Chenu P C, Donckier J E, Schroeder E, Berbinschi A, Ketelslegers J M, Marchandise B, Krémer R
Division of Cardiology, University of Louvain, University Hospital of Mont-Godinne, Yvoir.
Acta Cardiol. 1991;46(6):595-603.
To study the release of plasma atrial natriuretic factor (ANF) and to explain the mechanism underlying its increase during myocardial ischemia, we measured plasma ANF and mean pulmonary capillary wedge pressure (PCW) before, during and after percutaneous transluminal coronary angioplasty (PTCA) in eight patients. All patients were free of calcium channel antagonists and beta-blocking drugs. Evidence of myocardial ischemia was observed in all patients with an increase of PCW from 3.2 +/- 1.2 to 10.6 +/- 2.9 mm Hg (mean +/- SD; p less than 0.001). Heart rate and mean blood pressure did not change significantly. We observed an increase of plasma ANF during PTCA, from 53 +/- 24 to 100 +/- 37 pmol/L (mean +/- SD; p less than 0.005). There was a correlation between absolute values of ANF and PCW before and during PTCA (r = 0.64, p less than 0.01). After PTCA, ANF levels remained increased for at least twenty minutes (p less than 0.005 vs basal state) despite a decrease in PCW. Thus, increase of PCW during this very short-term left ventricular ischemic dysfunction induces an increase of plasma ANF, which persists during a certain time when PCW returns to normal.
为研究血浆心钠素（ANF）的释放情况并解释心肌缺血时其升高的机制，我们测定了8例患者经皮腔内冠状动脉成形术（PTCA）前、术中及术后的血浆ANF和平均肺毛细血管楔压（PCW）。所有患者均未使用钙通道拮抗剂和β受体阻滞剂。所有患者均出现心肌缺血证据，PCW从3.2±1.2 mmHg升高至10.6±2.9 mmHg（均值±标准差；p<0.001）。心率和平均血压无明显变化。我们观察到PTCA期间血浆ANF升高，从53±24 pmol/L升至100±37 pmol/L（均值±标准差；p<0.005）。PTCA前及术中ANF绝对值与PCW之间存在相关性（r = 0.64，p<0.01）。PTCA后，尽管PCW下降，但ANF水平至少持续升高20分钟（与基础状态相比，p<0.005）。因此，在这种非常短期的左心室缺血性功能障碍期间PCW升高会诱导血浆ANF升高，当PCW恢复正常时，ANF会在一定时间内持续升高。
