Chapter 1 - Cardiac Natriuretic Peptides

Add time:08/31/2019    Source:sciencedirect.com

The natriuretic peptide family contains three members; A-type atrial natriuretic peptide (ANP), B-type or brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). ANP and BNP are produced primarily in the heart whereas CNP originates more widely in the systemic vasculature as well as from the heart. All the natriuretic peptides share a similar gene and peptide synthetic pathway that results in a common di-sulfide linked ring structure in their carboxyl terminal, bioactive forms. The amino terminal portions of the natriuretic peptide have no identified bioactivity and circulate at much higher concentrations compared with their bioactive counterparts. Over the last 30 years, a remarkable array of cardiovascular activities has been ascribed to the natriuretic peptides, mediated via their guanylate cyclase receptors, and this has solidified these peptides and their cognate receptors as an important cardiovascular regulatory system. Furthermore, measurement of the natriuretic peptide is clinically relevant, especially in the diagnosis and therapeutic management of congestive heart failure. This chapter reviews the biochemistry, physiology, and clinical utility of the natriuretic peptides and offers some insights into future directions for their study.

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