Klinge R, Jørgensen B, Thaulow E, Sirnes P A, Hall C
Institute for Surgical Research, National Hospital, University of Oslo, Norway.
Int J Cardiol. 1999 Jan;68(1):1-8. doi: 10.1016/s0167-5273(98)00342-8.
We investigated whether levels of N-terminal proatrial natriuretic peptide (N-terminal proANP) reflect the severity of coronary artery disease in chronic, stable angina pectoris. Furthermore, we investigated if revascularization by percutaneous transluminal coronary angioplasty (PTCA) affected the N-terminal proANP level and, finally, whether restenosis could be predicted by changes in N-terminal proANP after PTCA.
N-terminal proANP was measured in 286 patients before and after PTCA. The patients' baseline level of N-terminal proANP (787+/-403 pmol/l) correlated significantly with left ventricular end diastolic pressure, age and serum creatinine, but not with the number of stenotic vessels. Twenty-four hours post-PTCA N-terminal proANP decreased significantly, and completely revascularized patients demonstrated a decline two-fold larger than those incompletely revascularized (deltaN-terminal proANP -114+/-178 vs. -53+/-231 pmol/l, P<0.05). After 14 days N-terminal proANP had returned to baseline in both groups. Changes in N-terminal proANP from post-PTCA to the final follow-up was not predictive of angiographic restenosis.
The significant decrease in N-terminal proANP observed after angioplasty, most pronounced in patients completely revascularized, is thought to reflect a transient improvement in resting left ventricular function.
我们研究了N末端前心钠素（N-terminal proANP）水平是否反映慢性稳定型心绞痛患者冠状动脉疾病的严重程度。此外，我们研究了经皮冠状动脉腔内血管成形术（PTCA）进行血运重建是否会影响N末端前心钠素水平，最后，PTCA术后N末端前心钠素的变化是否可预测再狭窄。
对286例患者在PTCA术前和术后测量N末端前心钠素。患者的N末端前心钠素基线水平（787±403 pmol/l）与左心室舒张末期压力、年龄和血清肌酐显著相关，但与狭窄血管数量无关。PTCA术后24小时，N末端前心钠素显著下降，完全血运重建的患者下降幅度比未完全血运重建的患者大两倍（N末端前心钠素变化值 -114±178 vs. -53±231 pmol/l，P<0.05）。14天后，两组患者的N末端前心钠素均恢复至基线水平。从PTCA术后到最终随访期间N末端前心钠素的变化不能预测血管造影再狭窄。
血管成形术后观察到的N末端前心钠素显著下降，在完全血运重建的患者中最为明显，被认为反映了静息左心室功能的短暂改善。
