Natriuretic peptides

Abstract

The cardiac natriuretic peptides (cNPs) ANF and BNP mediate the endocrine function of the heart. From the hemodynamic point of view the endocrine heart serves to regulate cardiac preload and afterload through to its influence in the regulation of extracellular fluid. However, many other targets have been characterized that are not primarily related to hemodynamics. In addition to their various roles in the physiological state, cNPs serve as useful biomarkers of cardiac disease and as therapeutic agents. cNPs are coordinately regulated in cardiovascular diseases such as congestive heart failure but are differently regulated in disorders having a significant inflammatory component such as in acute cardiac allograft rejection, sepsis and autoimmune myocarditis. BNP plasma levels are more influenced by inflammation compared to ANF. Because inflammation and hemodynamic changes coexist in many cardiovascular disorders the measurement of both ANF and BNP in individual patients may be advisable.