title: Atrial natriuretic peptides in heart failure: pathophysiological significance, diagnostic and prognostic value.
abstract: Neurohormonal activation in patients with heart failure is dominated by the deleterious long-term effects of activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system. The natriuretic peptides, including brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP), are also upregulated in heart failure, and partially counteract these deleterious effects by promoting vasodilation, natriuresis, and diuresis. Although BNP has been established as an important biomarker in the diagnosis and prognosis of heart failure, growing evidence suggests that measurement of plasma ANP, specifically its metabolite mid-regional pro-ANP, has similar diagnostic and prognostic value. Furthermore, its measurement may provide incremental diagnostic value when BNP levels fall into "grey zone" levels and may be a more potent prognostic marker of mortality.
authors.affiliation: Division of Cardiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON K1Y 4W7, Canada.
authors.forename: Nina
authors.initials: N
authors.lastname: Ghosh
authors.forename: Haissam
authors.initials: H
authors.lastname: Haddad
mesh_terms: D009320:Atrial Natriuretic Factor / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D006333:Heart Failure / Q000175:diagnosis* / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor