TY - T1的利钠肽测量part of the diagnostic work-up in pleural effusions: an emerging concept? JF - European Respiratory Journal JO - Eur Respir J SP - 7 LP - 9 DO - 10.1183/09031936.06.00056306 VL - 28 IS - 1 AU - Mueller, T. AU - Haltmayer, M. Y1 - 2006/07/01 UR - //www.qdcxjkg.com/content/28/1/7.abstract N2 - In the 1950s and 60s, the possible role of the heart in the control of renal excretion of salt and water, and thereby of the extra cellular fluid volume, as well as the presence of specific granules within atrial muscle cells was recognised 1,2. Nevertheless, little attention was paid to the possibility of the existence of an endocrine cardiac natriuretic hormone system until the landmark experiments in the late 1970s by de Bold et al. 3, which led to the discovery of atrial natriuretic peptide (A-type natriuretic peptide; ANP) having potent natriuretic, diuretic and vasodilatator actions. This initiated intense research characterising a family of structurally similar but genetically distinct natriuretic peptides, including B-type natriuretic peptide (BNP, formerly named brain natriuretic peptide), C-type natriuretic peptide (CNP), dendroaspis natriuretic peptide and urodilatin. ANP and BNP are synthesised by cardiac myocytes (so-called cardiac natriuretic peptides). It is now generally accepted that their release into the blood is increased by factors that raise intra-cardiac pressure and volume overload 4. Unlike ANP, the primary source of BNP is considered to be the cardiac ventricles. Other natriuretic peptides, such as CNP and urodilatin, are not secreted by cardiomyocytes but by other tissues. Cardiac natriuretic peptides are derived from pre-prohormones 4. In particular, BNP is derived from the precursor pre-proBNP, which contains 134 amino acids including a signal peptide of 26 amino acids. The prohormone containing 108 amino acids (proBNP), produced by cleavage of the signal peptide, is further split into BNP, which is considered to be the biologically active hormone, and an inactive amino terminal fragment (NT-proBNP). BNP and NT-proBNP are secreted on an equimolar basis, but their molar ratio in plasma is not 1:1 because BNP has a shorter plasma half-life than NT-proBNP. As indicated, the natriuretic peptide hormones … ER -