The renal and cardiovascular effects of natriuretic peptides

Abstract

The landmark report by de Bold et al. in 1981 signified the heart as one of the endocrine organs involved in fluid and salt balance (de Bold AJ, Borenstein HB, Veress AT, Sonnenberg H. 28: 89-94, 1981). Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are secreted from cardiomyocytes in response to cardiac stretch as in the case of heart failure, whereas C-type natriuretic peptide (CNP) is secreted from endothelial and renal cells in response to cytokines and endothelium-dependent agonists, such as acetylcholine. Binding ANP or BNP to natriuretic peptide receptor A induces cyclic guanylyl monophosphate as second messenger in the target cells to mediate the following: natriuresis; water diuresis; increasing glomerular filtration rate; decreasing systemic sympathetic activities; plasma volume; cardiac output and blood pressure; and curbing mitoses of heart fibroblasts and hypertrophy of cardiovascular muscle cells. ANP, BNP, and CNP are cleared from the bloodstream by natriuretic peptide receptor C and degraded by an ectoenzyme called neprilysin (NEP). The plasma levels of BNP are typically>100 pg/ml in patients with congestive heart failure. Sacubitril/valsartan is an angiotensin receptor NEP inhibitor that prevents the clinical progression of surviving patients with heart failure more effectively than enalapril, an angiotensin-converting enzyme inhibitor. A thorough understanding of the renal and cardiovascular effects of natriuretic peptides is of major importance for first-year medical students to gain insight into the significance of plasma levels of BNP in patients with heart failure.

Changes in the nitric oxide pathway of the pulmonary vasculature after exposure to hypoxia in swine model of neonatal pulmonary vascular disease

“…It is possible that the significant increase in PAP during incremental exercise causes secretion of natriuretic peptides by cardiomyocytes in response to cardiac stretch (Wong et al. ), and thus pGC activation. In support of this hypothesis, PAP and the pulmonary vasodilator effect of PDE5 inhibition were highly correlated ( r 2 = 0.82; P < 0.05; Fig.…”

“…The activity of pGC can be stimulated by natriuretic peptides (ANP and BNP) (Kobialka and Gorczyca 2000). It is The Physiological Society and the American Physiological Society possible that the significant increase in PAP during incremental exercise causes secretion of natriuretic peptides by cardiomyocytes in response to cardiac stretch (Wong et al 2017), and thus pGC activation. In support of this hypothesis, PAP and the pulmonary vasodilator effect of PDE5 inhibition were highly correlated (r 2 = 0.82; P < 0.05; Fig.…”

Estimates of global HIV/AIDS mortality, prevalence and incidence rates, and their association with the Human Development Index

“…Many studies have shown that HIV/AIDS has a significant effect on health and that good indicators include mortality rates and life expectancy. For example, two studies in the field of global inequality of life expectancy have shown that the 6 years of the difference in life expectancy between Africa and North America is related to AIDS (Dorling D;Wong et al, 2017).…”

“…Education is an important component of HDI and it is necessary to include that parameter, especially in countries with low-and medium-income. In most African countries, HIV/AIDS has shown an inverse association with primary education, especially in girls (Wong et al, 2017). In these countries the death of parents due to AIDS is frequent; the issue of family economic situations will aggravate and also will increase the number of children dismissed from school (Boulogne et al, 2017;Lou et al, 2014).…”

Up-to-date clinical approaches of biomarkers’ use in heart failure

“…Indeed, new era in use of NPs in monitoring of HF evolution has been opened after implementation in the routine clinical practice (Malek and Gaikwad, 2017). Recent clinical trials have been shown that nephrilisin inhibition auxiliary to chronic renin-angiotensin system blockage with LCZ696 (Sacubitril/Valsartan) may increase the bioavailability of NPs and promotes additional benefits the cardio-renal system and hence protected against all-cause mortality, CV mortality and HF death (Wong et al, 2017). Because of biologically active BNP is degraded by neprilysin, in HF patients treated with ARNI circulating level of BNP sufficiently increases, whereas NT-proBNP concentration declines dramatically.…”