ABSTRACT
This chapter reviews the known actions of atrial natriuretic factor, and then discuss the potential role of this peptide in the cardiovascular and renal derangements that occur in chronic liver disease. Although the precise details concerning the mechanism of action of ANF at a cellular level are not known, cyclic GMP is considered to be a potential intracellular, second messenger. The discovery of ANF has led naturally to an investigation into its possible contribution to the salt and water retention in cirrhosis. Studies from our own institution, which have been performed under strict metabolic conditions, have clearly demonstrated that ANF levels in cirrhotics with and without documented sodium retention are elevated, compared to normal volunteers consuming the same sodium diet. With the present controversy in plasma ANF levels in cirrhosis, any corroborative evidence is welcome. Original experiments with crude atrial extracts from rats and human atrial tissue demonstrated relaxation of preconstricted rabbit aorta and chick rectal smooth muscle preparations.
