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Cardiovascular Research 2006 69(2):318-328; doi:10.1016/j.cardiores.2005.10.001
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Copyright © 2005, European Society of Cardiology

The role of natriuretic peptides in cardioprotection

Toshio Nishikimia,*, Nobuyo Maedab and Hiroaki Matsuokaa

aDepartment of Hypertension and Cardiorenal Medicine, Dokkyo University School of Medicine, Mibu, Tochigi, 321-0293 Japan
bDepartment of Pathology and Laboratory Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7525

* Corresponding author. Tel.: +81 282 86 1111; fax: +81 282 86 1596. Email address: nishikim{at}dokkyomed.ac.jp

Atrial natriuretic peptide (ANP) and brain (B-type) natriuretic peptide (BNP) are circulating hormones of cardiac origin that play an important role in the regulation of intravascular blood volume and vascular tone. The plasma concentrations of ANP and BNP are elevated in heart failure, and they are considered to compensate for heart failure because of their diuretic, natriuretic, and vasodilating actions and inhibitory effects on renin and aldosterone secretion. Evidence is also accumulating from recent work that ANP and BNP exert their cardioprotective functions not only as circulating hormones but also as local autocrine and/or paracrine factors. In studies using cultured neonatal myocytes and fibroblasts, exogenous administration of both ANP and ANP antagonists demonstrated that ANP has antihypertrophic and antifibrotic functions. Corroborating these in vitro results, mice lacking natriuretic receptor-A (NPR-A), the receptor for ANP and BNP, develop cardiac hypertrophy and fibrosis independent of their blood pressure. Recent studies also suggest that the intracardiac natriuretic peptides/cGMP system plays a counter-regulatory role against the intracardiac renin–angiotensin–aldosterone system and TGF-beta mediated pathway. In a clinical setting, human recombinant ANP and BNP may be used for a therapy of heart failure; however, further evaluation is required in the future.

KEYWORDS Atrial natriuretic peptide; Brain natriuretic peptide; C-type natriuretic peptide; Cyclic guanosine monophosphate; Hypertrophy; Heart failure; Fibroblast; Fibrosis; Cardioprotective

Time for primary review 19 days


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