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In both CHF and CON, L-NMMA induced an immediate and significant increase in MAP (CON-LNMMA:?+12 �� 2% [P?= .01]; CHF-LNMMA:?+11 �� 1% [P PDGFRB A short-lived (10�C20 min) significant reduction in heart rate was also observed in both groups (CON-LNMMA: ?10 �� 1% [P?= .002]; CHF-LNMA: ?9 �� 3% [P?= .02]). Fig.?1.? Mean arterial pressure (MAP) and heart rate (HR) after NG-monomethyl-L-arginine (L-NMMA) treatment in congestive heart failure patients (CHF; squares) and healthy control subjects (CON; circles). For clarity the response to placebo is shown in dash-dotted (CHF-Placebo) and dotted (CON-Placebo) lines. Absolute values of RPF, GFR, and RVR are presented in Table?3 and relative changes in these variables in Figure?2. Baseline values were characterized by reduced GFR and RPF in CHF-LNMMA and CHF-Placebo and increased RVR. No significant change in GFR was observed after L-NMMA. However, RPF decreased significantly in CHF and CON after L-NMMA, most clearly 30 minutes after injection (CON-LNMMA: ?13 �� 5% [P?= .014]; CHF-LNMMA: ?17 �� 6% [P?= .017]). RVR increased profoundly after L-NMMA (CON-LNMMA:?+26 �� 7% [P?= buy CT99021 .009]; CHF-LNMMA:?+37 �� 10% [P?= .005]). There was no significant difference in the relative effects of L-NMMA on RPF and RVR. Table?3. Glomerular Filtration Rate (GFR), Renal Plasma Flow (RPF), and Renal Vascular Resistance (RVR) in 12 CHF and 10 CON Treated With L-NMMA (CHF-LNMMA, CON-LNMMA) and in 10 CHF and 10 CON Treated With Placebo (CHF-Placebo, CON-Placebo) Basal UNa��V was significantly reduced in CHF-LNMMA. FENa and FELi were similar at baseline in all groups (Table 4). Table?4. Absolute Sodium Excretion (UNa��V), Fractional Sodium Excretion (FENa), and Fractional Lithium Excretion (FELi) in 12 CHF and 10 CON Treated With L-NMMA (CHF-LNMMA, CON-LNMMA) and in 10 CHF and 10 CON Treated With Placebo selleck products (CHF-Placebo, CON-Placebo) After L-NMMA there were significant decreases in UNa��V (CON-LNMMA: ?21 �� 8% [P?= .011]; CHF-LNMMA: ?31 �� 7% [P?= .009]), FENa (CON-LNMMA: ?17 �� 6% [P?= .01]; CHF-LNMMA: ?27 �� 5% [P?= .001]), and FELi (CON-LNMMA: ?8 �� 2% [P?= .017]; CHF-LNMMA: ?20 �� 6% [P?= .009]). These changes occurred mainly 30 minutes after L-NMMA and to a lesser extent after 60 minutes ( Table 4). There were no significant differences regarding the relative magnitude of these changes ( Fig.?2). The values of UNa��V, FENa, and FELi remained stable in CHF-Placebo and CON-Placebo. Owing to sampling problems, only 11 patients in CHF-LNMMA were analyzed for vasoactive hormones. Plasma levels of the natriuretic peptides and cGMP are presented in Table?5. Baseline levels of ANP, BNP, P-cGMP, and U-cGMP were all significantly increased in CHF-LNMMA and CHF-Placebo. L-NMMA treatment was associated with a significant decrease in P-cGMP (?17 �� 3%; P?=?.007) and U-cGMP (?18 �� 2%; P?= .