NATRIURETIC PEPTIDE SYSTEM IN HUMAN HEART-FAILURE
NATRIURETIC PEPTIDE SYSTEM IN HUMAN HEART-FAILURE
复制标题
DOI：
10.1161/01.cir.88.3.1004
复制
发表时间：
1993-09-01
期刊：
影响因子：
37.8
通讯作者：
BURNETT, JC
中科院分区：
文献类型：
--
作者：
WEI, CM;HEUBLEIN, DM;BURNETT, JC
背景心房利钠肽（ANP）、脑利钠肽（BNP）和C型利钠肽（CNP）是结构相关的肽家族，参与肾和心血管功能的综合控制。以前的研究表明，这些激素肽在充血性心力衰竭（CHF）的心肾调节中的功能作用。本研究采用放射免疫分析和免疫组织化学染色（IHCS）对正常受试者（n=6）和轻度（纽约心脏协会[NYHA] I至II级，n=20）和重度（NYHA III至IV级，n=20）CHF患者进行了研究。轻度和重度CHF患者血浆心钠素水平均显著高于正常人。相比之下，重度CHF组血浆BNP仅中度升高，CHF组血浆CNP浓度与正常受试者相比无变化。心房组织中利钠肽的浓度与循环中的浓度不平行。在正常心房组织中ANP占优势，而在CHF中BNP占优势。在心室组织中，IHCS染色存在于正常心室肌中的所有三种肽，并且在CHF中显著增强。这些研究支持人CHF中ANP、BNP和CNP循环浓度和组织活性的差异调节。
Background. Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) are a family of structurally related peptides that participate in the integrated control of renal and cardiovascular function. Previous studies suggest a functional role for these hormonal peptides in cardiorenal regulation in congestive heart failure (CHF).Methods and Results. The present studies were performed in normal subjects (n=6) and in patients with mild (New York Heart Association [NYHA] class I to II, n=20) and severe (NYHA class III to IV, n=20) CHF by use of radioimmunoassay and immunohistochemical staining (IHCS). Plasma ANP was significantly increased in both mild and severe CHF compared with normal subjects. In contrast, plasma BNP was only moderately increased in the severe CHF group, and plasma CNP concentration was unchanged in CHF compared with normal subjects. Atrial tissue concentrations of the natriuretic peptides did not parallel circulating concentrations. ANP predominated in normal atrial tissue, but BNP predominated in CHF. In ventricular tissue, IHCS staining was present for all three peptides in normal ventricular myocardium and was markedly enhanced in CHF.Conclusions. These studies support,a differential regulation of ANP, BNP, and CNP circulating concentrations and tissue activity in human CHF.