Hryniewiecki T, Rawczyńska-Englert I, Orłowska-Baranowska E, Pszona B
I Kliniki Wad Serca Instytutu Kardiologii w Warszawie.
Pol Arch Med Wewn. 1993 Apr;89(4):293-7.
The aim of the study was to analyze atrial natriuretic peptide (ANP) plasma level in patients with rheumatic mitral valve disease in correlation with NYHA functional class and selected hemodynamic parameters based on noninvasive diagnostic procedures. Echocardiographic (2-D, Doppler) and X-ray chest examination were performed to measure left atrium dimension, mitral gradient and relative heart volume (RHV). Control group consisted of 10 healthy subjects. ANP were measured (radioimmunoassay) in 35 patients before valve replacement. Mean values for ANP were significantly elevated in all patients compared to control group (p < 0.001). No significant difference between ANP secretion in pts with sinus rhythm (mean ANP level 25.3 +/- 6.9 pmol/l) and pts with atrial fibrillation (mean ANP level 26.7 +/- 7.6 pmol/l) occurred. Positive correlation between left atrium dimension and ANP level were found (r = 0.964) and also between RHV and ANP level (r = 0.9) and between NYHA class and ANP level (r = 0.63). The conclusion is that ANP secretion is elevated in all patients with heart failure due to mitral valve disease proportional to its stage.
本研究旨在基于无创诊断程序，分析风湿性二尖瓣疾病患者的血浆心房利钠肽（ANP）水平与纽约心脏协会（NYHA）心功能分级及选定血流动力学参数之间的相关性。进行超声心动图（二维、多普勒）和胸部X线检查以测量左心房大小、二尖瓣压差和相对心脏容积（RHV）。对照组由10名健康受试者组成。对35例瓣膜置换术前患者进行了ANP测量（放射免疫测定法）。与对照组相比，所有患者的ANP平均值均显著升高（p < 0.001）。窦性心律患者（平均ANP水平25.3±6.9 pmol/l）与房颤患者（平均ANP水平26.7±7.6 pmol/l）的ANP分泌无显著差异。发现左心房大小与ANP水平之间存在正相关（r = 0.964），RHV与ANP水平之间（r = 0.9）以及NYHA分级与ANP水平之间（r = 0.63）也存在正相关。结论是，所有因二尖瓣疾病导致心力衰竭的患者，其ANP分泌均升高，且与疾病阶段成正比。
