Biology And Physiology Of Natriuretic Peptides

In addition to being an extremely effective pump, the human heart is an important endocrine organ that functions together with other physiological systems to control fluid homeo-

2000 Year

Fig. 2. Prevalence of heart failure (HF) in United States. *Expected increase. (Data from refs. 5,6.)

2000 Year

Fig. 2. Prevalence of heart failure (HF) in United States. *Expected increase. (Data from refs. 5,6.)

Antiproliferative

Fig. 3. Actions of natriuretic peptide system. ET, endothelin; CNP, C-type natriuretic peptide. (Reproduced from ref. 65, with permission.)

Antiproliferative

Fig. 3. Actions of natriuretic peptide system. ET, endothelin; CNP, C-type natriuretic peptide. (Reproduced from ref. 65, with permission.)

stasis. Cells of the heart synthesize a family of structurally related peptide hormones, collectively termed the natriuretic peptides, that include atrial natriuretic peptide (ANP) and brain or BNP. The biology of this family of proteins is described in detail in Chapter 21. The natriuretic peptides are released in response to wall stretch, ventricular dilation, and/or increased pressures, all resulting from fluid overload (8), and exert powerful diuretic, natriuretic, and vascular smooth muscle relaxing actions (Fig. 3). These hormones are also natural antagonists for the sympathetic nervous system and the renin-angiotensin-

aldosterone axis (8-10). The main physiological role ofthe natriuretic peptides is to protect the cardiovascular and other systems from the effects of volume overload.

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