Vogelsang Thomas Wiis, Marving Jens, Crandall Craig G, Wilson Chad, Yoshiga Chie C, Secher Niels H, Hesse Birger, Kjær Andreas
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Denmark ; Cluster for Molecular Imaging, University of Copenhagen, Denmark.
Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Denmark.
Open Neuroendocrinol J. 2012;5:1-4. doi: 10.2174/1876528901205010001. Epub 2012 Jan 23.
Hyperthermia induces vasodilatation that reduces central blood volume (CBV), central venous pressure (CVP) and mean arterial pressure (MAP). Inhibition of atrial natriuretic peptide (ANP) could be a relevant homeostatic defense mechanism during hyperthermia with a decrease in CBV. The present study evaluated how changes in plasma ANP reflect the changes in CBV during hyperthermia.
Ten healthy subjects provided with a water perfused body suit increased body core temperature 1 °C. In situ labeled autologous red blood cells were used to measure the CBV with a gamma camera. Regions of interest were traced manually on the images of the whole body blood pool scans. Two measures of CBV were used: Heart/whole body ratio and thorax/whole body ratio. CVP and MAP were recorded. Arterial (ANP) and venous plasma ANP were determined by radioimmunoassay.
The ratio thorax/whole body and heart/whole body decreased 7 % and 11 %, respectively (p<0.001). MAP and CVP decreased during hyperthermia by 6.8 and 5.0 mmHg, respectively (p<0.05; p<0.001). Changes in both thorax/whole body (R=0.80; p<0.01) and heart/whole body ratios (R=0.78; p<0.01) were correlated with changes in ANP. However, there was no correlation between venous ANP and changes in CBV, nor between ANP and MAP or CVP.
Arterial but not venous plasma concentration of ANP, is correlated to changes in CBV, but not to pressures. We suggest that plasma ANP may be used as a surrogate marker of acute CBV changes.
热疗可引起血管扩张,从而降低中心血容量(CBV)、中心静脉压(CVP)和平均动脉压(MAP)。心房利钠肽(ANP)的抑制可能是热疗期间CBV降低时一种相关的稳态防御机制。本研究评估了热疗期间血浆ANP的变化如何反映CBV的变化。
10名健康受试者穿着水灌注的紧身衣,使体核温度升高1℃。使用原位标记的自体红细胞通过γ相机测量CBV。在全身血池扫描图像上手动描绘感兴趣区域。使用两种CBV测量方法:心脏/全身比率和胸部/全身比率。记录CVP和MAP。通过放射免疫测定法测定动脉(ANP)和静脉血浆ANP。
胸部/全身比率和心脏/全身比率分别下降了7%和11%(p<0.001)。热疗期间MAP和CVP分别下降了6.8和5.0 mmHg(p<0.05;p<0.001)。胸部/全身比率(R=0.80;p<0.01)和心脏/全身比率(R=0.78;p<0.01)的变化均与ANP的变化相关。然而,静脉ANP与CBV的变化之间没有相关性,ANP与MAP或CVP之间也没有相关性。
ANP的动脉血浆浓度而非静脉血浆浓度与CBV的变化相关,但与压力无关。我们建议血浆ANP可作为急性CBV变化的替代标志物。