallium treadmill stress tests. After exercise, patients with coronary artery disease showed higher increments of plasma ANF than patients without coronary disease, but the increase of ANF was not related to exercise-induced ischemia, nor to changes in catecholamines, heart rate, or blood pressure. This suggests that ANF release is not associated with myocardial ischemia per se, but to other factors which are more pronounced in the presence of coronary disease, such as changes in intracardiac pressures associated with exercise. Further studies are needed to clarify the role of myocardial ischemia on ANF release.