SYSTEMIC HEMODYNAMICS AND RENAL-FUNCTION DURING BRAIN NATRIURETIC PEPTIDE INFUSION IN PATIENTS WITH ESSENTIAL-HYPERTENSION

被引：21

作者：

LAZZERI, C ^{[1
]}

FRANCHI, F ^{[1
]}

PORCIANI, C ^{[1
]}

FRONZAROLI, C ^{[1
]}

RAGGI, VC ^{[1
]}

DEFEO, ML ^{[1
]}

MANNELLI, M ^{[1
]}

CERSOSIMO, RM ^{[1
]}

LAVILLA, G ^{[1
]}

机构：

[1] UNIV FLORENCE,SCH MED,IST MED INTERNA,CARDIOVASC UNIT,I-50134 FLORENCE,ITALY

来源：

AMERICAN JOURNAL OF HYPERTENSION | 1995年 / 8卷 / 08期

关键词：

BRAIN NATRIURETIC PEPTIDE; ESSENTIAL HYPERTENSION; RENAL FUNCTION; SODIUM EXCRETION; SYSTEMIC HEMODYNAMICS;

D O I：

10.1016/0895-7061(95)00147-H

中图分类号：

R6 [外科学];

学科分类号：

1002 ; 100210 ;

摘要：

We assessed the cardiovascular and renal effects of human brain natriuretic peptide (BNP) infused at a dose inducing an increase in plasma BNP to pathophysiologic levels, in eight hypertensive patients in a randomized, placebo-controlled, crossover study. Left ventricular performance, cardiac output (echocardiography), heart rate, arterial pressure, glomerular filtration rate (GFR; creatinine clearance), sodium excretion, intrarenal sodium handling (lithium clearance method), and urine flow rate were measured in the infusion and postinfusion periods (1 h each), together with plasma BNP and the urinary excretion rate of cGMP. Plasma BNP levels increased from 2.90 +/- 0.74 to 36.43 +/- 5.51 pmol/L (P < .01) at the end of the infusion and were still elevated at the end of the postinfusion period (7.03 +/- 1.41 pmol/L, P < .05). The urinary excretion of cGMP was also significantly higher during BNP infusion. Left ventricular performance, cardiac output, arterial pressure, and peripheral vascular resistance were not affected by BNP. Peptide infusion induced a significant increase in GFR (placebo, 115 +/- 24; BNP, 147 +/- 19 mL/min), sodium excretion (placebo, 129 +/- 40; BNP, 243 +/- 60 mu mol/min), and urine flow rate. All these effects were observed also in the postinfusion period. The natriuretic effect of BNP was attributable to both an increase in filtered sodium load and a reduction of distal sodium reabsorption. These results suggest that BNP may contribute to maintain renal function and sodium excretion in patients with essential hypertension.

引用

页码：799 / 807

页数：9

共 36 条

[21] Marsh, Green, Wynne, Et al., Left ventricular end-systolic pressure-dimension and stress-length relations in human subjects, Am J Cardiol, 44, pp. 1311-1317, (1979)
[22] De Simone, Di Lorenzo, Moccia, Et al., Hemodynamic hypertrophied left ventricular patterns in systemic hypertension, Am J Cardiol, 60, pp. 1317-1321, (1987)
[23] Sagawa, Suga, Shoukas, Et al., End systolic pressure/volume ratio: a new index of ventricular contractility, Am J Cardiol, 40, pp. 748-753, (1977)
[24] Benjamin, Levy, Anderson, Et al., Determinants of Doppler indexes of left ventricular diastolic function in normal subjects, Am J Cardiol, 70, pp. 508-515, (1992)
[25] Devereux, Reichek, Echocardiographic determination of left ventricular mass in man. Anatomic validation of the method, Circulation, 55, pp. 613-618, (1977)
[26] Devereux, Alonzo, Lutas, Et al., Echocardiographic assessment of left ventricular hypertrophy: comparison to necroscopy findings, Am J Cardiol, 57, pp. 450-458, (1986)
[27] Koomans, Boher, Mees, Evaluation of lithium clearance as a marker of proximal tubule sodium handling, Kidney Int, 36, pp. 2-12, (1989)
[28] Yoshimura, Yasue, Morita, Et al., Hemodynamic, renal, and hormonal responses to brain natriuretic peptide infusion in patients with congestive heart failure, Circulation, 84, pp. 1581-1588, (1991)
[29] Lang, Choy, Henderson, Et al., Effects of haemodialysis on plasma levels of brain natriuretic peptide in patients with chronic renal failure, Clin Sci, 82, pp. 127-131, (1990)
[30] Richards, Crozier, Holmes, Et al., Brain natriuretic peptide natriuretic and endocrine effects in essential hypertension, Journal of Hypertension, 11, pp. 163-170, (1994)

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