Liguori A, Napoli C, Di Gregorio F, Sibilio G, Di Ieso N, Ciafrè S A, Piatto A, Varriale A
Divisione di Cardiologia, Ospedale Regionale dei Pellegrini, Napoli.
Recenti Prog Med. 1993 Jul-Aug;84(7-8):495-502.
Atrial natriuretic factor (ANF) is a potent natriuretic and vasoactive (vasorelaxant) peptide localized in the secretory-like atrial specific granules. The main peptide in this storage granules is the 126 amino acid proatrial natriuretic peptide, but the principal circulating form in human plasma is the 28 amino acid, alpha-human natriuretic peptide. Animal and in vitro studies have suggested that ANF modulates autonomic circulatory control, probably with a dose-dependent mechanism. Moreover, recent human studies have resulted contradictory. In particular, it is still unclear if high circulating levels of ANF, which are present in congestive heart diseases constantly, may be correlated with sympathetic nervous system activity in man. Previously we have shown that in congestive diseases there is a relation between ANF and catecholamine secretion. From these basis, the aim of this study was to investigate on the pathophysiological relations between atrial natriuretic factor (ANF) release and adrenergic activation in patients with obstructive hypertrophic cardiomyopathy (n = 6) and non obstructive hypertrophic cardiomyopathy (n = 4). Sympathetic activation in physiologic way was induced by cycloergometer sub-maximal exercise. Then specimens of venous blood were achieved for plasma determination of ANF and catecholamines pre- and post-exercise. Results have shown that in obstructive hypertrophic cardiomyopathy patients basal levels of ANF and catecholamines were higher than levels of these parameters in non obstructive hypertrophic cardiomyopathy patients.(ABSTRACT TRUNCATED AT 250 WORDS)
心房利钠因子(ANF)是一种强效的利钠和血管活性(血管舒张)肽,定位于分泌样心房特异性颗粒中。这种储存颗粒中的主要肽是126个氨基酸的前心房利钠肽,但人血浆中的主要循环形式是28个氨基酸的α-人利钠肽。动物和体外研究表明,ANF可能通过剂量依赖性机制调节自主循环控制。此外,最近的人体研究结果相互矛盾。特别是,目前仍不清楚充血性心脏病中持续存在的高循环水平的ANF是否与人的交感神经系统活动相关。此前我们已经表明,在充血性疾病中,ANF与儿茶酚胺分泌之间存在关联。基于这些,本研究的目的是调查梗阻性肥厚型心肌病患者(n = 6)和非梗阻性肥厚型心肌病患者(n = 4)中心房利钠因子(ANF)释放与肾上腺素能激活之间的病理生理关系。通过蹬车测力计次最大运动以生理方式诱导交感神经激活。然后采集静脉血标本,用于运动前和运动后血浆中ANF和儿茶酚胺的测定。结果表明,梗阻性肥厚型心肌病患者的ANF和儿茶酚胺基础水平高于非梗阻性肥厚型心肌病患者的这些参数水平。(摘要截断于250字)