Atrial natriuretic peptides in heart failure: pathophysiological significance, diagnostic and prognostic value

作者：Ghosh Nina; Haddad Haissam^*

来源：Canadian Journal of Physiology and Pharmacology, 2011, 89(8): 587-591.

DOI：10.1139/Y11-040

• heart failure
• sympathetic nervous system
• renin-angiotensin-aldosterone system
• atrial natriuretic peptide
• brain natriuretic peptide

Neurohormonal activation in patients with heart failure is dominated by the deleterious long-term effects of activation of the sympathetic nervous system and the renin angiotensin aldosterone system. The natriuretic peptides, including brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP), are also upregulated in heart failure, and partially counteract these deleterious effects by promoting vasodilation, natriuresis, and diuresis. Although BNP has been established as an important biomarker in the diagnosis and prognosis of heart failure, growing evidence suggests that measurement of plasma ANP, specifically its metabolite mid-regional pro-ANP, has similar diagnostic and prognostic value. Furthermore, its measurement may provide incremental diagnostic value when BNP levels fall into "grey zone" levels and may be a more potent prognostic marker of mortality.

• 出版日期2011-8