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特发性高血压患者心房利钠肽和脑利钠肽的浓度。

The concentration of atrial and brain natriuretic peptide in patients with idiopathic hypertension.

作者信息

Irzmanski Robert, Barylski Marcin, Banach Maciej, Piechota Mariusz, Kowalski Jan, Cierniewski Czesław, Pawlicki Lucjan

机构信息

Department of Internal Diseases and Cardiological Rehabilitation, University Hospital No. 5, Medical University of Łódź, Łódź, Poland.

出版信息

Med Sci Monit. 2007 Oct;13(10):CR449-56.

Abstract

BACKGROUND

The aim was to study the maintenance of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in patients with idiopathic hypertension and relationships between cardiac morphological parameters and concentrations of the peptides in patients with hypertension and left ventricular hypertrophy (LVH).

MATERIAL/METHODS: Seventy-six patients were enrolled: 21 with confirmed idiopathic hypertension (group I), 18 with idiopathic hypertension and eccentric hypertrophy (group Ia), 14 with idiopathic hypertension and concentric hypertrophy (group Ib), and 23 healthy controls (group II). All underwent echocardiographic evaluation. Posterior wall thickness (PWT), interventricular septum thickness (IVST), left ventricular mass index (LVMI), relative wall thickness index (RWT), fractional shortening (FS), midwall shortening fraction (MWS), and left atrium diameter (LAd) were studied.

RESULTS

Considerably increased ANP and BNP were observed in all patients with hypertension (group I) compared with controls (group II). Significant increases in ANP in groups Ia and Ib compared with groups I and II were found as well as considerably increased BNP in group Ib compared with groups I, Ia, and II. Significant correlations were found between ANP and BNP concentrations and PWT, IVST, LVMI, and RWT. In group Ib, correlation between ANP and BNP and MWS and LAd was found. Multiple regression analysis showed that RWT independently correlated with ANP and BNP and that BNP is more closely related to RWT than is ANP.

CONCLUSIONS

Increased ANP in patients with idiopathic hypertension may indicate the coexistence of complications with types of LVH. High concentrations of BNP may specifically suggest concentric LVH.

摘要

背景

目的是研究特发性高血压患者心房利钠肽(ANP)和脑利钠肽(BNP)的维持情况,以及高血压合并左心室肥厚(LVH)患者心脏形态学参数与肽浓度之间的关系。

材料/方法:纳入76例患者:21例确诊为特发性高血压(I组),18例特发性高血压合并离心性肥厚(Ia组),14例特发性高血压合并向心性肥厚(Ib组),23例健康对照者(II组)。所有患者均接受超声心动图评估。研究了后壁厚度(PWT)、室间隔厚度(IVST)、左心室质量指数(LVMI)、相对壁厚度指数(RWT)、缩短分数(FS)、中层壁缩短分数(MWS)和左心房直径(LAd)。

结果

与对照组(II组)相比,所有高血压患者(I组)的ANP和BNP均显著升高。与I组和II组相比,Ia组和Ib组的ANP显著升高,与I组、Ia组和II组相比,Ib组的BNP显著升高。发现ANP和BNP浓度与PWT、IVST、LVMI和RWT之间存在显著相关性。在Ib组中,发现ANP和BNP与MWS和LAd之间存在相关性。多元回归分析表明,RWT与ANP和BNP独立相关,且BNP与RWT的关系比ANP更密切。

结论

特发性高血压患者ANP升高可能表明存在LVH类型的并发症。高浓度的BNP可能特别提示向心性LVH。

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