The cardiac natriuretic peptides, ANP (atrial natriuretic peptide) and BNP (brain natriuretic peptide), are secreted by the heart in proportion to cardiac transmural pressures. They possess a wide range of effects in multiple tissues facilitating overall pressure/volume homoeostasis. The close relationship between plasma concentrations of these peptides and ‘cardiac load’ has led to their use as biomarkers of cardiac health with diagnostic and prognostic applications in a variety of disorders affecting the cardiovascular system. BNP and its N-terminal fragment (NT-BNP) are especially sensitive indicators of cardiac dysfunction and remodelling, and correlate strongly with severity. Given that cardiac ischaemia is also an important trigger for the release of these ventricular peptides, they may likewise play a role in the detection of coronary artery disease. Measurement of BNP/NT-BNP shows particular promise as a ‘rule out’ test for suspected cases of HF (heart failure) in both emergency care and outpatient settings, and may assist in identifying individuals with asymptomatic ventricular impairment who will benefit from therapy preventing progression to overt HF. The BNP peptides also predict subsequent haemodynamic deterioration and adverse events in cardiovascular disease, and can therefore be used to monitor those at high risk and act as a guide to optimization of treatment. The favourable biological properties of the natriuretic peptides have also led to their use as therapeutic agents.
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January 2005
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Review Article|
December 15 2004
Cardiac natriuretic peptides for cardiac health
Miriam T. RADEMAKER;
1Christchurch Cardioendocrine Research Group, Department of Medicine, The Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
Correspondence: Dr Miriam T. Rademaker (email [email protected]).
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A. Mark RICHARDS
A. Mark RICHARDS
1Christchurch Cardioendocrine Research Group, Department of Medicine, The Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand
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Publisher: Portland Press Ltd
Received:
August 26 2004
Revision Received:
October 07 2004
Accepted:
October 12 2004
Accepted Manuscript online:
October 12 2004
Online ISSN: 1470-8736
Print ISSN: 0143-5221
The Biochemical Society
2005
Clin Sci (Lond) (2005) 108 (1): 23–36.
Article history
Received:
August 26 2004
Revision Received:
October 07 2004
Accepted:
October 12 2004
Accepted Manuscript online:
October 12 2004
Citation
Miriam T. RADEMAKER, A. Mark RICHARDS; Cardiac natriuretic peptides for cardiac health. Clin Sci (Lond) 1 January 2005; 108 (1): 23–36. doi: https://doi.org/10.1042/CS20040253
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