Edwards B S, Rodeheffer R J, Reeder G S, Burnett J C
Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
J Am Coll Cardiol. 1990 Dec;16(7):1589-93. doi: 10.1016/0735-1097(90)90305-9.
This study investigated the presence of atrial natriuretic factor in ventricular tissue obtained from humans with dilated or restrictive heart disease. In 17 patients with ventricular dilation and impaired systolic function and in 8 patients with restrictive heart disease and preserved systolic function, the presence of ventricular atrial natriuretic factor was investigated in tissue obtained by ventricular endomyocardial biopsy. The objective of the study was to determine if the ventricular presence of atrial natriuretic factor is dependent on ventricular dilation. Left ventricular end-diastolic volume index was greater in the group with dilated cardiomyopathy than in the group with restrictive cardiomyopathy (134 +/- 13 versus 78 +/- 5 ml/m2, p less than 0.05); end-diastolic pressure was elevated in the two groups (20 +/- 2 versus 25 +/- 4 mm Hg, p = NS). With the use of immunohistochemical techniques, ventricular atrial natriuretic factor was clearly detected in 15 of the 17 patients with dilated cardiomyopathy and in 6 of the 8 patients with restrictive cardiomyopathy. This study demonstrates the high prevalence of ventricular atrial natriuretic factor in living patients with either systolic or diastolic dysfunction. Whereas in the atria, stretch or dilation may be an important stimulus, atrial natriuretic factor in the ventricular chamber occurs independent of dilation.
本研究调查了从患有扩张型或限制性心脏病的人类获取的心室组织中是否存在心钠素。在17例心室扩张且收缩功能受损的患者以及8例收缩功能正常的限制性心脏病患者中,通过心室心内膜活检获取组织,研究心室心钠素的存在情况。该研究的目的是确定心室心钠素的存在是否依赖于心室扩张。扩张型心肌病组的左心室舒张末期容积指数高于限制性心肌病组(134±13对78±5ml/m²,p<0.05);两组的舒张末期压力均升高(20±2对25±4mmHg,p=无显著性差异)。使用免疫组化技术,在17例扩张型心肌病患者中的15例以及8例限制性心肌病患者中的6例中清楚地检测到心室心钠素。本研究表明,在有收缩或舒张功能障碍的活体患者中心室心钠素的患病率很高。虽然在心房中,牵张或扩张可能是一个重要刺激因素,但心室中的心钠素独立于扩张而产生。