Haug C, Metzele A, Kochs M, Hombach V, Grünert A
Institute of Clinical Chemistry, University of Ulm, Germany.
Clin Cardiol. 1993 Jul;16(7):553-7. doi: 10.1002/clc.4960160708.
The present study was designed to investigate whether brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) plasma concentrations correlate with left ventricular end-diastolic pressure (LVEDP), pulmonary capillary wedge pressure (PCWP), diastolic pulmonary arterial pressure (DPAP), right atrial pressure (RAP), or ejection fraction (EF). Plasma BNP and ANP levels were determined by commercial radioimmunoassays (Peninsula) after Sep Pak C18 extraction in blood samples withdrawn from the pulmonary artery and the left ventricle or from the left ventricle and the femoral vein in 85 patients undergoing diagnostic cardiac catheterization. Linear and nonlinear regression analysis and the paired sample t-test were applied to the data. Pulmonary arterial plasma BNP and ANP levels showed a close nonlinear correlation with LVEDP (BNP: r = 0.94, p < 0.001; ANP: r = 0.81, p < 0.001), a significant linear correlation with PCWP, DPAP, and RAP, and a significant negative correlation with EF. ANP concentrations decreased significantly from the pulmonary artery to the left ventricle and from the left ventricle to the femoral vein (p < 0.001). BNP levels also decreased significantly between the left ventricle and the femoral vein (p < 0.001), but there was no significant difference between pulmonary arterial and left ventricular BNP concentrations. BNP and ANP concentrations correlated significantly between pulmonary arterial and left ventricular blood samples (BNP: r = 0.99, ANP: r = 0.93, p < 0.001) and between left ventricular and peripheral blood samples (BNP: r = 0.99, ANP: r = 0.94, p < 0.001). The present data suggest that peripheral plasma BNP and ANP levels are useful non-invasive indices of cardiac performance.
本研究旨在调查血浆脑钠肽（BNP）和心钠肽（ANP）浓度是否与左心室舒张末期压力（LVEDP）、肺毛细血管楔压（PCWP）、舒张期肺动脉压（DPAP）、右心房压力（RAP）或射血分数（EF）相关。在85例接受诊断性心导管检查的患者中，从肺动脉和左心室或从左心室和股静脉采集血样，经Sep Pak C18萃取后，采用商业放射免疫分析法（半岛公司）测定血浆BNP和ANP水平。对数据应用线性和非线性回归分析以及配对样本t检验。肺动脉血浆BNP和ANP水平与LVEDP呈密切的非线性相关（BNP：r = 0.94，p < 0.001；ANP：r = 0.81，p < 0.001），与PCWP、DPAP和RAP呈显著线性相关，与EF呈显著负相关。从肺动脉到左心室以及从左心室到股静脉，ANP浓度显著降低（p < 0.001）。BNP水平在左心室和股静脉之间也显著降低（p < 0.001），但肺动脉和左心室BNP浓度之间无显著差异。肺动脉和左心室血样之间以及左心室和外周血样之间，BNP和ANP浓度显著相关（BNP：r = 0.99，ANP：r = 0.93，p < 0.001）。目前的数据表明，外周血浆BNP和ANP水平是评估心脏功能的有用无创指标。
