Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage
Subarachnoid haemorrhage is commonly associated with natriuresis and hyponatraemia. One possible explanation for these features is a defect in the central regulation of renal sodium reabsorption with increased secretion of a natriuretic factor. We investigated whether excess sodium secretion in pati...
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| Veröffentlicht in: | The Lancet (British edition) 1997-01, Vol.349 (9047), p.245-249 |
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| creator | Berendes, Elmar Walter, Michael Cullen, Paul Prien, Thomas Aken, Hugo Van Horsthemke, Jürgen Schulte, Manfred von Wild, Klaus Scherer, Ralf |
| description | Subarachnoid haemorrhage is commonly associated with natriuresis and hyponatraemia. One possible explanation for these features is a defect in the central regulation of renal sodium reabsorption with increased secretion of a natriuretic factor. We investigated whether excess sodium secretion in patients with subarachnoid haemorrhage is related to increased secretion of natriuretic peptides or to the presence of digoxin-like immunoreactive substances.
We measured the plasma concentrations of digoxin-like immunoreactive substances (by a fluorescence polarisation immunoassay) and natriuretic peptides, aldosterone, renin, and antidiuretic hormone (by radioimmunoassay) in ten patients with aneurysmal subarachnoid haemorrhage, ten patients undergoing elective craniotomy for cerebral tumours, and 40 healthy controls of similar age and sex distribution. Samples were collected before surgery, 1 h, 4 h, and 12 h after surgery, then daily until 7 days postoperatively in the two groups of patients.
All patients with subarachnoid haemorrhage, but none of the tumour patients, showed increased urine output and urinary excretion of sodium (p=0·018 for comparison of means of curves to 7 days). The patients with subarachnoid haemorrhage had much higher plasma concentrations of brain natriuretic peptide (BNP) than controls, on admission (mean 15·1 [SE 3·8] vs 1·6 [1·0] pmol/L, p |
| doi_str_mv | 10.1016/S0140-6736(96)08093-2 |
| format | Article |
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We measured the plasma concentrations of digoxin-like immunoreactive substances (by a fluorescence polarisation immunoassay) and natriuretic peptides, aldosterone, renin, and antidiuretic hormone (by radioimmunoassay) in ten patients with aneurysmal subarachnoid haemorrhage, ten patients undergoing elective craniotomy for cerebral tumours, and 40 healthy controls of similar age and sex distribution. Samples were collected before surgery, 1 h, 4 h, and 12 h after surgery, then daily until 7 days postoperatively in the two groups of patients.
All patients with subarachnoid haemorrhage, but none of the tumour patients, showed increased urine output and urinary excretion of sodium (p=0·018 for comparison of means of curves to 7 days). The patients with subarachnoid haemorrhage had much higher plasma concentrations of brain natriuretic peptide (BNP) than controls, on admission (mean 15·1 [SE 3·8] vs 1·6 [1·0] pmol/L, p<0·001) and throughout the study period, accompanied by lower than normal aldosterone concentrations and normal plasma concentrations of atrial and C-type natriuretic peptides (ANP, CNP). The patients with tumours had similar plasma concentrations of ANP, BNP, and CNP to the controls. We did not detect digoxin-like immunoreactive substances in either group of patients.
Salt-wasting of central origin may induce hyponatraemia in patients with aneurysmal subarachnoid haemorrhage, possibly as a result of increased secretion of BNP with subsequent suppression of aldosterone synthesis.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(96)08093-2</identifier><identifier>PMID: 9014912</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Biological and medical sciences ; Brain ; Brain Neoplasms - metabolism ; Brain Neoplasms - surgery ; Cardenolides ; Digoxin ; Enzyme Inhibitors - blood ; Female ; Fluorescence Polarization Immunoassay ; Hemorrhage ; Humans ; Hyponatremia - etiology ; Intracranial Aneurysm - metabolism ; Male ; Medical research ; Medical sciences ; Middle Aged ; Natriuretic Agents - blood ; Natriuretic Peptide, Brain ; Nerve Tissue Proteins - metabolism ; Neurology ; Peptides ; Saponins - blood ; Sodium ; Sodium - metabolism ; Sodium-Potassium-Exchanging ATPase - antagonists & inhibitors ; Subarachnoid Hemorrhage - metabolism ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>The Lancet (British edition), 1997-01, Vol.349 (9047), p.245-249</ispartof><rights>1997 Elsevier Ltd</rights><rights>1997 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Jan 25, 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c468t-2e022cef85ed7125eb055abbe3f9cceea50f87635b7e06c33c2718b670aa5f693</citedby><cites>FETCH-LOGICAL-c468t-2e022cef85ed7125eb055abbe3f9cceea50f87635b7e06c33c2718b670aa5f693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/198988187?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,64361,64363,64365,65309,72215</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2555906$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9014912$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Berendes, Elmar</creatorcontrib><creatorcontrib>Walter, Michael</creatorcontrib><creatorcontrib>Cullen, Paul</creatorcontrib><creatorcontrib>Prien, Thomas</creatorcontrib><creatorcontrib>Aken, Hugo Van</creatorcontrib><creatorcontrib>Horsthemke, Jürgen</creatorcontrib><creatorcontrib>Schulte, Manfred</creatorcontrib><creatorcontrib>von Wild, Klaus</creatorcontrib><creatorcontrib>Scherer, Ralf</creatorcontrib><title>Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Subarachnoid haemorrhage is commonly associated with natriuresis and hyponatraemia. One possible explanation for these features is a defect in the central regulation of renal sodium reabsorption with increased secretion of a natriuretic factor. We investigated whether excess sodium secretion in patients with subarachnoid haemorrhage is related to increased secretion of natriuretic peptides or to the presence of digoxin-like immunoreactive substances.
We measured the plasma concentrations of digoxin-like immunoreactive substances (by a fluorescence polarisation immunoassay) and natriuretic peptides, aldosterone, renin, and antidiuretic hormone (by radioimmunoassay) in ten patients with aneurysmal subarachnoid haemorrhage, ten patients undergoing elective craniotomy for cerebral tumours, and 40 healthy controls of similar age and sex distribution. Samples were collected before surgery, 1 h, 4 h, and 12 h after surgery, then daily until 7 days postoperatively in the two groups of patients.
All patients with subarachnoid haemorrhage, but none of the tumour patients, showed increased urine output and urinary excretion of sodium (p=0·018 for comparison of means of curves to 7 days). The patients with subarachnoid haemorrhage had much higher plasma concentrations of brain natriuretic peptide (BNP) than controls, on admission (mean 15·1 [SE 3·8] vs 1·6 [1·0] pmol/L, p<0·001) and throughout the study period, accompanied by lower than normal aldosterone concentrations and normal plasma concentrations of atrial and C-type natriuretic peptides (ANP, CNP). The patients with tumours had similar plasma concentrations of ANP, BNP, and CNP to the controls. We did not detect digoxin-like immunoreactive substances in either group of patients.
Salt-wasting of central origin may induce hyponatraemia in patients with aneurysmal subarachnoid haemorrhage, possibly as a result of increased secretion of BNP with subsequent suppression of aldosterone synthesis.</description><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Brain Neoplasms - metabolism</subject><subject>Brain Neoplasms - surgery</subject><subject>Cardenolides</subject><subject>Digoxin</subject><subject>Enzyme Inhibitors - blood</subject><subject>Female</subject><subject>Fluorescence Polarization Immunoassay</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Hyponatremia - etiology</subject><subject>Intracranial Aneurysm - metabolism</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Natriuretic Agents - blood</subject><subject>Natriuretic Peptide, Brain</subject><subject>Nerve Tissue Proteins - 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edition)</jtitle><addtitle>Lancet</addtitle><date>1997-01-25</date><risdate>1997</risdate><volume>349</volume><issue>9047</issue><spage>245</spage><epage>249</epage><pages>245-249</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Subarachnoid haemorrhage is commonly associated with natriuresis and hyponatraemia. One possible explanation for these features is a defect in the central regulation of renal sodium reabsorption with increased secretion of a natriuretic factor. We investigated whether excess sodium secretion in patients with subarachnoid haemorrhage is related to increased secretion of natriuretic peptides or to the presence of digoxin-like immunoreactive substances.
We measured the plasma concentrations of digoxin-like immunoreactive substances (by a fluorescence polarisation immunoassay) and natriuretic peptides, aldosterone, renin, and antidiuretic hormone (by radioimmunoassay) in ten patients with aneurysmal subarachnoid haemorrhage, ten patients undergoing elective craniotomy for cerebral tumours, and 40 healthy controls of similar age and sex distribution. Samples were collected before surgery, 1 h, 4 h, and 12 h after surgery, then daily until 7 days postoperatively in the two groups of patients.
All patients with subarachnoid haemorrhage, but none of the tumour patients, showed increased urine output and urinary excretion of sodium (p=0·018 for comparison of means of curves to 7 days). The patients with subarachnoid haemorrhage had much higher plasma concentrations of brain natriuretic peptide (BNP) than controls, on admission (mean 15·1 [SE 3·8] vs 1·6 [1·0] pmol/L, p<0·001) and throughout the study period, accompanied by lower than normal aldosterone concentrations and normal plasma concentrations of atrial and C-type natriuretic peptides (ANP, CNP). The patients with tumours had similar plasma concentrations of ANP, BNP, and CNP to the controls. We did not detect digoxin-like immunoreactive substances in either group of patients.
Salt-wasting of central origin may induce hyponatraemia in patients with aneurysmal subarachnoid haemorrhage, possibly as a result of increased secretion of BNP with subsequent suppression of aldosterone synthesis.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>9014912</pmid><doi>10.1016/S0140-6736(96)08093-2</doi><tpages>5</tpages></addata></record> |
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| subjects | Biological and medical sciences Brain Brain Neoplasms - metabolism Brain Neoplasms - surgery Cardenolides Digoxin Enzyme Inhibitors - blood Female Fluorescence Polarization Immunoassay Hemorrhage Humans Hyponatremia - etiology Intracranial Aneurysm - metabolism Male Medical research Medical sciences Middle Aged Natriuretic Agents - blood Natriuretic Peptide, Brain Nerve Tissue Proteins - metabolism Neurology Peptides Saponins - blood Sodium Sodium - metabolism Sodium-Potassium-Exchanging ATPase - antagonists & inhibitors Subarachnoid Hemorrhage - metabolism Vascular diseases and vascular malformations of the nervous system |
| title | Secretion of brain natriuretic peptide in patients with aneurysmal subarachnoid haemorrhage |
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