The natriuretic peptides (NP) are a group of structurally related but genetically distinct peptides that exert diverse actions on cardiovascular, renal and endocrine functions. The NP system includes three principal peptides: atrial natriuretic peptide (ANP), B-type natriuretic peptide (brain natriuretic peptide, BNP) and C-type natriuretic peptide (CNP). ANP has important effects on blood pressure and cardiac function regulation by promoting natriuresis, diuresis and vasorelaxation.Previous studies have demonstrated a significant contribution of ANP into the pathophysiological basis of cardiovascular diseases, i.e. hypertension and heart failure. In fact, ANP levels are found to be elevated in hypertension as well as in heart failure, where they parallel the progression of the underlying cardiac disease. Of interest, high NT-proANP levels predict the cardiovascular risk and the mortality for cardiovascular events in the general population.More recently, the molecular genetic approach has shown a significant impact of the ANP gene and of its structural alterations on susceptibility to develop vascular damage and the consequent clinical sequelae in both an animal model and in humans. Furthermore, a pharmacogenomic study has proven the beneficial effects of a diuretic-based therapy in hypertensive carriers of 2238CC ANP variant. In this regard, ongoing studies from our group are exploring the fine mechanisms underlying vascular damage induced by human ANP gene structural alterations.A new view of ANP strongly supports its role in the susceptibility to vascular damage development, mainly dependent on either altered gene structure or abnormal plasma concentrations. Thus, a careful characterization of NT-proANPANP in the clinical setting is recommended since it represents a valuable tool for prognostic, diagnostic and therapeutic strategies.
- Atrial-natriuretic-peptide, general
- Myocardial-infarction, treatment
- Stroke, treatment
- Vascular-injuries, treatment
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Internal Medicine