Akaike M, Ishikura F, Nagata S, Kimura K, Miyatake K
Department of Medicine, National Cardiovascular Center, Osaka, Japan.
Am Heart J. 1992 Apr;123(4 Pt 1):984-9. doi: 10.1016/0002-8703(92)90707-3.
To evaluate direct secretion from the left atrium and pulmonary extraction of human atrial natriuretic peptide (hANP), we measured plasma hANP levels in the pulmonary artery, pulmonary vein, and left atrium in patients with either mitral stenosis or atrial septal defect. Left atrial pressure in patients with mitral stenosis was significantly higher than that in patients with atrial septal defect (7.5 +/- 1.0 mm Hg vs 3.1 +/- 0.5 mm Hg, p less than 0.01). The significant increase in the hANP level in the left atrium was recognized only in patients with mitral stenosis (149 +/- 33 pg/ml in the left atrium vs 130 +/- 28 pg/ml in the pulmonary vein, p less than 0.05). The plasma hANP level in the pulmonary vein was significantly lower than that in the pulmonary artery in both patients with mitral stenosis and those with atrial septal defect, which suggests that hANP is extracted in the lung. We conclude that hANP is secreted not only through the coronary sinus but also directly from the left atrium, stimulated by high left atrial pressure, and that circulating hANP is partially extracted in the pulmonary circulation.
为评估人心房利钠肽（hANP）的左心房直接分泌及肺摄取情况，我们测量了二尖瓣狭窄或房间隔缺损患者肺动脉、肺静脉及左心房中的血浆hANP水平。二尖瓣狭窄患者的左心房压力显著高于房间隔缺损患者（7.5±1.0 mmHg对3.1±0.5 mmHg，p<0.01）。仅在二尖瓣狭窄患者中发现左心房hANP水平显著升高（左心房为149±33 pg/ml，肺静脉为130±28 pg/ml，p<0.05）。二尖瓣狭窄患者和房间隔缺损患者的肺静脉血浆hANP水平均显著低于肺动脉，这表明hANP在肺中被摄取。我们得出结论，hANP不仅通过冠状窦分泌，还在高左心房压力刺激下直接从左心房分泌，并且循环中的hANP在肺循环中被部分摄取。
