Natriuretic peptides and therapeutic applications

Candace Y W Lee, John C Jr. Burnett

Research output: Contribution to journalArticle

130 Citations (Scopus)

Abstract

Since the discovery of atrial natriuretic factor by de Bold et al., there has been tremendous progress in our understanding of the physiologic, diagnostic and therapeutic roles of the natriuretic peptides (NPs) in health and disease. Natriuretic peptides are endogenous hormones that are released by the heart in response to myocardial stretch and overload. Three mammalian NPs have been identified and characterized, including atrial natriuretic peptide (ANP or atrial natriuretic factor), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). In addition, Dendroaspisnatriuretic peptide (DNP) has been isolated from the venom of Dendroaspis angusticeps (the green mamba snake), and urodilatin from human urine. These peptides are structurally similar and they consist of a 17-amino-acid core ring and a cysteine bridge. Both ANP and BNP bind to natriuretic peptide receptor A (NPR-A) that are expressed in the heart and other organs. Activation of NPR-A generates an increase in cyclic guanosine monophosphate, which mediates natriuresis, inhibition of renin and aldosterone, as well as vasorelaxant, anti-fibrotic, anti-hypertrophic, and lusitropic effects. The NP system thus serves as an important compensatory mechanism against neurohumoral activation in heart failure. This provides a strong rationale for the use of exogenous NPs in the management of acutely decompensated heart failure. In this article, the therapeutic applications of NPs in the acute heart failure syndromes are reviewed. Emerging therapeutic agents and areas for future research are discussed.

Original languageEnglish (US)
Pages (from-to)131-142
Number of pages12
JournalHeart Failure Reviews
Volume12
Issue number2
DOIs
StatePublished - Jun 2007

Fingerprint

Natriuretic Peptides
Atrial Natriuretic Factor
Elapidae
Heart Failure
Brain Natriuretic Peptide
Therapeutics
C-Type Natriuretic Peptide
Natriuresis
Peptides
Snakes
Cyclic GMP
Venoms
Aldosterone
Vasodilator Agents
Renin
Cysteine
Urine
Amino Acids
Health

Keywords

  • Acute heart failure
  • cGMP
  • Heart
  • Kidney
  • Natriuretic peptides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Natriuretic peptides and therapeutic applications. / Lee, Candace Y W; Burnett, John C Jr.

In: Heart Failure Reviews, Vol. 12, No. 2, 06.2007, p. 131-142.

Research output: Contribution to journalArticle

Lee, Candace Y W ; Burnett, John C Jr. / Natriuretic peptides and therapeutic applications. In: Heart Failure Reviews. 2007 ; Vol. 12, No. 2. pp. 131-142.
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