心房压力在分泌心钠素中的作用。

The role of atrial pressure in secreting atrial natriuretic polypeptides.

作者信息

Matsubara H, Nishikawa M, Umeda Y, Taniguchi T, Iwasaka T, Kurimoto T, Yamane Y, Inada M

出版信息

Am Heart J. 1987 Jun;113(6):1457-63. doi: 10.1016/0002-8703(87)90662-4.

Abstract

The role of atrial pressure and catecholamines in secreting human atrial natriuretic polypeptides (hANP) were investigated in patients with acute or old myocardial infarction (AMI or OMI). No differences were observed in hANP levels obtained from brachial vein, right atrium, pulmonary artery and femoral artery, suggesting that hANP degradation in the pulmonary circulation has little clinical significance in hANP measurement. Plasma hANP levels in 10 patients with AMI were higher than those in controls and significantly correlated to both mean right atrial pressure (mRA) and pulmonary wedge pressure (PCW) (r = 0.76, p less than 0.05; r = 0.95; p less than 0.01, respectively). In 12 patients with OMI, plasma hANP levels were normal at rest and were significantly increased (p less than 0.01) with bicycle ergometer exercise associated with significant elevations of plasma catecholamine levels, mRA, and PCW. However, the increments of hANP correlated only to those of PCW. These results suggest that the elevation of atrial (principally left atrial) pressure rather than catecholamine stimulates hANP secretion.

摘要

研究了急性或陈旧性心肌梗死（AMI或OMI）患者中，心房压力和儿茶酚胺在分泌人心房利钠多肽（hANP）中的作用。从肱静脉、右心房、肺动脉和股动脉获取的hANP水平未观察到差异，这表明肺循环中hANP的降解在hANP测量中临床意义不大。10例AMI患者的血浆hANP水平高于对照组，且与平均右心房压力（mRA）和肺楔压（PCW）均显著相关（r = 0.76，p < 0.05；r = 0.95；p < 0.01）。在12例OMI患者中，静息时血浆hANP水平正常，在进行自行车测力计运动时显著升高（p < 0.01），同时血浆儿茶酚胺水平、mRA和PCW也显著升高。然而，hANP的增量仅与PCW的增量相关。这些结果表明，心房（主要是左心房）压力升高而非儿茶酚胺刺激hANP分泌。