title: Association of atrial natriuretic peptide and type a natriuretic peptide receptor gene polymorphisms with left ventricular mass in human essential hypertension.
abstract: OBJECTIVE
  The goal of our study was to investigate the relationships between atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and type A natriuretic peptide receptor (NPRA) gene polymorphisms and left ventricular structure in human essential hypertension.
  
  
  BACKGROUND
  Experimental evidence supports a key role for natriuretic peptides in the modulation of cardiac mass. This relationship has not yet been described in human disease.
  
  
  METHODS
  A total of 203 hypertensive patients were studied by mono-bidimensional echocardiography. Three markers of the ANP gene (-C664G, G1837A, and T2238C polymorphisms) and a microsatellite marker of both NPRA and BNP genes were characterized.
  
  
  RESULTS
  Patients carrying the ANP gene promoter allelic variant had increased left ventricular mass index (117.4 +/- 1.7 g vs. 95.7 +/- 1.7 g, p = 0.005), left ventricular posterior wall thickness (1.14 +/- 0.07 cm vs. 0.96 +/- 0.01 cm, p < 0.0001), left ventricular septal thickness (1.12 +/- 0.10 cm vs. 1.04 +/- 0.01 cm, p = 0.01), and relative wall thickening (47.5 +/- 4.1% vs. 39.4 +/- 5.3%, p = 0.001) as compared with the wild-type genotype. These associations were independent from anthropometric factors and major clinical features and were confirmed in a large subgroup of never-treated hypertensive patients (n = 148). Carrier status of the ANP gene promoter allelic variant was associated with significantly lower plasma proANP levels: 1,395 +/- 104 fmol/ml versus 3,110 +/- 141 fmol/ml in hypertensive patients carrying the wild-type genotype (p < 0.05). A significant association for NPRA gene variants with left ventricular mass index and left ventricular septal thickness was found. The analysis of BNP did not reveal any effect on cardiac phenotypes.
  
  
  CONCLUSIONS
  Our findings show that the ANP/NPRA system significantly contributes to ventricular remodeling in human essential hypertension.
authors.affiliation: IRCCS Neuromed, Polo Molisano University of Rome La Sapienza, Pozzilli, Italy. rubattu.speranza@neuromed.it
authors.forename: Speranza
authors.initials: S
authors.lastname: Rubattu
authors.forename: Giada
authors.initials: G
authors.lastname: Bigatti
authors.forename: Anna
authors.initials: A
authors.lastname: Evangelista
authors.forename: Chiara
authors.initials: C
authors.lastname: Lanzani
authors.forename: Rosita
authors.initials: R
authors.lastname: Stanzione
authors.forename: Laura
authors.initials: L
authors.lastname: Zagato
authors.forename: Paolo
authors.initials: P
authors.lastname: Manunta
authors.forename: Simona
authors.initials: S
authors.lastname: Marchitti
authors.forename: Vanessa
authors.initials: V
authors.lastname: Venturelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bianchi
authors.forename: Massimo
authors.initials: M
authors.lastname: Volpe
authors.forename: Paola
authors.initials: P
authors.lastname: Stella
mesh_terms: D000225:Adenine; D000328:Adult; D000483:Alleles; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000235:genetics*; D003596:Cytosine; D004452:Echocardiography; D005260:Female; D014644:Genetic Variation; D006147:Guanine; D006162:Guanylate Cyclase / Q000235:genetics*; D006579:Heterozygote; D006720:Homozygote; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging* / Q000235:genetics* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000235:genetics*; D007438:Introns; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000235:genetics; D010641:Phenotype; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D017461:Receptors, Atrial Natriuretic Factor / Q000235:genetics*; D013941:Thymine; D020257:Ventricular Remodeling / Q000235:genetics
chemical_list: D020097:Natriuretic Peptide, Brain; D006147:Guanine; D009320:Atrial Natriuretic Factor; D003596:Cytosine; D006162:Guanylate Cyclase; D017461:Receptors, Atrial Natriuretic Factor; C091715:atrial natriuretic factor receptor A; D000225:Adenine; D013941:Thymine