Hu K, Bahner U, Gaudron P, Palkovits M, Ring M, Fehle A, Kruse B, Ertl G
Medizinische Universitätsklinik, Universität Würzburg, Germany.
Basic Res Cardiol. 2001 May-Jun;96(3):258-66. doi: 10.1007/s003950170056.
Alterations of the central nervous system may be important for imbalance of cardiovascular and fluid regulation in heart failure. The central renin-angiotensin and atrial natriuretic peptide (ANP) systems act as mutual antagonists. The effects of angiotensin converting enzyme (ACE) inhibition (quinapril, 6 mg/kg/day) and angiotensin II type 1 (AT1) receptor blockade (losartan, 10 mg/kg/day) on ANP levels in 18 selected, microdissected brain nuclei were determined in sham-operated rats and rats with left ventricular dysfunction 8 weeks after myocardial infarction (MI). Plasma ANP tended to increase in MI rats and was further increased by quinapril. ANP was decreased in 12 brain areas of MI rats. ANP concentration was also significantly decreased by quinapril in six brain nuclei including subfornical organ and organum vasculosum laminae terminalis (areas lacking blood-brain barrier), and by losartan in 16 brain nuclei outside and within the blood-brain barrier in sham operated rats. However, both quinapril and losartan prevented a further reduction of central ANP as a result of myocardial infarction. These data suggest that there are effects on central ANP that result from chronic left ventricular dysfunction as well as an ACE-inhibitor and AT1-antagonist. Mechanisms and consequences of central ANP depression remain unclear. They could, however, support systemic vasoconstriction and sodium and fluid retention.
中枢神经系统的改变可能对心力衰竭时心血管和液体调节失衡至关重要。中枢肾素-血管紧张素系统和心房利钠肽(ANP)系统起相互拮抗作用。在假手术大鼠和心肌梗死(MI)8周后出现左心室功能障碍的大鼠中,测定了18个选定的、经显微解剖的脑核中血管紧张素转换酶(ACE)抑制(喹那普利,6毫克/千克/天)和血管紧张素II 1型(AT1)受体阻断(氯沙坦,10毫克/千克/天)对ANP水平的影响。MI大鼠血浆ANP有升高趋势,喹那普利使其进一步升高。MI大鼠的12个脑区中ANP降低。在包括穹窿下器官和终板血管器(缺乏血脑屏障的区域)在内的6个脑核中,喹那普利也显著降低了ANP浓度,在假手术大鼠的血脑屏障内外的16个脑核中,氯沙坦降低了ANP浓度。然而,喹那普利和氯沙坦都阻止了由于心肌梗死导致的中枢ANP的进一步降低。这些数据表明,慢性左心室功能障碍以及ACE抑制剂和AT1拮抗剂对中枢ANP有影响。中枢ANP降低的机制和后果尚不清楚。然而,它们可能会支持全身血管收缩以及钠和液体潴留。