Atrial natriuretic peptides in the diagnosis and treatment of congestive heart failure.
Atrial natriuretic peptides (ANPs) consist of a family of peptides (atrial natriuretic factor [ANF], long acting natriuretic peptide, vessel dilator, kaliuretic peptide, urodilatin, brain natriuretic peptide [BNP], and C type natriuretic peptide [CNP]) which are synthesized within the heart, except for urodilatin. Of these natriuretic peptides, the vessel dilator radioimmunoassay (RIA) of a single plasma sample is the most sensitive and specific in the diagnosis of early (i.e., NYHA class I) congestive heart failure (CHF). Vessel dilator is beneficial in the treatment of CHF, enhancing of urine flow two- to 13-fold and sodium excretion three- to four-fold for 3 hours after stopping its infusion. This 37 amino acid peptide hormone simultaneously decreases systemic vascular resistance 24%, pulmonary vascular resistance 25%, pulmonary capillary wedge pressure 33%, and central venous pressure 27% while increasing cardiac output 34%, cardiac index 35%, and stroke volume index 24% in individuals with CHF. (c)1999 by CHF, Inc.
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Departments of Medicine, Physiology, and Biophysics, University of South Florida Health Sciences Center and James A. Haley Veterans Hospital, Tampa, FL 33612.