Edwards B S, Ackermann D M, Lee M E, Reeder G S, Wold L E, Burnett J C
Department of Internal Medicine, Mayo Medical School, Rochester, Minnesota 55905.
J Clin Invest. 1988 Jan;81(1):82-6. doi: 10.1172/JCI113314.
In normal mammals, atrial natriuretic factor (ANF) is present within atrial myocardial cells but is absent from ventricular myocardium. In primitive organisms ANF is present within both atria and ventricle, suggesting that the ventricle may participate both in the synthesis and release of the hormone. The current study was designed to test the hypothesis that ventricular ANF develops as a homeostatic response to intravascular volume overload. Studies were performed on cardiac tissue obtained from (i) normal and cardiomyopathic hamsters, (ii) autopsied humans with and without cardiac disease, and (iii) living humans with congestive heart failure (CHF) undergoing diagnostic right ventricular endomyocardial biopsy. The myocardium was examined for the presence of immunoreactive ANF using a two-stage immunohistochemical technique, with nonimmune rabbit sera used as a negative control. There was unequivocal evidence of focal subendocardial deposits of immunoreactive ANF present in both of the ventricles of all six cardiomyopathic hamsters, four of five autopsied human subjects with CHF, and five of seven biopsied humans. No immunoreactive ANF was observed within the ventricular myocardium of control hamsters or normal humans. Utilizing crude tissue homogenates and radioimmunoassay techniques, the quantity of ANF was determined in cardiac atria, ventricles, and noncardiac skeletal muscle. Heart failure is characterized by a reduction in atrial ANF and an increase in ventricular ANF. This study demonstrates immunoreactive ANF is present within the ventricular myocardium in cardiomyopathic hamsters and humans with CHF, and suggests that the ventricle may be capable of responding to chronic volume overload by producing ANF.
在正常哺乳动物中,心房利钠因子(ANF)存在于心房心肌细胞内,但心室心肌中不存在。在原始生物中,心房和心室中都存在ANF,这表明心室可能参与该激素的合成与释放。本研究旨在验证心室ANF作为对血管内容量过载的一种稳态反应而产生这一假说。研究对象为取自以下来源的心脏组织:(i)正常和患心肌病的仓鼠,(ii)有无心脏病的尸检人类,以及(iii)患有充血性心力衰竭(CHF)且正在接受诊断性右心室心内膜活检的活体人类。采用两阶段免疫组织化学技术检查心肌中免疫反应性ANF的存在情况,以非免疫兔血清作为阴性对照。有明确证据表明,所有六只患心肌病的仓鼠的两个心室、五名尸检的CHF人类受试者中的四名以及七名活检人类中的五名,其心室均存在局灶性心内膜下免疫反应性ANF沉积物。在对照仓鼠或正常人类的心室心肌中未观察到免疫反应性ANF。利用粗制组织匀浆和放射免疫测定技术,测定了心脏心房、心室和非心脏骨骼肌中ANF的含量。心力衰竭的特征是心房ANF减少,心室ANF增加。本研究表明,在患心肌病的仓鼠和患CHF的人类的心室心肌中存在免疫反应性ANF,并提示心室可能能够通过产生ANF来应对慢性容量过载。