Brain natriuretic peptide increases acutely and much more prominently than atrial natriuretic peptide during coronary angioplasty
Brain natriuretic peptide increases acutely and much more prominently than atrial natriuretic peptide during coronary angioplasty
复制标题
冠状动脉成形术期间脑钠尿肽急剧增加，且比心房钠尿肽更显着
作者：
C. Haller;M. Meyer
Kyriakides等人报告了PTCA期间体循环中的利钠肽A”和BNP增加。虽然这是一个有趣的观察结果，但其机制尚不清楚。除了作者的推测外，还应纳入/讨论放射造影剂给药引起的急性容量负荷，作为观察到的利钠肽分泌增加的合理解释。我们已经证明，在有和没有PTCA的冠状动脉造影期间，尿钠排泄与血浆A的增加有关，特别是与肾利钠肽尿扩张素的尿排泄有关。由于大多数放射性造影剂的高渗性，生理学相关的血管内容量负荷超过所施用化合物的体积。因此，了解Kyriakides等人使用的放射性造影剂的（a）体积和（B）渗透压摩尔浓度对于解释报告的结果是相关的。
Kyriakides et al. report an increase of the natriuretic peptides A" and BNP in the systemic circulation during PTCA. While this is an interesting observation, its mechanism is not clear. In addition to the authors' speculations, an acute volume load due to radiocontrast administration should be included/discussed as a plausible explanation for the observed increase in the secretion of natriuretic peptides. We have shown a natriuresis during coronary angiography with and without PTCA that was associated with an increase in plasma A" and particularly with the urinary excretion of the renal natriuretic peptide urodilatin. Because of the hypertonicity of most radiocontrast agents, the physiologically relevant intravascular volume load exceeds the volume of the administered compound. Therefore it would be pertinent for the interpretation of the reported findings to know (a) the volume and (b) the osmolality of the radiocontrast agents employed by Kyriakides et al.