Qi W, Kjekshus H, Klinge R, Kjekshus J K, Hall C
Institute for Surgical Research and Department of Cardiology, The National Hospital, The University of Oslo, Norway.
Acta Physiol Scand. 2000 Jun;169(2):95-102. doi: 10.1046/j.1365-201x.2000.00724.x.
Changes in atrial natriuretic peptide (ANP), N-terminal proatrial natriuretic peptide and brain natriuretic peptide (BNP) were evaluated in relation to continuously monitored atrial pressures in a pacing model of heart failure. Pigs were subjected to rapid atrial pacing (225 beats min-1) for 3 weeks with adjustments of pacing frequencies if the pigs showed overt signs of cardiac decompensation. Atrial pressures were monitored by a telemetry system with the animals unsedated and freely moving. Left atrial pressure responded stronger and more rapidly to the initiation of pacing and to alterations in the rate of pacing than right atrial pressure. Plasma natriuretic peptide levels were measured by radioimmunoassay and all increased during pacing with BNP exhibiting the largest relative increase (2.9-fold increase relative to sham pigs). Multiple regression analysis with dummy variables was used to evaluate the relative changes in natriuretic peptides and atrial pressures and the strongest correlation was found between BNP and left atrial pressure with R 2=0.81. Termination of pacing resulted in rapid normalization of ANP values in spite of persistent elevations in atrial pressures. This may reflect an increased metabolism or an attenuated secretory response of ANP to atrial stretch with established heart failure. In conclusion, 3 weeks of rapid pacing induced significant increases in atrial pressures and natriuretic peptide levels. All the natriuretic peptides correlated with atrial pressures with BNP appearing as a more sensitive marker of cardiac filling pressures than ANP and N-terminal proatrial natriuretic peptide.
在心力衰竭的起搏模型中，结合连续监测的心房压力，评估了心房利钠肽（ANP）、N末端前心房利钠肽和脑利钠肽（BNP）的变化。对猪进行快速心房起搏（每分钟225次），持续3周，如果猪出现明显的心功能不全迹象，则调整起搏频率。通过遥测系统监测心房压力，动物未使用镇静剂且可自由活动。与右心房压力相比，左心房压力对起搏开始和起搏频率变化的反应更强、更快。通过放射免疫分析法测定血浆利钠肽水平，起搏期间所有水平均升高，其中BNP的相对升高幅度最大（相对于假手术猪增加了2.9倍）。使用虚拟变量进行多元回归分析，以评估利钠肽和心房压力的相对变化，发现BNP与左心房压力之间的相关性最强，R² = 0.81。尽管心房压力持续升高，但起搏终止后ANP值迅速恢复正常。这可能反映了在已发生心力衰竭的情况下，ANP对心房牵张的代谢增加或分泌反应减弱。总之，3周的快速起搏导致心房压力和利钠肽水平显著升高。所有利钠肽均与心房压力相关，与ANP和N末端前心房利钠肽相比，BNP似乎是心脏充盈压力更敏感的标志物。
