Nicolau N, Butur G, Laky D
Victor Babeş, Institute, Bucharest, Romania.
Rom J Morphol Embryol. 1997 Jul-Dec;43(3-4):119-37.
As part of studies regarding the human myocardium biology in hereditary and acquired cardiopathies, we showed the presence of natriuretic granules (NG) not only in atriums but also in ventricles, in ten of our cases with intraoperative myocardium biopsies. Ultrastructurally, the natriuretic granules occur in lesions produced by hemodynamic and consecutively hypoxic disturbances, being present at the ventricular level, too, both near the Golgi apparatus that secrets them, and diffusely, in cardiomyocytes, beneath the altered organelles and phagolysosomes. Their aspect in similar in cardiac malformations (DSIA. Fallot tetralogy) and in mitral valvulopathies, their abundance being in connection with congestive heart failure (CHF). Although predominant in CHF class I and II, they occur also in the severe decompensations class III and IV, being perhaps felt at the cardiac level as they are released in the blood. This phenomenon is expressed by electronmicroscopic presence of natriuretic granules in the subsarcolema and the increased plasma level of natriuretic peptide, according to biochemical findings reported in the literature. They produce a vasodilating, diuretic, natriuretic effect, contributing to blood pressure regulation and testifying in the neuroendocrine role of human myocardium.
作为遗传性和获得性心脏病中人类心肌生物学研究的一部分，我们在十例术中进行心肌活检的病例中发现，利钠颗粒（NG）不仅存在于心房，也存在于心室。在超微结构上，利钠颗粒出现在由血流动力学以及随之而来的缺氧干扰所产生的病变中，在心室层面也有，既存在于分泌它们的高尔基体附近，也分散在心肌细胞中，位于细胞器和吞噬溶酶体发生改变的区域之下。它们在心脏畸形（如法洛四联症）和二尖瓣病变中的形态相似，其数量与充血性心力衰竭（CHF）有关。尽管在I级和II级CHF中占主导，但它们也出现在III级和IV级严重失代偿中，可能因其释放到血液中而在心脏层面被感知到。根据文献报道的生化研究结果，这种现象表现为肌膜下利钠颗粒的电镜观察结果以及利钠肽血浆水平的升高。它们产生血管舒张、利尿、利钠作用，有助于血压调节，并证明了人类心肌的神经内分泌作用。
