CONSISTENT CHANGES IN THE CIRCADIAN-RHYTHMS OF BLOOD-PRESSURE AND ATRIAL-NATRIURETIC-PEPTIDE IN CONGESTIVE-HEART-FAILURE

被引:29
作者
PORTALUPPI, F
MONTANARI, L
FERLINI, M
VERGNANI, L
DAMBROSI, A
CAVALLINI, AR
BAGNI, B
UBERTI, ED
机构
[1] Internal Medicine and Endocrinology Section, University of Ferrara, Ferrara
[2] Institute of Internal Medicine, University of Ferrara, Ferrara
[3] Nuclear Medicine Service, St. Anna Hospital, Ferrara
关键词
ATRIAL NATRIURETIC PEPTIDE; BLOOD PRESSURE; HEART RATE; CONGESTIVE HEART FAILURE; CIRCADIAN RHYTHMS;
D O I
10.3109/07420529109059178
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
We demonstrated in previous works that the circadian rhythms of blood pressure (BP) and atrial natriuretic peptide (ANP) are antiphasic in normal subjects and in essential hypertension. The aim of the present study was to assess the circadian rhythms of BP and ANP in 20 patients with stable congestive heart failure (CHF), divided into two groups of 10 according to their New York Heart Association functional class. A matched control group of 10 normal volunteers was also studied. Noninvasive BP monitoring at 15-min intervals was performed for 24 h. Peripheral blood samples were also obtained at 4-h intervals starting from 08:00 h. The mean (+/- SEM) circadian mesors of ANP plasma levels were 13.4 +/- 1.7 pmol/L in the control group, 28.6 +/- 2.4 pmol/L in the group of 10 patients in class II, and 81.5 +/- 12 pmol/L in the group of 10 patients in class III-IV. In normal subjects, plasma ANP concentration was highest at 04:00 h (21.5 +/- 2.7 pmol/L) and lowest at 16:00 h (8.8 +/- 2.4 pmol/L; p < 0.01). Both groups of patients with CHF showed no significant circadian change in the plasma levels of ANP and also a significantly blunted circadian rhythm of BP. Cosinor analysis confirmed the loss of the circadian rhythms of ANP and BP in CHF patients. Our findings support the existence of a causal relationship between the circadian rhythms of ANP and BP.
引用
收藏
页码:432 / 439
页数:8
相关论文
共 49 条
[1]  
Portaluppi F., Montanan L., Bagni B., degli Uberti E., Trasforini G., Margutti A., Circadian rhythms of atrial natriuretic peptide, blood pressure and heart rate in normal subjects, Cardiology, 76, pp. 428-432, (1989)
[2]  
Portaluppi F., Bagni B., degli Uberti E., Et al., Circadian rhythms of atrial natriuretic peptide, renin, aldosterone, cortisol, blood pressure and heart rate in normal and hypertensive subjects, J Hyperfens, 8, pp. 85-95, (1990)
[3]  
Donckier J., Anderson J.V., Yeo T., Bloom S.R., Diurnal rhythm in the plasma concentration of atrial natriuretic peptide, N Engl J Med, 315, pp. 710-711, (1986)
[4]  
Richards A.M., Tonolo G., Fraser R., Et al., Diurnal change in plasma atrial natriuretic peptide concentrations, Clin Sci, 73, pp. 489-495, (1987)
[5]  
McCance D.R., Roberts G., Sheridan B., Et al., Variations in the plasma concentration of atrial natriuretic factor across 24 hours, Actu Endocrinol, 120, pp. 266-270, (1989)
[6]  
Sumioki H., Shimokawa H., Miyamoto S., Uezono K., Utsunomiya T., Nakano H., Circadian variations of plasma atrial natriuretic peptide in four types of hypertensive disorder during pregnancy, Br J Obstet Gynaecol, 96, pp. 922-927, (1989)
[7]  
Gordon R.D., Wolfe J.K., Island D.P., Liddle G., A diurnal rhythm in plasma renin activity in man, JClin Invest, 45, pp. 1587-1592, (1966)
[8]  
Katz F.H., Romfh P., Smith J.A., Episodic secretion of aldosterone in supine man: relationship to cortisol, J Clin Endocrinol Metab, 35, pp. 178-181, (1972)
[9]  
Vagnucci A.H., MacDonald R.M., Drash A.L., Intradiem changes of plasma aldosterone, cortisol, corticosterone, and growth hormone in sodium restriction, J Clin Endocrinol Metab, 38, pp. 761-776, (1974)
[10]  
Armbruster H., Vetter W., Beckerhoff R., Nussberger J., Vetter H., Siegenthaler W: Diurnal variations of plasma aldosterone in supine man. Relationship to plasma renin activity and plasma cortisol, Acta Endocrinol, 80, pp. 95-103, (1975)