ATRIAL-NATRIURETIC-PEPTIDE IN HEART-FAILURE
ATRIAL-NATRIURETIC-PEPTIDE IN HEART-FAILURE
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DOI：
10.1016/0735-1097(93)90468-g
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发表时间：
1993-10-01
影响因子：
24
通讯作者：
BURNETT, JC
中科院分区：
文献类型：
--
作者：
BRANDT, RR;WRIGHT, RS;BURNETT, JC
心房钠尿肽是一种源自心脏的肽激素，其在心房扩张时释放，用于维持钠稳态并抑制肾素-血管紧张素-醛固酮系统的激活。充血性心力衰竭是一种临床综合征，其特征是心脏容量增加和压力超负荷，并且无法排泄钠负荷，这与全身神经体液和局部自分泌和旁分泌机制的活动增加有关。由于这种激素的合成和释放增加，循环心房钠尿肽在充血性心力衰竭中大大增加。心钠素已成为充血性心力衰竭的重要诊断和预后血清标志物。在早期心力衰竭中，它可能在保持无症状左心室功能障碍的代偿状态方面发挥关键作用。尽管心力衰竭时循环心房钠尿肽增加，但肾脏保留钠并且对外源性和内源性心房钠尿肽反应低下。肾脏反应减弱的机制是多因素的，包括肾脏灌注不足、肾素-血管紧张素-醛固酮和交感神经系统的激活。增强心房钠尿肽生物学作用的治疗策略可能会延长无症状期并延缓进展为明显的充血性心力衰竭。
Atrial natriuretic peptide is a peptide hormone of cardiac origin, which is released in response to atrial distension and serves to maintain sodium homeostasis and inhibit activation of the renin-angiotensin-aldosterone system. Congestive heart failure is a clinical syndrome characterized by increased cardiac volume and pressure overload with an inability to excrete a sodium load, which is associated with increased activity of systemic neurohumoral and local autocrine and paracrine mechanisms. Circulating atrial natriuretic peptide is greatly increased in congestive heart failure as a result of increased synthesis and release of this hormone. Atrial natriuretic peptide has emerged as an important diagnostic and prognostic serum marker in congestive heart failure. In early heart failure, it may play a key role in preserving the compensated state of asymptomatic left ventricular dysfunction. Despite increased circulating atrial natriuretic peptide in heart failure, the kidney retains sodium and is hyporesponsive to exogenous and endogenous atrial natriuretic peptide. The mechanism for the attenuated renal response is multifactorial and includes renal hypoperfusion, activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Therapeutic strategies to potentiate the biologic actions of atrial natriuretic peptide may prolong the asymptomatic phase and delay progression to overt congestive heart failure.