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慢性胸段下腔静脉缩窄期间的血浆心钠素

Plasma atrial natriuretic factor during chronic thoracic inferior vena caval constriction.

作者信息

Paganelli W C, Cant J R, Pintal R R, Kifor I, Barger A C, Dzau V J

机构信息

Department of Physiology, Harvard Medical School, Boston, MA 02115.

出版信息

Circ Res. 1988 Feb;62(2):279-85. doi: 10.1161/01.res.62.2.279.

Abstract

The effects of chronic constriction of the thoracic inferior vena cava (TIVCC) on plasma atrial natriuretic factor (pANF) were studied in conscious dogs (n = 5). TIVCC decreased left and right atrial pressure and led to a decrease in pANF concentration from 199 +/- 12 to 104 +/- 14 pg/ml while plasma renin and vasopressin concentrations increased. These hormonal changes were associated with a significant fall in sodium excretion to less than 5 meg/day. pANF remained suppressed during chronic TIVCC as the dogs expanded their extracellular fluid volume and developed ascites. Acute release of TIVCC resulted in abrupt increases in left and right atrial pressure but only a modest rise in pANF from 96 +/- 16 to 185 +/- 45 pg/ml. The magnitude of the rise in pANF (twofold) contrasted sharply with the eightfold increase in sodium excretion that occurred over the first 24 hours. Our data suggest that decrease in atrial pressure below normal results in a decline in pANF, which, acting in concert with the activated renin-angiotensin system and vasopressin, may contribute to sodium retention. On the other hand, during acute release of TIVCC, which markedly increased atrial pressure and sodium excretion, pANF only returned to control levels. These data suggest that ANF release may be attenuated during chronic reduction in atrial pressure and also raise a question concerning the magnitude of the primary role of ANF in this natriuretic response.

摘要

在清醒犬(n = 5)中研究了慢性缩窄胸段下腔静脉(TIVCC)对血浆心房钠尿肽(pANF)的影响。TIVCC降低了左、右心房压力,导致pANF浓度从199±12 pg/ml降至104±14 pg/ml,同时血浆肾素和血管加压素浓度升高。这些激素变化与钠排泄显著减少至低于5μg/天有关。在慢性TIVCC期间,随着犬的细胞外液量增加并出现腹水,pANF仍受到抑制。急性解除TIVCC导致左、右心房压力突然升高,但pANF仅从96±16 pg/ml适度升高至185±45 pg/ml。pANF升高的幅度(两倍)与最初24小时内钠排泄增加八倍形成鲜明对比。我们的数据表明,心房压力降至正常以下会导致pANF下降,这与激活的肾素-血管紧张素系统和血管加压素共同作用,可能导致钠潴留。另一方面,在急性解除TIVCC期间,心房压力和钠排泄显著增加,pANF仅恢复到对照水平。这些数据表明,在心房压力长期降低期间,ANF释放可能减弱,也提出了一个关于ANF在这种利钠反应中主要作用程度的问题。

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