Natriuretic peptides in cardiovascular diseases of fetus, infants and children.

The natriuretic peptides (NP) appear to be functional by midgestation, respond to volume stimuli, and regulate blood pressure and salt and water balance in the developing embryo. In addition, the NP may help regulate the blood supply to the fetus, acting as vasodilators in the placental vasculature. Peaks of ANP and BNP expression during gestation coincide with significant events in cardiac organogenesis, suggesting a role for NP in the formation of the heart. Levels of atrial natriuretic peptide (ANP) are higher in the fetal circulation than in adults, and fetal ventricles express higher levels of ANP and B-type natriuretic peptide (BNP) than adult ventricles. In this comprehensive review we have discussed the role NP during development of the fetal heart and circulation and in various cardiovascular diseases of neonatal and pediatric age group.