Modulation of the natriuretic peptide system in heart failure: from bench to bedside?
Since the discovery of atrial natriuretic peptide, the unravelling of the natriuretic peptide system has been a story of scientific success. However, bridging the gap between bench and bedside has proved difficult, and as yet has not provided any major clinical progress. In this review we will first give a detailed outline of the key elements constituting the natriuretic peptide system. Secondly, we will briefly explain the underlying rationale, basic concepts and evidence behind currently pursued strategies to potentiate the natriuretic peptide system. Thirdly, we will highlight some of the problems that have so far hindered successful translation of these theoretically viable treatment options into tangible clinical progress.
Schmitt
Matthias
M
Department of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Academic Avenue, Cardiff CF14 4XN, UK. matthschmitt@doctors.org.uk
Cockcroft
John R
JR
Frenneaux
Michael P
MP
D000818:Animals; D009320:Atrial Natriuretic Factor / Q000502:physiology; D002316:Cardiotonic Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D051379:Mice; D020097:Natriuretic Peptide, Brain / Q000502:physiology; D020098:Natriuretic Peptide, C-Type / Q000502:physiology; D036361:Peptide Hormones / Q000502:physiology* / Q000627:therapeutic use
D002316:Cardiotonic Agents; D036361:Peptide Hormones; D020097:Natriuretic Peptide, Brain; D020098:Natriuretic Peptide, C-Type; D009320:Atrial Natriuretic Factor