Portaluppi F, Montanari L, Ferlini M, Vergnani L, D'Ambrosi A, Cavallini A R, Bagni B, degli Uberti E
Chair of Internal Medicine, University of Ferrara, Italy.
Chronobiol Int. 1991;8(5):432-9. doi: 10.3109/07420529109059178.
We demonstrated in previous works that the circadian rhythms of blood pressure (BP) and atrial natriuretic peptide (ANP) are antiphasic in normal subjects and in essential hypertension. The aim of the present study was to assess the circadian rhythms of BP and ANP in 20 patients with stable congestive heart failure (CHF), divided into two groups of 10 according to their New York Heart Association functional class. A matched control group of 10 normal volunteers was also studied. Noninvasive BP monitoring at 15-min intervals was performed for 24 h. Peripheral blood samples were also obtained at 4-h intervals starting from 08:00 h. The mean (+/- SEM) circadian mesors of ANP plasma levels were 13.4 +/- 1.7 pmol/L in the control group, 28.6 +/- 2.4 pmol/L in the group of 10 patients in class II, and 81.5 +/- 12 pmol/L in the group of 10 patients in class III-IV. In normal subjects, plasma ANP concentration was highest at 04:00 h (21.5 +/- 2.7 pmol/L) and lowest at 16:00 h (8.8 +/- 2.4 pmol/L; p less than 0.01). Both groups of patients with CHF showed no significant circadian change in the plasma levels of ANP and also a significantly blunted circadian rhythm of BP. Cosinor analysis confirmed the loss of the circadian rhythms of ANP and BP in CHF patients. Our findings support the existence of a causal relationship between the circadian rhythms of ANP and BP.
我们在先前的研究中证明，在正常人和原发性高血压患者中，血压（BP）和心房利钠肽（ANP）的昼夜节律呈反相。本研究的目的是评估20例稳定型充血性心力衰竭（CHF）患者的血压和ANP昼夜节律，根据纽约心脏协会功能分级将其分为两组，每组10例。还研究了10名正常志愿者组成的匹配对照组。每隔15分钟进行一次24小时无创血压监测。从08:00开始，每隔4小时采集一次外周血样本。对照组ANP血浆水平的平均（±SEM）昼夜中值为13.4±1.7 pmol/L，II级10例患者组为28.6±2.4 pmol/L，III-IV级10例患者组为81.5±12 pmol/L。在正常受试者中，血浆ANP浓度在04:00时最高（21.5±2.7 pmol/L），在16:00时最低（8.8±2.4 pmol/L；p<0.01）。两组CHF患者的ANP血浆水平均无明显的昼夜变化，血压的昼夜节律也明显减弱。余弦分析证实CHF患者ANP和BP的昼夜节律消失。我们的研究结果支持ANP和BP昼夜节律之间存在因果关系。
