We examined the effect of atrial natriuretic peptide on cerebral edema in 96 rats. Forty-four rats were given 30 (TI=11), 120 (TI=26), or 150 (n=7) ftg/kg of the peptide intravenously over 24 hours after occlusion of the left middle cerebral artery to induce cerebral ischemia. We then measured the brain water content, the brain sodium and potassium contents, the in vitro proton nuclear magnetic resonance longitudinal (T,) and transverse (T 2 ) relaxation times, and the area of the edematous regions. Compared with saline treatment (n =39), peptide treatment decreased the brain water content in a dose-dependent manner and decreased the brain sodium content significantly (p<0.05). Peptide treatment also suppressed the lengthening of both T, and T 2 in edematous tissue (p<0.05 and p<0.01, respectively) and reduced the area of the edematous regions observed by magnetic resonance imaging (p<0.01). Atrial natriuretic peptide appears to have a pharmacological effect on ischemic brain edema, possibly by suppressing the elevation of water content through regulation of electrolyte transport in the brain. (Stroke 1991;22:61-65) S ince its initial discovery as a substance with a diuretic effect, 1 atrial natriuretic peptide (ANP) has been shown to be a unique hormone that regulates blood pressure and fluid homeostasis.2 -5 Recent studies have shown that this hormone regulates sodium transport in vascular endothelial 6 -7 and other 89 cells through activation of guanylate cyclase, suggesting that ANP may regulate water content in tissue.Binding sites for ANP have been found on brain microvessel endothelial cells 10 and astrocytes, 11 and elevated levels of guanosine 3',5'-cyclic monophosphate (cGMP) have been noted in these cells following ANP binding. In view of the known role of these cells in the origin and development of brain edema,
12-13 we inferred that ANP may have a pharmacological effect on brain edema. To investigate this hypothesis, we monitored changes in brain water, sodium, and potassium contents; changes in proton nuclear magnetic resonance (NMR) relaxation times From the Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.Supported in part by grants-in-aid for scientific research 01570817 and 02670636 from the Ministry of Education, Science, and Culture of Japan.Address for reprints: Shoji Naruse, MD, Department of Neurosurgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602, Japan.Received November 16, 1989; accepted August 29, 1990. in vitro; and changes in the area of edematous regions detected by in vivo magnetic resonance imaging (MRI) to examine the effects of ANP on ischemic brain edema induced in rats.
Materials and MethodsWe used 96 male Wistar rats aged 8-11 weeks. Ninety-one rats were anesthetized with 50 mg/kg i.p. sodium pentobarbital. In eight sham-operated rats, the dura mater and arachnoid membrane were opened without middle cerebral artery (MCA) occlusion. In the other 83 rats, the main trunk of the left MCA was occluded...