Possible vascular role of increased plasma arginine vasopressin in congestive heart failure
Possible vascular role of increased plasma arginine vasopressin in congestive heart failure
复制标题
DOI：
10.1016/j.ijcard.2005.01.043
复制
发表时间：
2006-01-13
影响因子：
3.5
通讯作者：
Ishikawa, S
中科院分区：
文献类型：
--
作者：
Nakamura, T;Funayama, H;Ishikawa, S
背景：本研究旨在确定充血性心力衰竭患者心功能不全与激素释放的关系。方法：对 72 名充血性心力衰竭患者进行检查，根据纽约心脏协会 (NYHA) 的标准将其分为四个亚组。此外，10 名年龄匹配的受试者作为对照。测定血浆精氨酸加压素（AVP）、去甲肾上腺素、心房钠尿肽（ANP）和脑钠尿肽（BNP）。对 72 名患者中的 51 名进行了心脏指数和肺毛细血管楔压 (PCWP) 测量。结果：根据 NYHA 分级的严重程度，血浆 AVP 水平显着升高；控制：1.7+/-0.2； NYHA I：4.9 +/- 0.8，NYHA II：5.5 +/- 0.9，NYHA III：13.4 +/- 2.6 (p < 0.05)，NYHA IV：26.9 +/- 5.6 pmol/l (p < 0.001)。血浆去甲肾上腺素、ANP 和 BNP 也获得了类似的结果。血浆 AVP 水平与心脏指数呈负相关（r = - 0.36，p < 0.01），但与 PCWP 和血浆渗透压无关。血浆 BNP 水平与 PCWP 呈正相关（r = 0.44，p < 0.001），但与心脏指数无关。血浆AVP和BNP之间没有相关性。根据NYHA III级和IV级患者心脏指数的改善，强化治疗显着降低了所有激素。血浆 AVP 下降百分比为 60.0%，该值大于血浆 BNP。结论：本研究表明，AVP 增加可能通过 V-1a 和 V-2 作用而恶化心功能，并且血浆 AVP 水平也是充血性心力衰竭存在和严重程度的适当标志。 (c) 2005 Elsevier Ireland Ltd. 保留所有权利。
Background: The present study was undertaken to determine the relation of cardiac dysfunction with hormonal release in patients with congestive heart failure.Methods: Seventy-two patients with congestive heart failure were examined, who were divided into four subgroups classified by the criteria of the New York Heart Association (NYHA). Also, 10 age-matched subjects were served as a control. Plasma arginine vasopressin (AVP), norepinephrine, atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) were determined. Cardiac index and pulmonary capillary wedge pressure (PCWP) were measured in 51 of 72 patients.Results: Plasma AVP levels were significantly increased according to the severity of NYHA classes; control: 1.7 +/- 0.2; NYHA I: 4.9 +/- 0.8, NYHA II: 5.5 +/- 0.9, NYHA III: 13.4 +/- 2.6 (p < 0.05), NYHA IV: 26.9 +/- 5.6 pmol/l (p < 0.001). Similar results were obtained with plasma norepinephrine, ANP and BNP. Plasma AVP levels had negative correlation with cardiac index (r = - 0.36, p < 0.01), but did not with PCWP and plasma osmolality. Plasma BNP levels positively correlated with PCWP (r =0.44, p < 0.001), but did not with cardiac index. There was no correlation between plasma AVP and BNP. Intensive therapy profoundly reduced all the hormones according to the improvement of cardiac index in the patients with NYHA class III and IV. The percent decrease in plasma AVP was 60.0%, a value greater than that in plasma BNP.Conclusion: The present study indicates that increased AVP may deteriorate cardiac function through V-1a as well as V-2 action, and that plasma AVP level is also a proper marker for the presence and severity of congestive heart failure. (c) 2005 Elsevier Ireland Ltd. All rights reserved.