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Sasaki N, Hiramatsu T, Hasegawa Y, Sawada M. High brain natriuretic peptide levels are associated with vulnerable plaque in cervical carotid artery. World Neurosurg X 2024; 23:100369. [PMID: 38577316 PMCID: PMC10992847 DOI: 10.1016/j.wnsx.2024.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 03/20/2024] [Indexed: 04/06/2024] Open
Affiliation(s)
- Nozomi Sasaki
- Department of Neurosurgery, Matsunami General Hospital, 〒501-6062, 185-1, Dendai, Kasamatsu Cho, Hashima Gun, Gifu, Japan
| | - Taku Hiramatsu
- Department of Neurosurgery, Matsunami General Hospital, 〒501-6062, 185-1, Dendai, Kasamatsu Cho, Hashima Gun, Gifu, Japan
| | - Yoshihito Hasegawa
- Department of Neurosurgery, Matsunami General Hospital, 〒501-6062, 185-1, Dendai, Kasamatsu Cho, Hashima Gun, Gifu, Japan
| | - Motoshi Sawada
- Department of Neurosurgery, Matsunami General Hospital, 〒501-6062, 185-1, Dendai, Kasamatsu Cho, Hashima Gun, Gifu, Japan
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Skrzypczyk P, Okarska-Napierała M, Pietrzak R, Pawlik K, Waścińska K, Werner B, Pańczyk-Tomaszewska M. NT-proBNP as a Potential Marker of Cardiovascular Damage in Children with Chronic Kidney Disease. J Clin Med 2021; 10:4344. [PMID: 34640365 PMCID: PMC8509500 DOI: 10.3390/jcm10194344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/16/2021] [Accepted: 09/22/2021] [Indexed: 12/11/2022] Open
Abstract
Assessing cardiovascular disease (CVD) in children with chronic kidney disease (CKD) is difficult. Great expectations have been associated with biomarkers, including the N-terminal pro-brain natriuretic peptide (NT-proBNP). This study aimed to determine the correlation between NT-proBNP and cardiovascular complications in children with CKD. Serum NT-proBNP, arterial stiffness, common carotid artery intima-media thickness (cIMT), echocardiographic (ECHO) parameters (including tissue Doppler imaging), and biochemical and clinical data were analyzed in 38 pediatric patients with CKD (21 boys, 12.2 ± 4.2 years). Mean NT-proBNP in CKD patients was 1068.1 ± 4630 pg/mL. NT-proBNP above the norm (125 pg/mL) was found in 16 (42.1%) subjects. NT-proBNP correlated with glomerular filtration rate (GFR) (r = -0.423, p = 0.008), and was significantly higher in CKD G5 (glomerular filtration rate grade) patients compared to CKD G2, G3, and G4 children (p = 0.010, p = 0.004, and p = 0.018, respectively). Moreover, NT-proBNP correlated positively with augmentation index (AP/PP: r = 0.451, p = 0.018, P2/P: r = 0.460, p = 0.016), cIMT (r = 0.504, p = 0.020), and E/E' in ECHO (r = 0.400, p = 0.032). In multivariate analysis, logNT-proBNP was the only significant predictor of cIMT Z-score (beta = 0.402, 95CI (0.082-0.721), p = 0.014) and P2/P1 (beta = 0.130, 95CI (0.082-0.721), p = 0.014). Conclusions: NT-proBNP may serve as a possible marker of thickening of the carotid artery wall in pediatric patients with CKD. The final role of NT-proBNP as a biomarker of arterial damage, left ventricular hypertrophy, or cardiac diastolic dysfunction in CKD children needs confirmation in prospective studies.
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Affiliation(s)
- Piotr Skrzypczyk
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.O.-N.); (M.P.-T.)
| | - Magdalena Okarska-Napierała
- Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.O.-N.); (M.P.-T.)
- Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Radosław Pietrzak
- Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland; (R.P.); (B.W.)
| | - Katarzyna Pawlik
- Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (K.W.)
| | - Katarzyna Waścińska
- Student Scientific Group at the Department of Pediatrics and Nephrology, Medical University of Warsaw, 02-091 Warsaw, Poland; (K.P.); (K.W.)
| | - Bożena Werner
- Department of Paediatric Cardiology and General Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland; (R.P.); (B.W.)
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Skripnikova IA, Alikhanova NA, Yaralieva EK, Myagkova MA, Novikov VE, Vygodin VA, Drapkina OM. The level of N-terminal pro-brain natriuretic peptide depending on vascular wall condition and bone mass in postmenopausal women. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To assess the relationship of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels with vascular wall condition and bone mineral density (BMD) in postmenopausal women.Material and methods. The cross-sectional study included 107 outpatients aged 45-82 years who signed informed consent. The inclusion criterion was a menopause during ≥1 year. The level of serum NT-proBNP was determined by electrochemiluminescence. BMD was assessed by dual energy x-ray absorptiometry. Intima-media thickness (IMT), the presence and number of atherosclerotic plaques were evaluated using carotid duplex scanning. Pulse wave velocity (PWV) and augmentation index were estimated by applanation tonometry. To assess 10-year cardiovascular risk, the SCORE high-risk charts were used. Using the Russian model of FRAX® score, 10-year fracture risk was assessed.Results. NT-proBNP level in women with postmenopause >10 years was significantly higher than in those with postmenopause <5 years — 98,7 vs 56,3 pg/ml (p<0,001), but there was no independent relationship according to the regression analysis. According to multivariate regression analysis adjusted for age, menopause duration, systolic blood pressure, hypercholesterolemia, smoking, elevated C-reactive protein and interleukin-6 levels, there were independent relationship between the following parameters: NT-proBNP and IMT (β=2,38, p<0,03), NT-proBNP and PWV (β=1,76, p<0,001). NT-proBNP level in patients with osteoporosis was significantly higher than in women with normal bone mass (p<0,01). A negative correlation was observed between NT-proBNP and BMD of the proximal femur (r=-0,26, p<0,05), while the relationship between BMD of the lumbar vertebrae (L1-L4) and NT-proBNP did not reach significance. In multivariate regression analysis, this relationship has not been confirmed. A positive correlation was obtained between cardiovascular risk (SCORE) and NT-proBNP levels (r=0,28, p<0,001). NT-proBNP levels did not differ in women with a high and low 10-year risk of both major osteoporotic fractures and femoral fractures.Conclusion. An independent relationship of NT-proBNP with vascular stiffness and preclinical atherosclerosis was demonstrated: IMT and PWV. This indicates the participation of NT-proBNP in the atherosclerosis development. The association of elevated NT-proBNP levels with osteoporosis is significant, but not independent, and is apparently related to other factors.
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Affiliation(s)
- I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. A. Alikhanova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. K. Yaralieva
- National Medical Research Center for Therapy and Preventive Medicine
| | - M. A. Myagkova
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. E. Novikov
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Vygodin
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
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4
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NT-pro-BNP: A novel predictor of stroke risk after transient ischemic attack. Int J Cardiol 2020; 298:93-97. [DOI: 10.1016/j.ijcard.2019.06.056] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/20/2019] [Accepted: 06/19/2019] [Indexed: 11/22/2022]
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Wentzel A, Malan L, Scheepers JD, Malan NT. QTc prolongation, increased NT-proBNP and pre-clinical myocardial wall remodeling in excessive alcohol consumers: The SABPA study. Alcohol 2018; 68:1-8. [PMID: 29413668 DOI: 10.1016/j.alcohol.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 12/26/2022]
Abstract
Alcohol contributes greatly to vascular and structural modifications. Due to differences in the metabolism and tolerance of alcohol between ethnic groups, the manner of these modifications may differ. We investigated the association between alcohol consumption - measured via ethnic-specific gamma glutamyl transferase (γ-GT) cut-points - and markers of cardiac perfusion, electrical activity, and pre-clinical structural alterations. A South African target population study was performed in a bi-ethnic cohort (n = 405). Alcohol consumption was determined according to previously defined ethnic-specific γ-GT cut-points, where γ-GT ≥ 19.5 U/L and γ-GT ≥ 55 U/L indicated excessive alcohol consumption in Caucasians and Africans, respectively. Ambulatory 24-h blood pressure and electrocardiograms (ECG), 10-lead ECG left ventricular hypertrophy (LVH), ischemic events, N-terminal pro-brain natriuretic peptide (NT-proBNP), and QTc prolongation were assessed. Fasting blood samples were obtained. A poorer cardio-metabolic profile and mean 24-h hypertensive and ECG-LVH values were evident in high γ-GT groups of both ethnicities, when compared to their low counterparts. The African high γ-GT group reported a higher intake of alcohol and presented significant increases in NT-proBNP (p < 0.001), QTc prolongation (p = 0.008), and ischemic events (p = 0.013). Regression analyses revealed associations between ECG-LVH and NT-proBNP, QTc prolongation, ischemic events, and SBP, in the African high γ-GT group exclusively. High alcohol consumers presented delayed electrical conduction in the heart accompanied by ECG-LVH, ischemic events, and increased vaso-responsiveness, predominantly in Africans. Ultimately, increased left ventricular distension on a pre-clinical level may elevate the risk for future cardiovascular events in this population.
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Gan L, Feng C, Liu C, Tian S, Song X, Yang L. Association between serum N-terminal pro-B-type natriuretic peptide levels and characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography. Exp Ther Med 2016; 12:667-675. [PMID: 27446259 PMCID: PMC4950222 DOI: 10.3892/etm.2016.3371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 01/15/2016] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to explore the association between the levels of serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) and the characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography (CCTA), in patients with unstable angina (UA). A total of 202 patients (age range, 47-82 years) were divided into the following three groups: Non-cardiac disease group (57 patients); stable angina pectoris (SAP) group (62 patients); and UA group (83 patients). There were significant differences between the serum NT-pro BNP levels among the three groups (P=0.007). However, in multivariant diagnoses, NT-pro BNP level was not an independent risk factor for UA. The levels of serum NT-pro BNP were observed to be positively correlated with the number of vessels involved (r=0.462; P<0.001), SIS (r=0.475; P<0.001), segment-stenosis score (r=0.453; P<0.001), coronary calcification score (r=0.412; P=0.001), number of obstructive diseases (r=0.346; P<0.001), and the number of segments with non-calcified plaque (r=0.235; P=0.017), mixed plaque (r=0.234; P=0.017) and calcified plaque (r=0.431; P<0.001). The levels of serum NT-pro BNP were significantly higher in patients with UA and left main-left anterior descending (LM-LAD) disease, compared with UA patients without LM-LAD disease (P<0.001). In addition, serum NT-pro BNP was significantly higher in patients with obstructive disease and UA than in those without obstructive disease (P<0.001). The area under the curve of log(NT-pro BNP) was 0.656 (P=0.006; optimal cut-off value, 1.74; sensitivity, 77.6%; specificity, 51.9%). In conclusion, the levels of serum NT-pro BNP are associated with the burden and severity of coronary artery atherosclerotic disease in patients with UA, and may be helpful in risk stratification of patients with UA.
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Affiliation(s)
- Lu Gan
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Cong Feng
- Department of Emergency, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Chunlei Liu
- The PLA Medical College, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Shuping Tian
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Xiang Song
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Li Yang
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
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Colbert G, Jain N, de Lemos JA, Hedayati SS. Utility of traditional circulating and imaging-based cardiac biomarkers in patients with predialysis CKD. Clin J Am Soc Nephrol 2015; 10:515-29. [PMID: 25403922 PMCID: PMC4348678 DOI: 10.2215/cjn.03600414] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cardiac biomarkers, such as cardiac troponin T (cTnT), brain natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-pro-BNP), are commonly used to diagnose acute coronary syndrome and congestive heart failure exacerbation in symptomatic patients. Levels of these biomarkers are frequently chronically elevated in asymptomatic patients with ESRD who are receiving maintenance dialysis. Other imaging biomarkers commonly encountered in nephrologists' clinical practice, such as coronary artery calcium measured by computed tomography, left ventricular hypertrophy, and carotid intima-media thickness, are also frequently abnormal in asymptomatic patients with ESRD. This article critically reviews the limited observational data on associations between cTnT, BNP, NT-pro-BNP, coronary artery calcium, left ventricular hypertrophy, and carotid intima-media thickness with cardiovascular events and death in non-dialysis-dependent patients with CKD. Although sufficient evidence suggests that these biomarkers may be used for prognostication, the diagnostic utility of cTnT, BNP, and NT-pro-BNP remain challenging in patients with CKD. Decreased renal clearance may affect the plasma levels of these biomarkers, and upper reference limits were originally derived in patients without CKD. Until better data are available, higher cutoffs, or a rise in level compared with previous values, have been proposed to help distinguish acute myocardial infarction from chronic elevations of cTnT in symptomatic patients with CKD. Additionally, it is not known whether these biomarkers are modifiable and amenable to interventions that could change hard clinical outcomes in patients with CKD not yet undergoing long-term dialysis.
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MESH Headings
- Biomarkers/blood
- Calcinosis/diagnostic imaging
- Carotid Intima-Media Thickness
- Coronary Artery Disease/complications
- Coronary Artery Disease/diagnostic imaging
- Humans
- Hypertrophy, Left Ventricular/blood
- Hypertrophy, Left Ventricular/complications
- Hypertrophy, Left Ventricular/diagnostic imaging
- Kidney Failure, Chronic/blood
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/therapy
- Natriuretic Peptide, Brain/blood
- Peptide Fragments/blood
- Renal Dialysis
- Tomography, X-Ray Computed
- Troponin T/blood
- Ventricular Dysfunction, Left/blood
- Ventricular Dysfunction, Left/complications
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Affiliation(s)
| | | | - James A de Lemos
- Division of Cardiology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - S Susan Hedayati
- Division of Nephrology and Division of Nephrology, Medical Service, Veterans Affairs North Texas Health Care System, Dallas, Texas
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Gopal DM, Larson MG, Januzzi JL, Cheng S, Ghorbani A, Wollert KC, Kempf T, D'Agostino RB, Polak JF, Ramachandran VS, Wang TJ, Ho JE. Biomarkers of cardiovascular stress and subclinical atherosclerosis in the community. Clin Chem 2014; 60:1402-8. [PMID: 25237063 DOI: 10.1373/clinchem.2014.227116] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Biomarkers of cardiovascular stress have been associated with incident cardiovascular outcomes. Their relations with measures of subclinical atherosclerosis, as assessed by carotid intima-media thickness, have not been well described. METHODS We measured plasma growth differentiation factor-15 (GDF-15), soluble ST2 (sST2), and high-sensitivity troponin I (hsTnI) in 3111 Framingham Offspring participants who also underwent carotid ultrasonography during the sixth examination (1995-1998, mean age 58 years, 54% women). Carotid measurements included maximal internal carotid artery (ICA) intima-media thickness (IMT), plaque presence (defined as ICA IMT >1.5 mm), and mean common carotid artery IMT. We carried out multivariable regressions for carotid measurements vs biomarkers using linear and logistic models; P < 0.0056 was deemed statistically significant. RESULTS Maximal ICA IMT was significantly associated with plasma GDF-15 [β-estimate 0.04 per 1-U increase in log(GDF-15), SE 0.01, P < 0.0001]. Similarly, the odds of having carotid plaque increased 33% [odds ratio 1.33 per 1-U increase in log(GDF-15), 95% CI 1.20-1.48, P < 0.0001]. In contrast, there was no significant association of maximal ICA IMT or plaque presence with sST2 or hsTnI, and none of the 3 biomarkers was significantly associated with mean CCA IMT. GDF-15 was a stronger predictor of maximal ICA thickness and plaque presence compared with BNP and CRP when these conventional biomarkers were tested together. CONCLUSIONS Increased GDF-15 concentrations are associated with subclinical atherosclerosis, including maximal ICA IMT and carotid plaque presence. Future studies investigating the role of GDF-15 for screening and management of patients with subclinical atherosclerosis are warranted.
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Affiliation(s)
- Deepa M Gopal
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Martin G Larson
- Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA; Department of Mathematics and Statistics, Boston University, Boston, MA
| | - James L Januzzi
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Susan Cheng
- Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA
| | | | - Kai C Wollert
- Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Tibor Kempf
- Division of Molecular and Translational Cardiology, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Ralph B D'Agostino
- Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA; Department of Mathematics and Statistics, Boston University, Boston, MA
| | - Joseph F Polak
- Department of Radiology, Tufts Medical Center, Boston, MA
| | - Vasan S Ramachandran
- Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA; Cardiology and Preventive Medicine and
| | - Thomas J Wang
- Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA; Division of Cardiovascular Medicine, Division of Medicine, Vanderbilt University, Nashville, TN
| | - Jennifer E Ho
- Framingham Heart Study of the National Heart, Lung, and Blood Institute and Boston University School of Medicine, Framingham, MA; Cardiovascular Medicine Section, Department of Medicine, Boston University School of Medicine, Boston, MA;
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Toyoda K, Ninomiya T. Stroke and cerebrovascular diseases in patients with chronic kidney disease. Lancet Neurol 2014; 13:823-33. [DOI: 10.1016/s1474-4422(14)70026-2] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Volpe M, Rubattu S, Burnett J. Natriuretic peptides in cardiovascular diseases: current use and perspectives. Eur Heart J 2014; 35:419-25. [PMID: 24227810 PMCID: PMC4023301 DOI: 10.1093/eurheartj/eht466] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Revised: 09/03/2013] [Accepted: 10/01/2013] [Indexed: 12/14/2022] Open
Abstract
The natriuretic peptides (NPs) family, including atrial, B-type, and C-type NPs, is a group of hormones possessing relevant haemodynamic and anti-remodelling actions in the cardiovascular (CV) system. Due to their diuretic, natriuretic, vasorelaxant, anti-proliferative, and anti-hypertrophic effects, they are involved in the pathogenic mechanisms leading to major CV diseases, such as heart failure (HF), coronary artery disease, hypertension and left ventricular hypertrophy, and cerebrovascular accidents. Blood levels of NPs have established predictive value in the diagnosis of HF, as well as for its prognostic stratification. In addition, they provide useful clinical information in hypertension and in both stable and unstable coronary artery disease. Structural abnormalities of atrial natriuretic peptide gene (NPPA), as well as genetically induced changes in circulating levels of NPs, have a pathogenic causal link with CV diseases and represent emerging markers of CV risk. Novel NP-based therapeutic strategies are currently under advanced clinical development, as they are expected to contribute to the future management of hypertension and HF. The present review provides a current appraisal of NPs' clinical implications and a critical perspective of the potential therapeutic impact of pharmacological manipulation of this class of CV hormones.
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Affiliation(s)
- Massimo Volpe
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Ospedale S. Andrea, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Speranza Rubattu
- Department of Clinical and Molecular Medicine, School of Medicine and Psychology, Sapienza University of Rome, Ospedale S. Andrea, Rome, Italy
- IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - John Burnett
- Cardiorenal Research Laboratory, Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA
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