Naruse M, Takeyama Y, Tanabe A, Hiroshige J, Naruse K, Yoshimoto T, Tanaka M, Katagiri T, Demura H
Department of Medicine, Tokyo women's Medical College, Japan.
Hypertension. 1994 Jan;23(1 Suppl):I231-4. doi: 10.1161/01.hyp.23.1_suppl.i231.
The human heart secretes both atrial natriuretic peptide and brain natriuretic peptide. This study attempts to clarify the pathophysiological significance of the peptides in cardiovascular diseases. Using immunoradiometric assay, plasma brain natriuretic peptide and atrial natriuretic peptide levels in essential hypertension, various secondary hypertension, chronic renal failure, chronic heart failure during cardiac pacing, and acute myocardial infarction were determined. Mean plasma brain natriuretic peptide and atrial natriuretic peptide levels in healthy subjects were 3.7 +/- 0.3 and 5.7 +/- 0.3 pmol/L, respectively, and increased as a function of age. Plasma brain natriuretic peptide levels showed a larger increase than atrial natriuretic peptide levels in various cardiovascular diseases. In chronic renal failure, whereas plasma atrial natriuretic peptide levels decreased significantly after hemodialysis and were correlated with the changes in body weight, changes in plasma brain natriuretic peptide levels were less prominent and did not show such a correlation. In chronic heart failure, both basal plasma brain natriuretic peptide and atrial natriuretic peptide levels were also significantly elevated. However, in response to acute ventricular or atrial pacing, brain natriuretic peptide levels did not show any increase in contrast to the marked increase of atrial natriuretic peptide levels. In acute myocardial infarction, brain natriuretic peptide levels showed more prominent changes than atrial natriuretic peptide levels and were correlated with serum levels of creatine kinase and cardiac myosin light chain I in most patients. These results suggest that both brain and atrial natriuretic peptides play an important role in the regulation of cardiovascular homeostasis.(ABSTRACT TRUNCATED AT 250 WORDS)
人类心脏会分泌心房利钠肽和脑利钠肽。本研究旨在阐明这些肽类在心血管疾病中的病理生理意义。采用免疫放射分析方法，测定了原发性高血压、各种继发性高血压、慢性肾衰竭、心脏起搏时的慢性心力衰竭以及急性心肌梗死患者血浆中的脑利钠肽和心房利钠肽水平。健康受试者血浆脑利钠肽和心房利钠肽的平均水平分别为3.7±0.3和5.7±0.3 pmol/L，并随年龄增长而升高。在各种心血管疾病中，血浆脑利钠肽水平的升高幅度大于心房利钠肽水平。在慢性肾衰竭中，血液透析后血浆心房利钠肽水平显著下降，并与体重变化相关，而血浆脑利钠肽水平变化不明显，且无此相关性。在慢性心力衰竭中，基础血浆脑利钠肽和心房利钠肽水平也显著升高。然而，在急性心室或心房起搏时，与心房利钠肽水平的显著升高相反，脑利钠肽水平未出现任何升高。在急性心肌梗死中，脑利钠肽水平的变化比心房利钠肽水平更显著，且在大多数患者中与肌酸激酶和心肌肌球蛋白轻链I的血清水平相关。这些结果表明，脑利钠肽和心房利钠肽在心血管稳态调节中均发挥重要作用。（摘要截选至250词）
