Christensen G, Leistad E
Institute for Experimental Medical Research and Research Forum, University of Oslo, Norway.
Am J Physiol. 1997 Feb;272(2 Pt 2):H820-6. doi: 10.1152/ajpheart.1997.272.2.H820.
The mechanism for increased secretion of atrial natriuretic factor (ANF) during tachycardia and atrial fibrillation has remained unsettled. In seven open-chest pigs, the plasma concentration of ANF increased from 49.8 +/- 12.4 to 131.8 +/- 15.7 pg/ml when heart rate was increased from 133 +/- 13 to 212 +/- 4 beats/min by atrial pacing. Right atrial maximal diameter, recorded by ultrasonic technique at the maximal atrial filling, did not increase. During pacing tachycardia, the atrial contraction (a wave) occurs during atrial filling, and the a wave becomes superimposed on the v wave. In the present study the systolic atrial pressure (a wave) increased from 5.8 +/- 0.8 to 9.6 +/- 0.5 mmHg. The significance of this pressure rise was subsequently examined. After complete atrioventricular (AV) block, the AV delay was progressively increased, without altering heart rate, until the a wave was similar to the the a wave during the preceding tachycardia. Plasma ANF increased to 113.8 +/- 14.7 pg/ml, which showed that the increase in atrial pressure during atrial systole is a stimulus for ANF release. In the second part of the study, atrial fibrillation was induced in six open-chest pigs by rapid atrial pacing after complete AV block. Plasma ANF increased from 83.5 +/- 7.2 to 269.0 +/- 45.4 pg/ml during atrial fibrillation. No increase in atrial dimensions occurred during atrial fibrillation, but atrial pressure was substantially elevated. Thus, although passive atrial stretch stimulates ANF release during blood volume expansion, the present study shows that the increase in atrial pressure during atrial contraction is a stimulus for release of ANF during tachycardia and atrial fibrillation.
心动过速和心房颤动期间心房利钠因子(ANF)分泌增加的机制尚未明确。在7只开胸猪中,通过心房起搏使心率从133±13次/分钟增加到212±4次/分钟时,血浆ANF浓度从49.8±12.4 pg/ml增加到131.8±15.7 pg/ml。在最大心房充盈时通过超声技术记录的右心房最大直径没有增加。在起搏性心动过速期间,心房收缩(a波)发生在心房充盈期,a波叠加在v波上。在本研究中,收缩期心房压力(a波)从5.8±0.8 mmHg增加到9.6±0.5 mmHg。随后研究了这种压力升高的意义。完全房室(AV)阻滞后,逐渐增加AV延迟,而不改变心率,直到a波与先前心动过速期间的a波相似。血浆ANF增加到113.8±14.7 pg/ml,这表明心房收缩期心房压力的增加是ANF释放的刺激因素。在研究的第二部分,在6只开胸猪中,在完全AV阻滞之后通过快速心房起搏诱发心房颤动。心房颤动期间血浆ANF从