The Endocrine Function of the Heart: Physiology and Involvements of Natriuretic Peptides and Cyclic Nucleotide Phosphodiesterases in Heart Failure

Abstract

Besides pumping, the heart participates in hydro-sodium homeostasis and systemic blood pressure regulation through its endocrine function mainly represented by the large family of natriuretic peptides (NPs), including essentially atrial natriuretic (ANP) and brain natriuretic peptides (BNP). Under normal conditions, these peptides are synthesized in response to atrial cardiomyocyte stretch, increase natriuresis, diuresis, and vascular permeability through binding of the second intracellular messenger’s guanosine 3′,5′-cyclic monophosphate (cGMP) to specific receptors. During heart failure (HF), the beneficial effects of the enhanced cardiac hormones secretion are reduced, in connection with renal resistance to NP. In addition, there is a BNP paradox characterized by a physiological inefficiency of the BNP forms assayed by current methods. In this context, it appears interesting to improve the efficiency of the cardiac natriuretic system by inhibiting cyclic nucleotide phosphodiesterases, responsible for the degradation of cGMP. Recent data support such a therapeutic approach which can improve the quality of life and the prognosis of patients with HF.

Peripheral Blood Mononuclear Cells and Platelets Mitochondrial Dysfunction, Oxidative Stress, and Circulating mtDNA in Cardiovascular Diseases

“…The 2019 report of the American Heart Association shows that between 2013 and 2016, CVDs, including hypertension, heart failure (HF), coronary heart disease, and stroke, were present in about 48% of patients older than 20 years in the United States [3][4][5]. Significant progress has been made concerning CVD diagnosis and therapies, particularly considering neuro-hormonal modulation, such as natriuretic peptide (NP)-guided therapy [2,[6][7][8][9], but it seems that a plateau has begun to be reached, suggesting new approaches. In this view, since CVDs are generally systemic diseases, an attempt based on circulating cells might be proposed to better understand CVD pathophysiology and to discover new biomarkers.…”

Seasonal morphology and immunoreactivity of cytokeratin and atrial natriuretic peptide in dromedary camel poll glands

“…ANP and BNP are found to be involved in the regulation of blood pressure and homeostasis of fluid‐volume, depending on their natriuretic and diuretic effect in the kidney and on their relaxation action in vascular smooth muscles (Ruskoaho, 1992). Moreover, cardiac NPs have a fundamental importance in blood pressure and hydro‐sodium regulation (Lugnier et al., 2019). According to the biological importance of ANPs shown in the different organs, their expression in the poll gland could also reflect a regulatory role in the glandular secretion.…”

Functional Role of Natriuretic Peptides in Risk Assessment and Prognosis of Patients with Mitral Regurgitation

“…As compared to ANP, BNP has a longer half-life (1-2 hours compared to approximately 22 minutes) and greater plasma concentrations (about 10-fold higher) [11,12]. Moreover, it has been proposed that NPs' responses may depend on the specific pathophysiology of the underlying cardiac stress, suggesting that ANP may be more sensitive in the case of subclinical damage, whereas the BNP level shows a greater increase in acute conditions [13,14].…”