Van Den Berg M P, Crijns H J, Van Veldhuisen D J, Van Gelder I C, De Kam P J, Lie K I
Department of Cardiology, Thorax Center, University Hospital Groningen, The Netherlands.
Am Heart J. 1998 Feb;135(2 Pt 1):242-4. doi: 10.1016/s0002-8703(98)70088-2.
The purpose of this study was to analyze the determinants of atrial natriuretic peptide level in patients with congestive heart failure and atrial fibrillation. In particular, the duration of atrial fibrillation was analyzed because atrial fibrillation per se might have a specific effect on atrial natriuretic peptide level. The study group consisted of 26 patients with mild to moderate stable congestive heart failure and chronic atrial fibrillation. Plasma samples of atrial natriuretic peptide were obtained at rest and were analyzed with radioimmunoassay. Median atrial natriuretic peptide level was 213 (range 42 to 438) ng/L. Multivariate determinants of atrial natriuretic peptide level were use of calcium antagonists and the duration of atrial fibrillation; both factors showed an inverse relation with atrial natriuretic peptide level. The finding that atrial natriuretic peptide level was lower among patients with atrial fibrillation of longer duration suggests a form of insufficiency of the atria to produce atrial natriuretic peptide because of degenerative changes in the atria inherent to chronic atrial fibrillation.
本研究的目的是分析充血性心力衰竭合并心房颤动患者心房利钠肽水平的决定因素。特别是对心房颤动的持续时间进行了分析，因为心房颤动本身可能对心房利钠肽水平有特定影响。研究组由26例轻度至中度稳定的充血性心力衰竭合并慢性心房颤动患者组成。在静息状态下采集心房利钠肽的血浆样本，并采用放射免疫分析法进行分析。心房利钠肽水平的中位数为213（范围42至438）ng/L。心房利钠肽水平的多变量决定因素是钙拮抗剂的使用和心房颤动的持续时间；这两个因素均与心房利钠肽水平呈负相关。心房颤动持续时间较长的患者心房利钠肽水平较低这一发现表明，由于慢性心房颤动固有的心房退行性改变，心房产生心房利钠肽的功能存在某种形式的不足。
