Anand I S, Kalra G S, Ferrari R, Harris P, Poole-Wilson P A
Postgradute Institute for Medical Education and Research, Chandigarh, India.
Am Heart J. 1989 Sep;118(3):500-5. doi: 10.1016/0002-8703(89)90264-0.
We report the effects of intravenous infusion of the atrial natriuretic peptide analogue, met-ANP-26 (2 micrograms/min for 2 to 4 hours), in four patients with cardiomyopathy and severe congestive cardiac failure who had not received any previous cardiac therapy. The average cardiac index before infusion was 1.8 L/min/m2. Severe sodium and water retention was confirmed by high levels of total body water and extracellular liquid, whereas renal blood flow and glomerular filtration rate were reduced. Plasma concentration of ANP, norepinephrine, cortisol, and growth hormone were significantly increased before infusion. The infusion had no significant hemodynamic effect. After 2 hours urine volume had increased significantly from 51 to 76 ml/hr, urinary concentration of sodium from 72 to 90 mmol/L, and sodium excretion from 4.5 to 8.2 mmol/hr. The infusion was accompanied by a significant increase in plasma ir-ANP from 193 to 980 pg/ml. There were no significant effects on the plasma concentrations of norepinephrine, epinephrine, aldosterone, vasopressin, cortisol, growth hormone, or prolactin and no significant change in plasma renin activity. After 2 hours of infusion one patient had a severe sinus tachycardia and another had a sinus bradycardia. Both arrhythmias disappeared without harmful effects soon after the infusion was stopped.
我们报告了对4例未接受过任何心脏治疗的心肌病伴严重充血性心力衰竭患者静脉输注心房利钠肽类似物met-ANP-26（2微克/分钟，持续2至4小时）的效果。输注前平均心脏指数为1.8升/分钟/平方米。高水平的全身水和细胞外液证实存在严重的钠和水潴留，而肾血流量和肾小球滤过率降低。输注前，血浆心房利钠肽、去甲肾上腺素、皮质醇和生长激素浓度显著升高。输注对血流动力学无显著影响。2小时后，尿量从51毫升/小时显著增加至76毫升/小时，尿钠浓度从72毫摩尔/升增至90毫摩尔/升，钠排泄量从4.5毫摩尔/小时增至8.2毫摩尔/小时。输注伴随着血浆免疫反应性心房利钠肽从193皮克/毫升显著增加至980皮克/毫升。对去甲肾上腺素、肾上腺素、醛固酮、血管加压素、皮质醇、生长激素或催乳素的血浆浓度无显著影响，血浆肾素活性也无显著变化。输注2小时后，1例患者出现严重窦性心动过速，另1例出现窦性心动过缓。停止输注后不久，两种心律失常均消失，未产生有害影响。
