Document Detail


Natriuretic peptide system: physiology and clinical utility.
MedLine Citation:
PMID:  15385748     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This review discusses the physiology of natriuretic peptides as a group and brain natriuretic peptide (BNP) in more detail. It will also highlight implications for the use of the natriuretic peptides in the diagnosis and treatment of patients with cardiovascular disease. RECENT FINDINGS: The heart secretes two major natriuretic peptides: atrial natriuretic peptide (ANP), which is synthesized in the atrial myocardium, and BNP, which is synthesized in the ventricular myocardium. Both ANP and BNP are released in response to atrial and ventricular stretch, respectively, and will cause balanced vasodilation, natriuresis, and inhibition of the sympathetic nervous system and the renin-angiotensin-aldosterone axis. BNP is reported to be the biochemical marker of choice for evaluating the acute risk of patients with cardiovascular disease states ranging from heart failure to myocardial ischemia. Increased blood BNP concentrations are highly predictive of the short- and long-term risk of cardiac death across the entire spectrum of acute coronary syndromes and in patients with decompensated congestive heart failure. Synthetic recombinant human BNP, which mimics the actions of endogenous BNP, has emerged as an important new therapeutic agent in patients with acute heart failure. SUMMARY: Current data suggest that single and serial plasma measurement of BNP concentrations is a useful tool in the diagnosis and risk stratification of patients with heart disease. Nesiritide, the human recombinant form of BNP, is a new promising parenteral treatment in decompensated heart failure.
Authors:
Stefan W Suttner; Joachim Boldt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in critical care     Volume:  10     ISSN:  1070-5295     ISO Abbreviation:  Curr Opin Crit Care     Publication Date:  2004 Oct 
Date Detail:
Created Date:  2004-09-23     Completed Date:  2005-01-28     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9504454     Medline TA:  Curr Opin Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  336-41     Citation Subset:  IM    
Copyright Information:
Copyright 2004 Lippincott Williams & Wilkins
Affiliation:
Department of Anesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Akademisches Lehrkrankenhaus der Universität Mainz, Ludwigshafen, Germany. suttner@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Amino Acid Sequence
Atrial Natriuretic Factor / metabolism
Biological Markers
Cardiovascular Diseases / diagnosis,  drug therapy
Humans
Molecular Sequence Data
Natriuretic Peptide, Brain / metabolism
Natriuretic Peptides / diagnostic use,  metabolism*,  therapeutic use
Prognosis
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Natriuretic Peptides; 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

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