Sakamaki T, Ichikawa S, Tonooka S, Matsuo H, Sugai Y, Murata K
Endocrinol Jpn. 1977 Oct;24(5):513-8. doi: 10.1507/endocrj1954.24.513.
Study on a diurnal rhythm of plasma aldosterone (PA) and plasma renin activity (PRA) was performed in 8 patients with congestive heart failure. All patients had been digitalized and received diuretics under mild sodium restriction. An obvious diurnal rhythm of PA similar to the normal subjects, with the lowest value in the evening and the highest value in the morning, was observed in 7 of 8 cases, while a diurnal rhythm of PRA was obscure except in one case. The PA generally did not run parallel with PRA. Although the reason of the absence of PRA diurnal rhythm in congestive heart failure was not clear, it was considered that reninangiotensin system did not play a significant role for the development of PA diurnal rhythm in congestive heart failure. The determined PA values were entirely within normal range except in 2 cases, although they were administered the potent diuretics chronically. A high PA value was observed only in early morning in one case, while all determined PA values were extremely high in another case with severe congestive heart failure involved in cardiac liver cirrhosis. The PRA values were relatively low in 2 cases, normal in 5 and high in one.
对8例充血性心力衰竭患者进行了血浆醛固酮（PA）和血浆肾素活性（PRA）昼夜节律的研究。所有患者均已进行洋地黄化，并在轻度限钠情况下接受利尿剂治疗。8例患者中有7例观察到与正常受试者相似的PA明显昼夜节律，傍晚值最低，早晨值最高，而除1例患者外，PRA的昼夜节律不明显。PA一般与PRA不平行。虽然充血性心力衰竭中PRA昼夜节律缺失的原因尚不清楚，但认为肾素 - 血管紧张素系统在充血性心力衰竭中PA昼夜节律的形成中未起重要作用。尽管患者长期使用强效利尿剂，但除2例患者外，所测PA值完全在正常范围内。1例患者仅在清晨观察到高PA值，而另1例合并心源性肝硬化的严重充血性心力衰竭患者所有测定的PA值均极高。2例患者的PRA值相对较低，5例正常，1例较高。
