Defective Regulation and Action of Atrial Natriuretic Peptide in Type 2 Diabetes

Nannipieri, Monica; Seghieri, Giuseppe; Catalano, Carlo; Prontera, Tina; Baldi, Simona; Ferrannini, Eleuterio

doi:10.1055/s-2002-32141

Cited by 31 publications

(21 citation statements)

References 27 publications

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“…2,25 Increased RWT was present when this ratio exceeded 0.43, which represents the 97.5th percentile in previously described normal subjects. 26 Normal geometry was present when LV mass/BSA and RWT were normal, whereas normal LV mass/BSA and increased RWT was classified as concentric remodeling. Increased LV mass/BSA but normal RWT identified eccentric LV hypertrophy, whereas increases in both variables identified concentric LV hypertrophy.…”

Section: Echocardiographymentioning

confidence: 99%

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

et al. 2005

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Abstract-We wanted to investigate the relationship of N-terminal pro brain natriuretic peptide (Nt-proBNP) The metabolic syndrome was associated with lower Nt-proBNP (35 pg/mL versus 48 pg/mL; PϽ0.001) and shifted the positive relationship between pulse pressure and Nt-proBNP to the right (ie, higher blood pressure for a given level of Nt-proBNP). The metabolic syndrome was associated with lower Nt-proBNP levels and shifted the positive relationship between Nt-proBNP and pulse pressure to the right, creating a possible link between the metabolic syndrome and hypertension. Key Words: risk factors Ⅲ albuminuria Ⅲ hypertrophy Ⅲ natriuretic peptides Ⅲ obesity B rain natriuretic peptide (BNP) is synthesized in myocardial cells as a response to increased wall stress 1 in relation to heart failure 2 or acute myocardial ischemia 3 as a prohormone that is cleaved into BNP and N-terminal proBNP (Nt-proBNP). High BNP as well as high NtproBNP are new promising cardiovascular (CV) risk markers 4 and have been associated with high blood pressure (BP), 5 left ventricular (LV) hypertrophy, 6 and albuminuria. 7,8 Because Nt-proBNP as well as BP, LV mass, and albuminuria increase with aging, it is unclear whether these associations merely rely on aging. Wang et al 9 demonstrated recently an inverse relationship between serum BNP and body mass index that could be a potential link between obesity and hypertension if obese patients have lower BNP levels at given levels of wall stress. However, others have not found this association, 10 and it has been suggested recently that the inverse relationship between BNP and body mass index may only reflect an increase in BNP and a decrease in body mass index with aging. 11 No studies of the effect of obesity or other elements of the metabolic syndrome on Nt-proBNP are available.Therefore, the aim of the present study was to evaluate the association of Nt-proBNP to metabolic and hemodynamic CV risk factors, including the metabolic syndrome, 24-hour ambulatory BP, LV hypertrophy, pulse wave velocity (PWV), and urine albumin/creatinine ratio (UACR) in 4 different age groups to control for age.

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Section: Echocardiographymentioning

confidence: 99%

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

et al. 2005

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“…In obesity/hyperinsulinemia, overexpression of NPr-C receptor and lower levels and function of ANP with a possible role for a promotor variant at position -55 in the NPr-C gene, have been reported, contributing to increased sodium retention (3,43,44). Nannipieri et al (45). assessed the interaction between insulin and ANP in type 2 diabetes compared with healthy subjects.…”

Section: Alterations In Natriuretic Peptide Systemmentioning

confidence: 99%

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

El‐Atat

Stas²,

McFarlane³

et al. 2004

Journal of the American Society of Nephrology

174

136

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Abstract. The incidence of end-stage renal disease (ESRD) has risen dramatically in the past decade, mainly due to the increasing prevalence of diabetes mellitus, and both impaired glucose tolerance and hypertension are important contributors to rising rates of ESRD. Obesity, especially the visceral type, is associated with peripheral resistance to insulin actions and hyperinsulinemia, which predisposes to development of diabetes. A common genetic predisposition to insulin resistance and hypertension and the coexistence of these two disorders predisposes to premature atherosclerosis. A constellation of metabolic and cardiovascular derangements, which also includes dyslipidemia, dysglycemia, endothelial dysfunction, fibrinolytic and inflammatory abnormalities, left ventricular hypertrophy, microalbuminuria, and increased oxidative stress, is referred to as the cardiometabolic syndrome.

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“…Interestingly, regulation of ANP actions may be defective in diabetes (27), although other reports indicate the persistence of protective action (53). Our results suggest that, at least in diabetes, high natriuretic peptide levels in A cells prevent further increase of ANG II and limit oxidative stress, presumably by inhibiting RAS activation.…”

Section: Discussionmentioning

confidence: 57%

Differential autocrine modulation of atrial and ventricular potassium currents and of oxidative stress in diabetic rats

Shimoni¹,

Hunt²,

Chen³

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

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. Differential autocrine modulation of atrial and ventricular potassium currents and of oxidative stress in diabetic rats. Am J Physiol Heart Circ Physiol 290: H1879 -H1888, 2006. First published December 9, 2005 doi:10.1152/ajpheart.01045.2005The autocrine modulation of cardiac K ϩ currents was compared in ventricular and atrial cells (V and A cells, respectively) from Type 1 diabetic rats. K ϩ currents were measured by using whole cell voltage clamp. ANG II was measured by ELISA and immunofluorescent labeling. Oxidative stress was assessed by immunofluorescent labeling with dihydroethidium, a measure of superoxide ions. In V cells, K ϩ currents are attenuated after activation of the renin-angiotensin system (RAS) and the resulting ANG II-mediated oxidative stress. In striking contrast, these currents are not attenuated in A cells. Inhibition of the angiotensin-converting enzyme (ACE) also has no effect, in contrast to current augmentation in V cells. ANG II levels are enhanced in V, but not in A, cells. However, the high basal ANG II levels in A cells suggest that in these cells, ANG II-mediated pathways are suppressed, rather than ANG II formation. Concordantly, superoxide ion levels are lower in diabetic A than in V cells. Several findings indicate that high atrial natriuretic peptide (ANP) levels in A cells inhibit RAS activation. In male diabetic V cells, in vitro ANP (300 nM-1 M, Ͼ5 h) decreases oxidative stress and augments K ϩ currents, but not when excess ANG II is present. ANP has no effect on ventricular K ϩ currents when the RAS is not activated, as in control males, in diabetic males treated with ACE inhibitor and in diabetic females. In conclusion, the modulation of K ϩ currents and oxidative stress is significantly different in A and V cells in diabetic rat hearts. The evidence suggests that this is largely due to inhibition of RAS activation and/or action by ANP in A cells. These results may underlie chamber-specific arrhythmogenic mechanisms. diabetes; cardiac potassium currents DIABETES MELLITUS is a growing epidemic (59). Despite improved treatment, cardiovascular complications develop, becoming the leading cause of diabetes-related death (24, 59). Diabetic cardiomyopathy impairs mechanical function, (3,38) and electrical abnormalities increase the propensity for some cardiac arrhythmias (1). Cardiac action potentials are prolonged in animal models of diabetes due to attenuated transient and sustained repolarizing K ϩ currents (39,56). A reduction in current magnitude reflects downregulation of K ϩ channel expression, as determined in earlier work by us and others (33,42,43). Diminished outward currents presumably underlie the prolongation of the QT interval in the human electrocardiogram. Prolongation and dispersion of the QT interval, established predictors of arrhythmias and mortality (23), are common in diabetes (50).

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Defective Regulation and Action of Atrial Natriuretic Peptide in Type 2 Diabetes

Cited by 31 publications

References 27 publications

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

The Relationship between Hyperinsulinemia, Hypertension and Progressive Renal Disease

Differential autocrine modulation of atrial and ventricular potassium currents and of oxidative stress in diabetic rats

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