Kuch-Wocial Agnieszka, Slubowska Katarzyna, Kostrubiec Maciej, Pasierski Tomasz, Januszewicz Włodzimierz, Switalska Hanna, Wocial Bozena, Pruszczyk Piotr
Department of Internal Medicine and Hypertension, The Medical University of Warsaw, Banacha 1a. 02-097 Warsaw, Poland.
Clin Chim Acta. 2004 Jul;345(1-2):43-7. doi: 10.1016/j.cccn.2004.01.027.
Left ventricular hypertrophy (LVH) in patients with arterial hypertension is closely related to the levels of blood pressure (BP), catecholamines, angiotensin II and other mitogenic peptides. Pheochromocytoma (pheo) is a type of hypertension caused by excessive production of catecholamines. The aim of this study was to determinate if left ventricular hypertrophy in patients with pheochromocytoma is related to catecholamines and neuropeptide Y (NPY).
29 patients with pheochromocytoma (22 F, age 40 +/- 13 years), plasma concentration of neuropeptide Y immunoreactivity, noradrenaline (NA), and adrenaline (A) were determined. Twenty-four hour urine collection for determination of noradrenaline and adrenaline were performed. Every patient had echocardiographic examination and 24 h ambulatory blood pressure monitoring.
Left ventricular hypertrophy was diagnosed in 14 patients. No differences in systolic and diastolic blood pressure in patients with and without left ventricular hypertrophy were found. Plasma noradrenaline and adrenaline levels did not differ between both groups, while plasma neuropeptide Y immunoreactivity was higher in patients with left ventricular hypertrophy than in patients without left ventricular hypertrophy (18.46 +/- 13.26 vs. 9.3 +/- 5.9 fmol/ml (p = 0.02)). Left ventricular mass index (LVMI) correlated with plasma neuropeptide Y-immunoreactivity (r = 0.42 p = 0.023), however, no relationship between left ventricular mass index and plasma or urine noradrenaline and adrenaline levels were found.
Our results indicate that mitogenic effect of neuropeptide Y may play a role in pathogenesis of left ventricular hypertrophy in patients with pheochromocytoma.
动脉高血压患者的左心室肥厚(LVH)与血压(BP)、儿茶酚胺、血管紧张素II和其他促有丝分裂肽的水平密切相关。嗜铬细胞瘤(pheo)是一种由儿茶酚胺过度产生引起的高血压类型。本研究的目的是确定嗜铬细胞瘤患者的左心室肥厚是否与儿茶酚胺和神经肽Y(NPY)有关。
对29例嗜铬细胞瘤患者(22例女性,年龄40±13岁),测定血浆神经肽Y免疫反应性、去甲肾上腺素(NA)和肾上腺素(A)的浓度。进行24小时尿收集以测定去甲肾上腺素和肾上腺素。每位患者均进行超声心动图检查和24小时动态血压监测。
14例患者被诊断为左心室肥厚。有和无左心室肥厚的患者在收缩压和舒张压方面未发现差异。两组间血浆去甲肾上腺素和肾上腺素水平无差异,而左心室肥厚患者的血浆神经肽Y免疫反应性高于无左心室肥厚的患者(18.46±13.26对9.3±5.9 fmol/ml(p = 0.02))。左心室质量指数(LVMI)与血浆神经肽Y免疫反应性相关(r = 0.42,p = 0.023),然而,未发现左心室质量指数与血浆或尿去甲肾上腺素和肾上腺素水平之间存在关系。
我们的结果表明,神经肽Y的促有丝分裂作用可能在嗜铬细胞瘤患者左心室肥厚的发病机制中起作用。