Natriuretic peptide system in human heart failure.
BACKGROUND
Atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) are a family of structurally related peptides that participate in the integrated control of renal and cardiovascular function. Previous studies suggest a functional role for these hormonal peptides in cardiorenal regulation in congestive heart failure (CHF).


RESULTS
The present studies were performed in normal subjects (n = 6) and in patients with mild (New York Heart Association [NYHA] class I to II, n = 20) and severe (NYHA class III to IV, n = 20) CHF by use of radioimmunoassay and immunohistochemical staining (IHCS). Plasma ANP was significantly increased in both mild and severe CHF compared with normal subjects. In contrast, plasma BNP was only moderately increased in the severe CHF group, and plasma CNP concentration was unchanged in CHF compared with normal subjects. Atrial tissue concentrations of the natriuretic peptides did not parallel circulating concentrations. ANP predominated in normal atrial tissue, but BNP predominated in CHF. In ventricular tissue, IHCS staining was present for all three peptides in normal ventricular myocardium and was markedly enhanced in CHF.


CONCLUSIONS
These studies support a differential regulation of ANP, BNP, and CNP circulating concentrations and tissue activity in human CHF.
Wei
C M
CM
Cardiorenal Research Laboratory, Mayo Clinic and Foundation, Rochester, MN 55905.
Heublein
D M
DM
Perrella
M A
MA
Lerman
A
A
Rodeheffer
R J
RJ
McGregor
C G
CG
Edwards
W D
WD
Schaff
H V
HV
Burnett
J C
JC
D009320:Atrial Natriuretic Factor / Q000032:analysis*; D005260:Female; D006325:Heart Atria / Q000737:chemistry; D006333:Heart Failure / Q000378:metabolism*; D006352:Heart Ventricles / Q000737:chemistry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000737:chemistry; D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D009419:Nerve Tissue Proteins / Q000032:analysis*; D011863:Radioimmunoassay
D009419:Nerve Tissue Proteins; D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D009320:Atrial Natriuretic Factor