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1 Laboratory of Cardiovascular Endocrinology, Consiglio Nazionale delle Ricerche Institute of Clinical Physiology, 56100 Pisa, Italy; and 2 Institute of Biophysics, First Medical Faculty, Charles University, Prague, Czech Republic
In an attempt to identify and quantify the sites
of atrial natriuretic peptide (ANP) degradation, a new tracer
experiment has been developed.
125I-ANP was injected as a bolus
just upstream from the right atrium, and blood was sampled from two
different sites (pulmonary artery and aorta) in eight cardiac
patients. Data were analyzed using a physiologically based circulatory
model consisting of three blocks in series (right heart, lungs and left
heart, and periphery) supplied by the same flow (cardiac output,
measured by thermodilution); the extraction coefficients of the three
blocks and of the whole body could be determined from the areas under
tracer concentration curves in plasma (AUCs). The values for AUCs
(means ± SD) were 64.8 ± 9.4 and 65.5 ± 10.7%
dose · l
1 · min
1
for pulmonary artery and aorta curves, respectively; the area under the pulmonary artery curve could be subdivided into the area
under the first-pass curve (30.6 ± 4.7% dose · l
1 · min
1)
and the area under the recirculating curve (34.0 ± 7.7%
dose · l
1 · min
1).
The metabolic clearance rate of
125I-ANP, computed as dose divided
by the area under the recirculating curve, was 3.1 ± 0.7 l/min, and
the whole body extraction was 47.6 ± 6.6%. In our patients with
myocardial dysfunction, neither right heart block nor lungs and left
heart block significantly extracted ANP, and periphery block
accounted for almost all removal of the hormone from the blood.
atrial natriuretic factor; tracer method; metabolic clearance rate; heart failure
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