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The natriuretic peptide system in heart failure: Diagnostic and therapeutic implications
- Source :
- Pharmacology & Therapeutics. 227:107863
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Natriuretic peptides, which are activated in heart failure, play an important cardioprotective role. The most notable of the cardioprotective natriuretic peptides are atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP), which are abundantly expressed and secreted in the atrium and ventricles, respectively, and C-type natriuretic peptide (CNP), which is expressed mainly in the vasculature, central nervous system, and bone. ANP and BNP exhibit antagonistic effects against angiotensin II via diuretic/natriuretic actions, vasodilatory actions, and inhibition of aldosterone secretion, whereas CNP is involved in the regulation of vascular tone and blood pressure, among other roles. ANP and BNP are of particular interest with respect to heart failure, as their levels, most notably BNP and N-terminal proBNP-a cleavage product produced when proBNP is processed to mature BNP-are increased in patients with heart failure. Furthermore, the identification of natriuretic peptides as sensitive markers of cardiac load has driven significant research into their physiological roles in cardiovascular homeostasis and disease, as well as their potential use as both biomarkers and therapeutics. In this review, I discuss the physiological functions of the natriuretic peptide family, with a particular focus on the basic research that has led to our current understanding of its roles in maintaining cardiovascular homeostasis, and the pathophysiological implications for the onset and progression of heart failure. The clinical significance and potential of natriuretic peptides as diagnostic and/or therapeutic agents are also discussed.
- Subjects :
- Cardiotonic Agents
medicine.drug_class
Pharmacology
chemistry.chemical_compound
Atrial natriuretic peptide
Renin–angiotensin system
medicine
Natriuretic peptide
Humans
Pharmacology (medical)
cardiovascular diseases
Natriuretic Peptides
Heart Failure
Aldosterone
business.industry
medicine.disease
Brain natriuretic peptide
Angiotensin II
Blood pressure
chemistry
Heart failure
cardiovascular system
business
Biomarkers
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- ISSN :
- 01637258
- Volume :
- 227
- Database :
- OpenAIRE
- Journal :
- Pharmacology & Therapeutics
- Accession number :
- edsair.doi.dedup.....bc41fa35e255e212f188b79698611d9b