Mathisen P, Hall C, Simonsen S
Medical Department B. Rikshospitalet, University of Oslo, Norway.
Scand J Clin Lab Invest. 1993 Feb;53(1):41-9. doi: 10.1080/00365519309092530.
To evaluate the possible role of atrial natriuretic peptides ANF (1-98) and ANF (99-126) as diagnostic parameters of atrial distension, measurements of peptide levels were performed in 47 patients with chronic ischemic and/or left sided valvular heart disease. Plasma samples were drawn from the pulmonary artery (PA) and superior vena cava (SVC) during diagnostic right heart catheterization. Forty of the patients also underwent left heart haemodynamic measurements, and in 28 patients two dimensional echocardiography with determination of left atrial diameter was performed. Enhanced plasma concentrations of both peptides were observed with increasing severity of heart failure assessed by the NYHA classification. Mean plasma levels of both peptides were closely correlated to mean pulmonary artery pressure (ANF (1-98): n = 47, r = 0.69 (SVC)/r = 0.72 (PA), p < 0.0001; ANF (99-126): n = 46, r = 0.75 (SVC)/r = 0.68 (PA), p < 0.0001) and mean pulmonary capillary wedge pressure (ANF (1-98): n = 47, r = 0.69 (SVC)/r = 0.72 (PA), p < 0.0001; ANF (99-126): n = 46, r = 0.70 (SVC)/r = 0.64 (PA), p < 0.0001). Positive correlations were also obtained between peptide levels and mean right atrial pressure and left ventricular end-diastolic pressure. When patients with high right atrial pressures (n = 2) were excluded from analysis, a significant correlation was found between peptide levels and echocardiography assessed left atrial diameter. The present study demonstrates the close correlation between concentrations of both atrial peptides and cardiopulmonary haemodynamics in patients with chronic heart disease.(ABSTRACT TRUNCATED AT 250 WORDS)
为评估心钠素（ANF）（1 - 98）和ANF（99 - 126）作为心房扩张诊断参数的可能作用，对47例慢性缺血性和/或左侧瓣膜性心脏病患者进行了肽水平测定。在诊断性右心导管检查期间，从肺动脉（PA）和上腔静脉（SVC）采集血浆样本。40例患者还进行了左心血流动力学测量，28例患者进行了二维超声心动图检查并测定了左心房直径。通过纽约心脏协会（NYHA）分级评估，随着心力衰竭严重程度增加，观察到两种肽的血浆浓度均升高。两种肽的平均血浆水平与平均肺动脉压密切相关（ANF（1 - 98）：n = 47，r = 0.69（SVC）/r = 0.72（PA），p < 0.0001；ANF（99 - 126）：n = 46，r = 0.75（SVC）/r = 0.68（PA），p < 0.0001）以及平均肺毛细血管楔压（ANF（1 - 98）：n = 47，r = 0.69（SVC）/r = 0.72（PA），p < 0.0001；ANF（99 - 126）：n = 46，r = 0.70（SVC）/r = 0.64（PA），p < 0.0001）。肽水平与平均右心房压和左心室舒张末期压力之间也呈正相关。当排除右心房压力高的患者（n = 2）进行分析时，发现肽水平与超声心动图评估的左心房直径之间存在显著相关性。本研究表明，慢性心脏病患者中两种心房肽浓度与心肺血流动力学之间密切相关。（摘要截断于250字）
