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Natriuretic peptides in the pathophysiology of congestive heart failure

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Abstract

A hallmark of congestive heart failure (CHF) is the activation of the cardiac endocrine system, in particular atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP). The natriuretic peptides are a group of structurally similar but genetically distinct peptides that have diverse actions in cardiovascular, renal, and endocrine homeostasis. ANP and BNP are of myocardial cell origin and C-type natriuretic peptide (CNP) is of endothelial origin. ANP and BNP bind to the natriuretic peptide-A receptor (NPR-A), which, via 3',5'-cyclic guanosine monophosphate (cGMP), mediates natriuresis, vasodilatation, renin inhibition, antimitogenesis, and lusitropic properties. CNP lacks natriuretic actions but possesses vasodilating and growth inhibiting actions via the guanylyl cyclase-linked natriuretic peptide-B receptor. All three peptides are cleared by the natriuretic peptide-C receptor and degraded by the ectoenzyme neutral endopeptidase 24.11, both of which are widely expressed in kidney, lung, and vascular wall. Recently, a fourth member of the natriuretic peptide, Dendroaspis natriuretic peptide (DNP) has been reported to be present in human plasma and atrial myocardium and is elevated in plasma of human CHF.

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  1. Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Guggenheim 9, 200 First Street SW, 55905, Rochester, MN, USA

    Horng H. Chen MB, BCh & John C. Burnett Jr. MD

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  1. Horng H. Chen MB, BCh
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  2. John C. Burnett Jr. MD
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Chen, H.H., Burnett, J.C. Natriuretic peptides in the pathophysiology of congestive heart failure. Curr Cardiol Rep 2, 198–205 (2000). https://doi.org/10.1007/s11886-000-0069-3

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