Goetze J P, Christoffersen C, Perko M, Arendrup H, Rehfeld J F, Kastrup J, Nielsen L B
Department of Clinical Biochemistry, KB 3011, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark.
FASEB J. 2003 Jun;17(9):1105-7. doi: 10.1096/fj.02-0796fje. Epub 2003 Apr 22.
Congestive heart failure is accompanied by increased cardiac brain natriuretic peptide (BNP) gene expression with elevated plasma concentrations of BNP and its precursor, proBNP. We investigated if myocardial ischemia in the absence of overt heart failure may be another mechanism for increased myocardial BNP expression. The BNP expression was examined in hypoxic myocardium of patients undergoing coronary bypass grafting surgery, in patients with coronary artery disease and normal left ventricular function undergoing percutaneous transluminal intervention therapy, and in heart failure patients without coronary artery disease. BNP mRNA was quantified by real-time PCR, and plasma BNP and proBNP concentrations were measured with radioimmunoassays. Quantitative analysis of BNP mRNA in atrial and ventricular biopsies from coronary bypass grafting patients revealed close associations of plasma BNP and proBNP concentrations to ventricular, but not atrial, BNP mRNA levels. Plasma BNP and proBNP concentrations were markedly increased in patients with coronary artery disease but without concomitant left ventricular dysfunction. These results are compatible with the notion that myocardial ischemia, even in the absence of left ventricular dysfunction, augments cardiac BNP gene expression and increases plasma BNP and proBNP concentrations. Thus, elevated BNP and proBNP concentrations do not necessarily reflect heart failure but may also result from cardiac ischemia.
充血性心力衰竭伴有心脏脑钠肽（BNP）基因表达增加，同时血浆BNP及其前体proBNP浓度升高。我们研究了在无明显心力衰竭情况下的心肌缺血是否可能是心肌BNP表达增加的另一种机制。对接受冠状动脉搭桥手术患者的缺氧心肌、接受经皮腔内介入治疗且左心室功能正常的冠心病患者以及无冠状动脉疾病的心力衰竭患者的BNP表达进行了检测。通过实时PCR对BNP mRNA进行定量，并采用放射免疫分析法测定血浆BNP和proBNP浓度。对冠状动脉搭桥患者心房和心室活检组织中BNP mRNA的定量分析显示，血浆BNP和proBNP浓度与心室BNP mRNA水平密切相关，而与心房BNP mRNA水平无关。在无左心室功能不全的冠心病患者中，血浆BNP和proBNP浓度显著升高。这些结果与以下观点一致：即使在无左心室功能不全的情况下，心肌缺血也会增强心脏BNP基因表达，并增加血浆BNP和proBNP浓度。因此，BNP和proBNP浓度升高不一定反映心力衰竭，也可能由心肌缺血导致。
