Ationu A, Burch M, Singer D, Littleton P, Carter N
St George's Hospital Medical School, London, United Kingdom.
Cardiovasc Res. 1993 Feb;27(2):188-91. doi: 10.1093/cvr/27.2.188.
The aim was to examine the ventricular expression of brain natriuretic peptide (BNP) in the transplanted human heart.
Serial right ventricular biopsies (n = 68) and plasma samples (n = 68) were obtained for measurement of BNP and atrial natriuretic peptide (ANP) from 14 orthotopic cardiac transplant recipients from 1-74 weeks after transplantation. Right ventricular specimens (n = 10) were also obtained from normal hearts during necropsy as controls.
Mean ventricular BNP in cardiac transplant recipients was higher (p < 0.05) than in normal hearts, at 13531(SEM 2244) pg.mg-1 soluble protein (range 3232-109448) v 56(11) pg.mg-1 (range 16-91). Ventricular BNP and ANP values were correlated (r = 0.57, p < 0.05). Plasma BNP concentrations were higher (p < 0.05) than plasma ANP concentrations, at 202(16) pg.ml-1 (range 84-655) v 100(12) pg.ml-1 (range 8-484), and were raised (p < 0.05) in comparison with normal plasma BNP concentrations of 20(1.8) pg.ml-1 (range 10-23). Mean ventricular BNP was correlated with time after transplant (r = 0.72, p < 0.05, n = 68) and with mean plasma BNP (r = 0.80, p < 0.05, n = 14). There was no significant relationship between BNP levels and intracardiac or systemic blood pressure, or prednisolone dose (0.1-0.3 mg.kg-1.d-1). The increase in ventricular BNP with time after transplant was not explained by cardiac rejection assessed from histology, and plasma BNP was not significantly increased during rejection episodes.
High levels of BNP are synthesised and secreted by the transplanted human ventricle, and the transplanted ventricle may be an important source of circulating BNP. The significant positive association between ventricular BNP and time after transplant suggests a possible self compensatory mechanism or functional adaptation of the transplanted heart which may be beneficial to ventricular function.
研究脑钠肽（BNP）在移植的人心脏中的心室表达情况。
对14例原位心脏移植受者在移植后1至74周内进行了68次右心室系列活检及采集了68份血浆样本，用于检测BNP和心房钠尿肽（ANP）。还在尸检时从正常心脏获取了10份右心室标本作为对照。
心脏移植受者的心室BNP平均水平高于正常心脏（p < 0.05），分别为13531（标准误2244）pg·mg⁻¹可溶性蛋白（范围3232 - 109448）和56（11）pg·mg⁻¹（范围16 - 91）。心室BNP和ANP值具有相关性（r = 0.57，p < 0.05）。血浆BNP浓度高于血浆ANP浓度（p < 0.05），分别为202（16）pg·ml⁻¹（范围84 - 655）和100（12）pg·ml⁻¹（范围8 - 484），且与正常血浆BNP浓度20（1.8）pg·ml⁻¹（范围10 - 23）相比有所升高（p < 0.05）。心室平均BNP与移植后时间相关（r = 0.72，p < 0.05，n = 68），与平均血浆BNP也相关（r = 0.80，p < 0.05，n = 14）。BNP水平与心内或全身血压以及泼尼松龙剂量（0.1 - 0.3 mg·kg⁻¹·d⁻¹）之间无显著关系。移植后心室BNP随时间的增加不能用组织学评估的心排斥反应来解释，且在排斥发作期间血浆BNP没有显著增加。
移植的人心室合成并分泌高水平的BNP，移植的心室可能是循环BNP的重要来源。心室BNP与移植后时间之间的显著正相关表明移植心脏可能存在一种自我代偿机制或功能适应，这可能对心室功能有益。
