Molecular forms of natriuretic peptides in heart failure and their implications

Xu-Cai, Ye Olivia; Wu, Qingyu

doi:10.1136/hrt.2008.164145

Cited by 45 publications

(37 citation statements)

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“…In addition, cross-reactivity with pro-BNP, the precursor form with six-to eightfold lower biological activity, and glycosylated forms of BNP has been demonstrated (13). This is of particular importance as patients with heart failure have evidence of increased levels of circulating pro-hormone (14,15). Further studies are needed to address this subject.…”

Section: Discussionmentioning

confidence: 99%

Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

et al. 2012

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Background: N-terminal pro-B-type natriuretic peptide (ntproBNP) is an established marker of heart failure in adult cardiology. We analyzed nt-proBNP in the circulation of fetuses with increased volume load secondary to anemia and investigated the effect of treatment on nt-proBNP concentration. Methods: Fetuses undergoing intrauterine transfusion (IUT) were examined. nt-proBNP was measured before IUT and correlated with hemoglobin concentrations, ultrasonographic findings, and Doppler measurements of the peak systolic velocity of the middle cerebral artery (Mca-PsV). Results: a total of 27 patients (7 with hydrops) and 78 controls were examined. nt-proBNP was markedly elevated in anemia (P < 0.001). concentrations were highest in hydropic fetuses (P < 0.03); no differences were present in hemoglobin and Mca-PsV values between hydropic and nonhydropic cases. In fetuses undergoing multiple IUTs nt-proBNP normalized after the third IUT, whereas hemoglobin and Mca-PsV remained abnormal. Conclusion: Levels of circulating nt-proBNP correlate well with the degree of myocardial workload in the hyperdynamic state of fetal anemia. We hypothesize that normalization of nt-proBNP after serial transfusions is an indicator of myocardial adjustment to chronic anemia. nt-proBNP measurement may be useful in the management of fetal anemia, particularly in cases at risk of hydrops and fetuses requiring multiple transfusions.

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Section: Discussionmentioning

confidence: 99%

Circulating N-terminal pro-B-type natriuretic peptide in fetal anemia before and after treatment

et al. 2012

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“…For example, in the early phase of ACS, and in human cardiac allograft acute rejection, BNP gene expression increases considerably, whereas ANP concentrations increase only slightly (25 ). In contrast, in cardiac hypertrophy, plasma ANP concentrations increase as atrial pressure increases, whereas BNP plasma concentrations increase when ventricular hypertrophy develops.…”

Section: Pathophysiological Implicationsmentioning

confidence: 94%

Prognostic Value of Midregional Pro–A-Type Natriuretic Peptide and N-Terminal Pro–B-Type Natriuretic Peptide in Patients with Stable Coronary Heart Disease Followed over 8 Years

et al. 2014

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BACKGROUND:Pathophysiological studies suggest that A-type natriuretic peptides (ANPs) might provide valuable information beyond B-type natriuretic peptides (BNPs) about cardiac dysfunction in patients with coronary heart disease (CHD). We aimed to assess the predictive value of midregional pro-A-type natriuretic peptide (MR-proANP) for recurrent cardiovascular disease (CVD) events in stable CHD patients for whom information on N-terminal proBNP (NTproBNP) was already available.

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“…It is now increasingly accepted that the key reason for this discrepancy is because of variable activation/processing of natriuretic peptides, resulting in much greater proportion of the peptides circulating as prohormones. 1 This finding in turn has stimulated closer evaluation of the enzymes and mechanisms responsible for natriuretic peptide activation.…”

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confidence: 99%

“…Despite stimulation of the same receptor, the physiological effects of ANP and BNP are somewhat different: ANP predominantly regulates sodiumwater homeostasis and blood pressure, whereas BNP has more antihypertrophic effects, although there is substantial overlap. 1 In theory, increases in generation of ANP and BNP in response to myocardial stretch should occur as part of compensatory mechanism(s) to restore homeostatic balance. However, the lusitropic, antihypertrophic, and natriuretic effects of ANP and BNP are significantly attenuated in congestive heart failure despite a considerable apparent increase in plasma concentrations.…”

mentioning

confidence: 99%

“…Both ANP and BNP are produced and stored as prohormones and are present in the circulation as a mixture of propeptide and active 28-and 32-amino acid, carboxyl-terminal peptide hormones, respectively. 1 Both ANP and BNP bind to the natriuretic peptide receptor-A, which is coupled to particulate guanylate cyclase to generate cGMP, the primary second messenger mediating downstream signaling cascades in target tissues. Despite stimulation of the same receptor, the physiological effects of ANP and BNP are somewhat different: ANP predominantly regulates sodiumwater homeostasis and blood pressure, whereas BNP has more antihypertrophic effects, although there is substantial overlap.…”

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confidence: 99%

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