Richards A M, Crozier I G, Yandle T G, Espiner E A, Ikram H, Nicholls M G
Department of Cardiology, Princess Margaret Hospital, Christchurch, New Zealand.
Br Heart J. 1993 May;69(5):414-7. doi: 10.1136/hrt.69.5.414.
To document regional plasma concentrations of brain natriuretic factor (BNF) and their relations to concurrent concentrations of atrial natriuretic factor, cyclic guanosine monophosphate, and haemodynamic state.
Regional blood sampling from a systemic artery and vein, renal vein, and coronary sinus together with concurrent haemodynamic indices in patients coming forward for left and right cardiac catheterisation.
Tertiary referral centre.
22 consecutive unselected patients coming forward for left and right cardiac catheterisation or electrophysiological studies in the course of standard diagnosis for a range of cardiac disorders.
Significant arteriovenous gradients for plasma BNF concentration were found across the lower limb, the kidney, and the heart. These were less than concurrent arteriovenous gradients in plasma atrial natriuretic factor (ANF). Arterial concentrations of plasma BNF were positively related to concurrent concentrations of ANF (r = 0.72, p < 0.01) and cyclic guanosine monophosphate (r = 0.52, p < 0.05). Arterial plasma concentrations of BNF showed a significant positive correlation with right atrial pressure and pulmonary artery wedge pressure and an inverse relation to cardiac output.
Regional plasma concentrations of BNF indicate cardiac secretion of this peptide and clearance in a number of tissues. Renal clearance is proportionally greater than that found across the limb. Absolute and proportional arteriovenous gradients of this peptide are considerably less than for concomitant concentrations of ANF suggesting slower metabolic clearance of BNF. Plasma BNF concentrations rise with increasing cardiac impairment and are related to indices of cardiac function. These findings are consistent with a role for BNF in the neurohumoral response to cardiac impairment.
记录脑钠素（BNF）的局部血浆浓度及其与心房钠尿肽、环磷酸鸟苷的同期浓度和血流动力学状态的关系。
对接受左右心导管插入术的患者，从体动脉和静脉、肾静脉及冠状窦进行局部采血，并同步测量血流动力学指标。
三级转诊中心。
22例连续入选的患者，因一系列心脏疾病在标准诊断过程中接受左右心导管插入术或电生理研究，未作其他选择。
发现下肢、肾脏和心脏的血浆BNF浓度存在显著的动静脉梯度。这些梯度小于血浆心房钠尿肽（ANF）同期的动静脉梯度。血浆BNF的动脉浓度与ANF同期浓度呈正相关（r = 0.72，p < 0.01），与环磷酸鸟苷呈正相关（r = 0.52，p < 0.05）。BNF的动脉血浆浓度与右心房压力和肺动脉楔压呈显著正相关，与心输出量呈负相关。
BNF的局部血浆浓度表明该肽在心脏的分泌及在多个组织中的清除情况。肾脏清除率在比例上大于肢体的清除率。该肽的绝对和比例动静脉梯度明显小于ANF的同期浓度，提示BNF的代谢清除较慢。血浆BNF浓度随心脏损害加重而升高，并与心功能指标相关。这些发现与BNF在心脏损害的神经体液反应中的作用一致。
