title: Relevance of brain natriuretic peptide in preload-dependent regulation of cardiac sarcoplasmic reticulum Ca2+ ATPase expression.
abstract: BACKGROUND
  In heart failure (HF), ventricular myocardium expresses brain natriuretic peptide (BNP). Despite the association of elevated serum levels with poor prognosis, BNP release is considered beneficial because of its antihypertrophic, vasodilating, and diuretic properties. However, there is evidence that BNP-mediated signaling may adversely influence cardiac remodeling, with further impairment of calcium homeostasis.
  
  
  RESULTS
  We studied the effects of BNP on preload-dependent myocardial sarcoplasmic reticulum Ca2+ ATPase (SERCA2a) expression. In rabbit isolated muscle strips stretched to high preload and shortening isotonically over 6 hours, the SERCA/glyceraldehyde phosphate dehydrogenase mRNA ratio was enhanced by 168% (n=8) compared with unloaded preparations (n=8; P<0.001). Recombinant human BNP at a concentration typically found in end-stage HF patients (350 pg/mL) abolished SERCA upregulation by stretch (n=9; P<0.0001 versus BNP free). Inhibition of cyclic guanosine 3',5' monophosphate (cGMP)-phosphodiesterase-5 mimicked this effect, whereas inhibition of cGMP-dependent protein kinase restored preload-dependent SERCA upregulation in the presence of recombinant human BNP. Furthermore, in myocardium from human end-stage HF patients undergoing cardiac transplantation (n=15), BNP expression was inversely correlated with SERCA levels. Moreover, among 23 patients treated with left ventricular assist devices, significant SERCA2a recovery occurred in those downregulating BNP.
  
  
  CONCLUSIONS
  Our data indicate that preload stimulates SERCA expression. BNP antagonizes this mechanism via guanylyl cyclase-A, cGMP, and cGMP-dependent protein kinase. This novel action of BNP to uncouple preload-dependent SERCA expression may adversely affect contractility in patients with HF.
authors.affiliation: Abteilung für Kardiologie, Georg August Universität, Göttingen, Germany. hkogler@med.uni-goettingen.de
authors.forename: Harald
authors.initials: H
authors.lastname: Kögler
authors.forename: Peter
authors.initials: P
authors.lastname: Schott
authors.forename: Karl
authors.initials: K
authors.lastname: Toischer
authors.forename: Hendrik
authors.initials: H
authors.lastname: Milting
authors.forename: Phuc Nguyen
authors.initials: PN
authors.lastname: Van
authors.forename: Michael
authors.initials: M
authors.lastname: Kohlhaas
authors.forename: Cornelia
authors.initials: C
authors.lastname: Grebe
authors.forename: Astrid
authors.initials: A
authors.lastname: Kassner
authors.forename: Erik
authors.initials: E
authors.lastname: Domeier
authors.forename: Nils
authors.initials: N
authors.lastname: Teucher
authors.forename: Tim
authors.initials: T
authors.lastname: Seidler
authors.forename: Ralph
authors.initials: R
authors.lastname: Knöll
authors.forename: Lars S
authors.initials: LS
authors.lastname: Maier
authors.forename: Aly
authors.initials: A
authors.lastname: El-Banayosy
authors.forename: Reiner
authors.initials: R
authors.lastname: Körfer
authors.forename: Gerd
authors.initials: G
authors.lastname: Hasenfuss
mesh_terms: D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000502:physiology; D000328:Adult; D000818:Animals; D019703:Calcineurin / Q000502:physiology; D020013:Calcium Signaling; D000252:Calcium-Transporting ATPases / Q000096:biosynthesis* / Q000235:genetics; D002311:Cardiomyopathy, Dilated / Q000150:complications; D015331:Cohort Studies; D006152:Cyclic GMP / Q000502:physiology; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D004790:Enzyme Induction / Q000187:drug effects; D005260:Female; D006162:Guanylate Cyclase / Q000502:physiology; D006333:Heart Failure / Q000201:enzymology / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D006353:Heart-Assist Devices; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications; D009206:Myocardium / Q000201:enzymology; D050778:NFATC Transcription Factors / Q000502:physiology; D020097:Natriuretic Peptide, Brain / Q000235:genetics / Q000494:pharmacology / Q000502:physiology*; D012333:RNA, Messenger / Q000096:biosynthesis; D017461:Receptors, Atrial Natriuretic Factor / Q000502:physiology; D011993:Recombinant Fusion Proteins / Q000494:pharmacology; D012519:Sarcoplasmic Reticulum / Q000201:enzymology*; D053498:Sarcoplasmic Reticulum Calcium-Transporting ATPases; D013314:Stress, Mechanical
chemical_list: D050778:NFATC Transcription Factors; D012333:RNA, Messenger; D011993:Recombinant Fusion Proteins; D020097:Natriuretic Peptide, Brain; D019703:Calcineurin; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human; D053498:Sarcoplasmic Reticulum Calcium-Transporting ATPases; D006162:Guanylate Cyclase; D017461:Receptors, Atrial Natriuretic Factor; C091715:atrial natriuretic factor receptor A; D000252:Calcium-Transporting ATPases; D006152:Cyclic GMP