What is the role of natriuretic peptides in the cardiovascular system?

Updated: Jul 30, 2021
  • Author: Kamal (Komo) Gursahani, MD, MBA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Natriuretic peptides (NP) are neurohormones involved in maintaining homeostasis in the cardiovascular system with respect to the regulation of sodium and water excretion and blood pressure. There are three NPs: atrial NP (ANP), brain-type NP (BNP), and C type NP (CNP). In clinical practice, BNP and N-terminal pro BNP (NT-proBNP) are used primarily to guide the management of heart failure. They are also used to prognosticate in other cardiovascular diseases.

BNP is produced and secreted primarily by the ventricular myocardium in response to wall stress. Mechanical stretch is sensed by cardiac myocytes in response to increases in volume or pressure in the ventricles, which triggers the production of the prohormone proBNP. ProBNP is cleaved into BNP and NT-proBNP, the inert molecule. Both can be assayed, and they are comparable in terms of their clinical utility for the management of heart failure and for prognostic value in other cardiovascular diseases. The half-life of BNP is 20 minutes, shorter than the 120 minutes half-life of NT-proBNP. Both significantly rise in concentration in heart failure. They can be useful markers of heart failure in that lower values lower the pretest probability of a diagnosis of heart failure.

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