Del Ry S, Maltinti M, Cabiati M, Emdin M, Giannessi D, Morales M A
CNR Institute of Clinical Physiology, Laboratory of Cardiovascular Biochemistry, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy.
Peptides. 2008 Jan;29(1):79-82. doi: 10.1016/j.peptides.2007.10.022. Epub 2007 Nov 4.
C-type natriuretic peptide (CNP) significantly increases in chronic heart failure (CHF) patients as a function of clinical severity. Aim of this study was to evaluate in CHF patients the relationship between circulating CNP concentrations and echo-Doppler conventional indices of left ventricular (LV) function as well as less load independent parameters as dP/dt. LV ejection fraction (EF), left ventricular end-diastolic dimension (LVEDD) and LV dP/dt were evaluated together with plasma CNP levels in 38 patients with CHF and in 63 controls. CNP levels resulted significantly higher in CHF patients than in controls (7.19+/-0.59 pg/ml vs. 2.52+/-0.12 pg/ml, p<0.0001). A significant correlation between dP/dt and CNP levels (r=-0.61, p<0.0001) was observed. A good correlation with EF (r=-0.55, p<0.001) and a less significant relation with LVEDD (r=0.316, p<0.05) were also reported. When patients were divided according to dP/dt values a very significant difference in CNP levels was observed: Group I (<600, n=25) vs. Group II (>600, n=13): 8.46+/-0.69 and 4.75+/-0.75 pg/ml, respectively, p<0.001. This is the first study that reports a correlation between CNP and dP/dt in CHF patients, thus suggesting a possible role on cardiac contractility.
C型利钠肽（CNP）在慢性心力衰竭（CHF）患者中会随着临床严重程度的增加而显著升高。本研究的目的是评估CHF患者循环中CNP浓度与左心室（LV）功能的超声多普勒常规指标以及诸如dP/dt等与负荷无关参数之间的关系。对38例CHF患者和63例对照者的左心室射血分数（EF）、左心室舒张末期内径（LVEDD）、LV dP/dt以及血浆CNP水平进行了评估。结果显示，CHF患者的CNP水平显著高于对照组（7.19±0.59 pg/ml对2.52±0.12 pg/ml，p<0.0001）。观察到dP/dt与CNP水平之间存在显著相关性（r=-0.61，p<0.0001）。还报告了与EF存在良好相关性（r=-0.55，p<0.001），与LVEDD的相关性较弱（r=0.316，p<0.05）。当根据dP/dt值对患者进行分组时，观察到CNP水平存在非常显著的差异：第一组（<600，n=25）与第二组（>600，n=13）：分别为8.46±0.69和4.75±0.75 pg/ml，p<0.001。这是第一项报道CHF患者中CNP与dP/dt之间存在相关性的研究，因此提示其可能对心脏收缩力有作用。
