Dietz R, Haass M, Kübler W
Department of Cardiology, University of Heidelberg, West Germany.
Am J Hypertens. 1989 Feb;2(2 Pt 2):29S-33S. doi: 10.1093/ajh/2.2.29s.
The atrial natriuretic factor (ANF) is a circulating peptide, consisting of 24 to 28 amino acids. Atrial natriuretic factor is synthetized in atrial cardiomyocytes and stored in specific cytoplasmatic granules. It possesses potent diuretic, natriuretic, and vasorelexant properties. The possible role of ANF in the pathogenesis of hypertension and heart failure was investigated in animal models and in men. We were able to show that the release of ANF from cardiac atria is positively correlated with atrial pressures in both men and rats. In experimental studies, plasma levels of ANF measured by radioimmunoassay, were increased by up to four-fold after acute blood volume expansion. Atrial natriuretic factor release in response to volume loading was markedly attenuated in four-week-old spontaneously hypertensive rats as compared to age-matched normotensive Wistar-Kyoto rats, but a similar responsiveness was found in 16-week-old rats of both strains. This finding can be reconciled with the hypothesis that ANF plays a pathophysiological role in initiating but not maintaining high blood pressure. Clinical studies demonstrate elevated plasma concentrations of ANF in patients with organic heart disease. Further increments in plasma levels of ANF were obtained during physical exercise and after acute volume loading. In patients with congestive cardiomyopathy, the elevated plasma concentrations of ANF reached almost normal levels following improvement of their hemodynamic disturbances after treatment with converting-enzyme inhibitors. These findings suggest that in patients with organic heart disease, plasma concentrations of ANF reflect the hemodynamic burden of the heart and may, therefore, be used as a noninvasive marker of the efficacy of the current cardiac therapy.
心房利钠因子（ANF）是一种循环肽，由24至28个氨基酸组成。心房利钠因子在心房心肌细胞中合成，并储存于特定的细胞质颗粒中。它具有强大的利尿、利钠和血管舒张特性。在动物模型和人类中研究了ANF在高血压和心力衰竭发病机制中的可能作用。我们能够证明，无论是在人类还是大鼠中，心房利钠因子从心脏心房的释放与心房压力呈正相关。在实验研究中，通过放射免疫测定法测量的ANF血浆水平在急性血容量扩张后增加了四倍。与年龄匹配的正常血压Wistar-Kyoto大鼠相比，四周龄的自发性高血压大鼠对容量负荷的心房利钠因子释放明显减弱，但在两个品系的16周龄大鼠中发现了类似的反应性。这一发现与ANF在高血压起始而非维持中起病理生理作用的假设相符。临床研究表明，患有器质性心脏病的患者血浆中ANF浓度升高。在体育锻炼期间和急性容量负荷后，血浆中ANF水平进一步升高。在充血性心肌病患者中，用转化酶抑制剂治疗改善其血液动力学紊乱后，血浆中升高的ANF浓度几乎恢复到正常水平。这些发现表明，在患有器质性心脏病的患者中，血浆中ANF浓度反映了心脏的血液动力学负担，因此可用作当前心脏治疗效果的非侵入性标志物。
