Atrial Natriuretic Peptide and Acute Changes in Central Blood Volume by Hyperthermia in Healthy Humans

T. Vogelsang, J. Marving, C. Crandall, Chad E. Wilson, C. Yoshiga, N. Secher, B. Hesse, A. Kjær
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引用次数: 7

Abstract

Background Hyperthermia induces vasodilatation that reduces central blood volume (CBV), central venous pressure (CVP) and mean arterial pressure (MAP). Inhibition of atrial natriuretic peptide (ANP) could be a relevant homeostatic defense mechanism during hyperthermia with a decrease in CBV. The present study evaluated how changes in plasma ANP reflect the changes in CBV during hyperthermia. Methods Ten healthy subjects provided with a water perfused body suit increased body core temperature 1 °C. In situ labeled autologous red blood cells were used to measure the CBV with a gamma camera. Regions of interest were traced manually on the images of the whole body blood pool scans. Two measures of CBV were used: Heart/whole body ratio and thorax/whole body ratio. CVP and MAP were recorded. Arterial (ANPart) and venous plasma ANP were determined by radioimmunoassay. Results The ratio thorax/whole body and heart/whole body decreased 7 % and 11 %, respectively (p<0.001). MAP and CVP decreased during hyperthermia by 6.8 and 5.0 mmHg, respectively (p<0.05; p<0.001). Changes in both thorax/whole body (R=0.80; p<0.01) and heart/whole body ratios (R=0.78; p<0.01) were correlated with changes in ANPart. However, there was no correlation between venous ANP and changes in CBV, nor between ANPart and MAP or CVP. Conclusion Arterial but not venous plasma concentration of ANP, is correlated to changes in CBV, but not to pressures. We suggest that plasma ANPart may be used as a surrogate marker of acute CBV changes.
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健康人群热疗后心房利钠肽与中枢血容量的急性变化
热疗诱导血管舒张,降低中心血容量(CBV)、中心静脉压(CVP)和平均动脉压(MAP)。抑制心房利钠肽(ANP)可能是热疗过程中CBV降低的相关稳态防御机制。本研究评估了血浆ANP的变化如何反映热疗期间CBV的变化。方法10例健康受试者身穿水灌注体衣,提高体核温度1℃。原位标记的自体红细胞用伽马照相机测量CBV。感兴趣的区域是在全身血库扫描图像上手工追踪的。CBV采用两种测量方法:心/全身比和胸/全身比。记录CVP和MAP。用放射免疫法测定动脉(ANPart)和静脉血浆ANP。结果胸/全身、心/全身比值分别下降7%、11% (p<0.001)。热疗时MAP和CVP分别降低6.8和5.0 mmHg (p<0.05;p < 0.001)。双胸/全身变化(R=0.80;p<0.01),心/全身比(R=0.78;p<0.01)与ANPart的变化相关。然而,静脉ANP与CBV变化之间没有相关性,ANPart与MAP或CVP之间也没有相关性。结论动脉血浆ANP浓度与CBV变化相关,与血压变化无关,与静脉血浆ANP浓度无关。我们建议血浆ANPart可作为急性CBV变化的替代标志物。
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