The Role of Alpha Atrial Natriuretic Hormone in Pneumonectomy: An Experimental Study

Objective: The alpha atrial natriuretic hormone (α-ANH) is released in response to atrial distension and excessive fluid volume in the body. The aim of the present study was to evaluate α-ANH levels before and after pneumonectomy and to investigate the effects of normal and increased volume of crystalloid–colloid fluids on α-ANH following pneumonectomy in a rabbit model. Methods: A total of 20 New Zealand rabbits were used in the study. The mean weight of the rabbits was 1.831 g. The subjects were divided into four groups with five in each group. The first group was given 3 mL/kg/h of crystalloid; the second group was given 10 mL/kg/h of crystalloid; the third group was given 3 mL/kg/h of colloid; the fourth group was given 10 mL/kg/h of colloid. Blood samples were preoperatively collected from the jugular vein. Posterolateral thoracotomy was applied to all subjects. The hilus was tied and cut en bloc with 2/0 silk, and pneumonectomy was performed. All groups received infusion for 3 h. Following infusion, blood samples from the contralateral jugular vein were collected at postoperative 3 h. Pre- and postoperative α-ANH levels were compared. Results: There was no significant difference in the mean weight of the groups (χ2 =1.417, p=0.478). There was no significant difference in the pre- and postoperative α-ANH levels among all groups (Z=0.674, p=0.5 in the first; Z=0.405, p=0.686 in the second; Z=1.753, p=0.08 in the third; Z=0.944, p=0.345 in the fourth). Conclusion: Our study results suggest that pneumonectomy alone appears not to change the α-ANH levels, and hypoxia, increased atrial pressure, and some neurohormonal factors may enhance α-ANH release.

Pnömonektomide Alfa Atrial Natriüretik Hormonun Rolü: Deneysel Çalışma

Amaç: Atrial natriüretik hormon (α-ANH) vücutta aşırı sıvı birikimi ve atrial distansiyona cevap olarak salgılanır. Biz, deneysel tavşan modelimizde pnömonektomi öncesi ve sonrası normal ve yüksek volüm kristaloid ve kolloid sıvı verilmesinin alfa atrial natriüretik hormon seviyesine etkisini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmada ortalama ağırlığı 1831 g olan toplam 20 Yeni Zelanda tavşanı kullanıldı. Örnekler her biri beş denekten oluşan dört gruba ayrıldı. Birinci gruba 3 mL/kg/sa kristaloid, ikinci gruba 10 mL/kg/sa kristaloid, üçüncü gruba 3 mL/kg/sa kolloid, dördüncü gruba 10 mL/kg/sa kolloid sıvı başlandı. Ameliyat öncesi juguler venden kan örnekleri alındı. Tüm deneklere posterolateral torakotomi uygulandı. Hilus 2/0 ipek ile en blok bağlandı ve kesildi, pnömonektomi yapıldı. Bütün gruplara üç saat infüzyon yapıldı, ameliyat sonrası üçüncü saat karşı taraf juguler venden kan örnekleri alındı. Ameliyat öncesi ve sonrası α-ANH seviyeleri karşılaştırıldı. Bulgular: Gruplar arasında ortalama ağırlık açısından farklılık yoktu. Ameliyat öncesi ve sonrası gruplar arasında α-ANH seviyeleri arasında anlamlı farklılık saptanmadı (birinci grup Z=0.674; p=0.5; ikinci grup Z=0.405; p=0.686; üçüncü grup Z=1.753; p=0.08; dördüncü grup Z=0.944; p=0.345). Sonuç: Çalışmamızda sonuçlar pnömonektominin α-ANH seviyesi değişimine yalnız başına etkisi olmadığını göstermektedir. Hipoksi, artmış atrial basınç ve bazı nörohormonal faktörler α-ANH salınımının artmasına yol açabilir.

Kaynakça

1. Needleman P, Greenwald JE. Atriopeptin: a cardiac hormone intimately involved in fluid, electrolyte, and blood-pressure homeostasis. N Engl J Med 1986;314:828–34.

2. Tota B, Cerra MC, Gattuso A. Catecholamines, cardiac natriuretic peptides and chromogranin A: evolution and physiopathology of a ‘whip-brake’ system of the endocrine heart. J Exp Biol 2010;213:3081–103.

3. Levin ER, Gardner DG, Samson WK. Natriuretic peptides. N Engl J Med 1998;339:321–8.

4. Flynn TG, de Bold ML, de Bold AJ. The amino acid sequence of an atrial peptide with potent diuretic and natriuretic properties. Biochem Biophys Res Commun 1983;117:859–65.

5. Cheung BM, Dickerson JE, Ashby MJ, Brown MJ, Brown J. Effects of physiological increments in human alpha-atrial natriuretic peptide and human brain natriuretic peptide in normal male subjects. Clin Sci (Lond) 1994;86:723–30.

6. Garcia R, Cantin M, Thibault G. Role of right and left atria in natriuresis and atrial natriuretic factor release during blood volume changes in the conscious rat. Circ Res 1987;61:99–106.

7. Lang RE, Thölken H, Ganten D, Luft FC, Ruskoaho H, Unger T. Atrial natriuretic factor--a circulating hormone stimulated by volume loading. Nature 1985;314:264–6.

8. Richards AM, Nicholls MG, Ikram H, Webster MW, Yandle TG, Espiner EA. Renal, haemodynamic, and hormonal effects of human alpha atrial natriuretic peptide in healthy volunteers. Lancet 1985;1:545–9.

9. Zeldin RA, Normandin D, Landtwing D, Peters RM. Postpneumonectomy pulmonary edema. J Thorac Cardiovasc Surg 1984;87:359–65.

10. Slinger PD. Perioperative fluid management for thoracic surgery: the puzzle of postpneumonectomy pulmonary edema. J Cardiothorac Vasc Anesth 1995;9:442–51.

11. Zarins CK, Rice CL, Peters RM, Virgilio RW. Lymph and pulmonary response to isobaric reduction in plasma oncotic pressure in baboons. Circ Res 1978;43:925–30.

12. Cope DK, Grimbert F, Downey JM, Taylor AE. Pulmonary capillary pressure: a review. Crit Care Med 1992;20:1043–56.

13. Tayama K, Mifune H, Takamori S, Ohtsuka S, Hayashi A, Tamura K, et al. Natriuretic peptides in the lung modulated by pneumonectomy. Ann Thorac Cardiovasc Surg 1998;4:325–31.

14. Schwab TR, Edwards BS, Heublein DM, Burnett JC Jr. Role of atrial natriuretic peptide in volume-expansion natriuresis. Am J Physiol 1986;251:R310–3.

15. Davis M, Espiner E, Richards G, Billings J, Town I, Neill A, et al. Plasma brain natriuretic peptide in assessment of acute dyspnoea. Lancet 1994;343:440–4.

16. Castro LC, Lam RW, Ross MG, Ervin MG, Leake RD, Hobel CJ, et al. Atrial natriuretic peptide in the sheep. J Dev Physiol 1988;10:235– 46.

17. Matsubara H, Nishikawa M, Umeda Y, Taniguchi T, Iwasaka T, Kurimoto T, et al. The role of atrial pressure in secreting atrial natriuretic polypeptides. Am Heart J 1987;113:1457–63.

18. Omari BO, Nelson RJ, Robertson JM. Effect of right atrial appendectomy on the release of atrial natriuretic hormone. J Thorac Cardiovasc Surg 1991;102:272–9.

19. Cody RJ, Atlas SA, Laragh JH, Kubo SH, Covit AB, Ryman KS, et al. Atrial natriuretic factor in normal subjects and heart failure patients. Plasma levels and renal, hormonal, and hemodynamic responses to peptide infusion. J Clin Invest 1986;78:1362–74.

20. Tayama K, Takamori S, Mitsuoka M, Hayashi A, Tamura K, Mifune H, et al. Natriuretic peptides after pulmonary resection. Ann Thorac Surg 2002;73:1582–6.

21. Tamura K, Takamori S, Mifune H, Hayashi A, Shirouzu K. Changes in atrial natriuretic peptide concentration and expression of its receptors after pneumonectomy in the rat. Clin Sci (Lond) 2000;99:343– 8.

22. Takamori S, Mifune H, Tayama K, Mitsuoka M, Tamura K, Terasaki Y, et al. An experimental study of atrial natriuretic peptide levels and the effect of inhaled nitric oxide after pneumonectomy. Surg Today 2000;30:360–3.

23. Chen YF. Atrial natriuretic peptide in hypoxia. Peptides 2005;26:1068–77.

24. Amano J, Suzuki A, Sunamori M, Shichiri M, Marumo F. Attenuation of atrial natriuretic peptide response to sodium loading after cardiac operation. J Thorac Cardiovasc Surg 1995;110:75–80.

25. Ledsome JR, Wilson N, Courneya CA, Rankin AJ. Release of atrial natriuretic peptide by atrial distension. Can J Physiol Pharmacol 1985;63:739–42.

26. Ahn YM, Choi YH, Yoon JJ, Lee YJ, Cho KW, Kang DG, et al. Oleanolic acid modulates the renin-angiotensin system and cardiac natriuretic hormone concomitantly with volume and pressure balance in rats. Eur J Pharmacol 2017;809:231–41.

Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1b367

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