Natriuretic Peptides for the Treatment of Heart Failure

Sackner‐Bernstein, Jonathan; Skopicki, Hal A.; Aaronson, Keith D.

doi:10.1002/9780470994740.ch11

Cited by 1 publication

(2 citation statements)

References 120 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…BNP Nesiritide, a purified preparation of human BNP, is manufactured from Escherichia coli using recombinant DNA technology [47]. Recombinant BNP exhibits similar physiologic actions as endogenous BNP [47,48]. The distribution half-life and the mean terminal elimination half-life of nesiritide are approximately 2 min and 18 min, respectively [47].…”

Section: Anpmentioning

confidence: 99%

See 1 more Smart Citation

Natriuretic peptides and therapeutic applications

2007

View full text Add to dashboard Cite

Since the discovery of atrial natriuretic factor by de Bold et al., there has been tremendous progress in our understanding of the physiologic, diagnostic and therapeutic roles of the natriuretic peptides (NPs) in health and disease. Natriuretic peptides are endogenous hormones that are released by the heart in response to myocardial stretch and overload. Three mammalian NPs have been identified and characterized, including atrial natriuretic peptide (ANP or atrial natriuretic factor), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). In addition, Dendroaspis natriuretic peptide (DNP) has been isolated from the venom of Dendroaspis angusticeps (the green mamba snake), and urodilatin from human urine. These peptides are structurally similar and they consist of a 17-amino-acid core ring and a cysteine bridge. Both ANP and BNP bind to natriuretic peptide receptor A (NPR-A) that are expressed in the heart and other organs. Activation of NPR-A generates an increase in cyclic guanosine monophosphate, which mediates natriuresis, inhibition of renin and aldosterone, as well as vasorelaxant, anti-fibrotic, anti-hypertrophic, and lusitropic effects. The NP system thus serves as an important compensatory mechanism against neurohumoral activation in heart failure. This provides a strong rationale for the use of exogenous NPs in the management of acutely decompensated heart failure. In this article, the therapeutic applications of NPs in the acute heart failure syndromes are reviewed. Emerging therapeutic agents and areas for future research are discussed.

show abstract

Section: Anpmentioning

confidence: 99%

“…Clearance of nesiritide is achieved through 3 mechanisms: binding to the NPR-C on cell surface, degradation by neutral endopeptidase, and renal filtration [47]. Dosage reduction is not needed in patients with renal insufficiency [47,48].…”

Section: Anpmentioning

confidence: 99%