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一种新型合成血管活性和利钠肽——树眼镜蛇利钠肽在实验性严重充血性心力衰竭中的治疗作用

Therapeutic actions of a new synthetic vasoactive and natriuretic peptide, dendroaspis natriuretic peptide, in experimental severe congestive heart failure.

作者信息

Lisy O, Lainchbury J G, Leskinen H, Burnett J C

机构信息

Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Departments of Physiology and Internal Medicine, Mayo Clinic and Foundation, Rochester, MN 55905, USA.

出版信息

Hypertension. 2001 Apr;37(4):1089-94. doi: 10.1161/01.hyp.37.4.1089.

Abstract

Dendroaspis natriuretic peptide (DNP), a recently discovered peptide, shares structural similarity to the other known natriuretic peptides, ANP, BNP, and CNP. Studies have reported that DNP is present in human and canine plasma and atrial myocardium and increased in plasma of humans with congestive heart failure (CHF). In addition, synthetic DNP is markedly natriuretic and diuretic and is a potent activator of cGMP in normal animals. To date, the ability of synthetic DNP to improve cardiorenal function in experimental CHF is unknown. Synthetic DNP was administered intravenously at 10 and 50 ng. kg(-1). min(-1) in dogs (n=7) with severe CHF induced by rapid ventricular pacing for 10 days at 245 bpm. In addition, we determined endogenous DNP in normal (n=4) and failing (n=4) canine atrial and ventricular myocardium. We report that administration of synthetic DNP in experimental severe CHF has beneficial cardiovascular, renal, and humoral properties. First, DNP in CHF decreased cardiac filling pressures, specifically right atrial pressure and pulmonary capillary wedge pressure. Second, DNP increased glomerular filtration rate in association with natriuresis and diuresis despite a reduction in mean arterial pressure. Third, DNP increased plasma and urinary cGMP and suppressed plasma renin activity. Fourth and finally, we report that DNP immunoreactivity is present in canine atrial and ventricular myocardium and increased in CHF. These studies report the acute intravenous actions of synthetic DNP in experimental severe CHF and suggest that on the basis of its beneficial properties, DNP may have potential as a new intravenous agent for the treatment of decompensated CHF.

摘要

树眼镜蛇利钠肽(DNP)是最近发现的一种肽,与其他已知的利钠肽,即心房钠尿肽(ANP)、脑钠肽(BNP)和C型钠尿肽(CNP)在结构上相似。研究报告称,DNP存在于人和犬的血浆及心房心肌中,在充血性心力衰竭(CHF)患者的血浆中含量升高。此外,合成的DNP具有显著的利钠和利尿作用,并且在正常动物中是一种强效的环磷酸鸟苷(cGMP)激活剂。迄今为止,合成DNP改善实验性CHF的心肾功能的能力尚不清楚。在通过以245次/分钟的频率快速心室起搏10天诱导出严重CHF的犬(n = 7)中,以10和50 ng·kg⁻¹·min⁻¹的剂量静脉注射合成DNP。此外,我们测定了正常(n = 4)和衰竭(n = 4)犬心房和心室心肌中的内源性DNP。我们报告称,在实验性严重CHF中给予合成DNP具有有益的心血管、肾脏和体液特性。首先,CHF中的DNP降低了心脏充盈压,特别是右心房压力和肺毛细血管楔压。其次,尽管平均动脉压降低,但DNP与利钠和利尿相关联地增加了肾小球滤过率。第三,DNP增加了血浆和尿液中的cGMP,并抑制了血浆肾素活性。第四也是最后一点,我们报告称DNP免疫反应性存在于犬心房和心室心肌中,并且在CHF中增加。这些研究报告了合成DNP在实验性严重CHF中的急性静脉作用,并表明基于其有益特性,DNP可能具有作为治疗失代偿性CHF的新型静脉药物的潜力。

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