Atrial natriuretic peptide in heart failure

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

Atrial natriuretic peptide is a peptide hormone of cardiac origin, which is released in response to atrial distension and serves to maintain sodium homeostasis and inhibit activation of the reninangiotensin-aldosterone system. Congestive heart failure is a clinical syndrome characterized by increased cardiac volume and pressure overload with an inability to excrete a sodium load, which is associated with increased activity of systemic neurohumoral and local autocrine and paracrine mechanisms. Circulating atrial natriuretic peptide is greatly increased in congestive heart failure as a result of increased synthesis and release of this hormone. Atrial natriuretic peptide has emerged as an important diagnostic and prognostic serum marker in congestive heart failure. In early heart failure, it may play a key role in preserving the compensated state of asymptomatic left ventricular dysfunction. Despite increased circulating atrial natriuretic peptide in heart failure, the kidney retains sodium and is hyporesponsive to exogenous and endogenous atrial natriuretic peptide. The mechanism for the attenuated renal response is multifactorial and includes renal hypoperfusion, activation of the renin-angiotensin-aldosterone and sympathetic nervous systems. Therapeutic strategies to potentiate the biologic actions of atrial natriuretic peptide may prolong the asymptomatic phase and delay progression to overt congestive heart failure.

Original languageEnglish (US)
JournalJournal of the American College of Cardiology
Volume22
Issue number4 SUPPL. 1
DOIs
StatePublished - 1993

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Atrial Natriuretic Factor
Heart Failure
Sodium
Aldosterone
Kidney
Asymptomatic Diseases
Cardiac Volume
Peptide Hormones
Sympathetic Nervous System
Angiotensins
Left Ventricular Dysfunction
Renin
Homeostasis
Biomarkers
Hormones
Pressure

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Atrial natriuretic peptide in heart failure. / Brandt, Roland R.; Wright, R. Scott; Redfield, Margaret May; Burnett, John C Jr.

In: Journal of the American College of Cardiology, Vol. 22, No. 4 SUPPL. 1, 1993.

Research output: Contribution to journalArticle

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