Shawn H Reginauld1, Valentina Cannone2, Seethalakshmi Iyer1, Christopher Scott3, Kent Bailey3, Jacob Schaefer1, Yang Chen1, S Jeson Sangaralingham4, John C Burnett5. 1. Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. 2. Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Division of Clinical Medicine, Department of Medicine and Surgery, University of Parma, Parma, Italy. 3. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota. 4. Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota. 5. Cardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota. Electronic address: burnett.john@mayo.edu.
Abstract
OBJECTIVES: This study investigated the differential regulation of circulating atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with acute decompensated heart failure (ADHF) and tested the hypothesis that a relative deficiency of ANP exists in a subgroup of patients with ADHF. BACKGROUND: The endocrine heart releases the cardiac hormones ANP and BNP, which play a key role in cardiovascular (CV), renal, and metabolic homeostasis. In heart failure (HF), both plasma ANP and BNP are increased as a compensatory homeostatic response to myocardial overload. METHODS: ANP and BNP concentrations were measured in a small group of patients with ADHF (n = 112). To support this study's goal, a total of 129 healthy subjects were prospectively recruited to establish contemporary normal values for ANP and BNP. Plasma 3',5'cyclic guanosine monophosphate (cGMP), ejection fraction (EF), and body mass index (BMI) were measured in these subjects. RESULTS: In cases of ADHF, 74% of patients showed elevated ANP and BNP. Importantly, 26% of patients were characterized as having normal ANP (21% of this subgroup had normal ANP and elevated BNP). Cyclic GMP was lowest in the ADHF group with normal levels of ANP (p < 0.001), whereas BMI and EF were inversely related to ANP levels (p = 0.003). CONCLUSIONS: Among a subgroup of patients hospitalized with ADHF, the presence of an ANP deficiency is consistent with a differential regulation of ANP and BNP and suggests the existence of a potentially compromised compensatory cardiac endocrine response. These findings have implications for the pathophysiology, diagnostics, and therapeutics of human HF.
OBJECTIVES: This study investigated the differential regulation of circulating atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) in patients with acute decompensated heart failure (ADHF) and tested the hypothesis that a relative deficiency of ANP exists in a subgroup of patients with ADHF. BACKGROUND: The endocrine heart releases the cardiac hormones ANP and BNP, which play a key role in cardiovascular (CV), renal, and metabolic homeostasis. In heart failure (HF), both plasma ANP and BNP are increased as a compensatory homeostatic response to myocardial overload. METHODS: ANP and BNP concentrations were measured in a small group of patients with ADHF (n = 112). To support this study's goal, a total of 129 healthy subjects were prospectively recruited to establish contemporary normal values for ANP and BNP. Plasma 3',5'cyclic guanosine monophosphate (cGMP), ejection fraction (EF), and body mass index (BMI) were measured in these subjects. RESULTS: In cases of ADHF, 74% of patients showed elevated ANP and BNP. Importantly, 26% of patients were characterized as having normal ANP (21% of this subgroup had normal ANP and elevated BNP). Cyclic GMP was lowest in the ADHF group with normal levels of ANP (p < 0.001), whereas BMI and EF were inversely related to ANP levels (p = 0.003). CONCLUSIONS: Among a subgroup of patients hospitalized with ADHF, the presence of an ANP deficiency is consistent with a differential regulation of ANP and BNP and suggests the existence of a potentially compromised compensatory cardiac endocrine response. These findings have implications for the pathophysiology, diagnostics, and therapeutics of human HF.
Authors: Fima Macheret; Denise Heublein; Lisa C Costello-Boerrigter; Guido Boerrigter; Paul McKie; Diego Bellavia; Sarah Mangiafico; Yasuhiro Ikeda; Kent Bailey; Christopher G Scott; Sharon Sandberg; Horng H Chen; Lorenzo Malatino; Margaret M Redfield; Richard Rodeheffer; John Burnett; Alessandro Cataliotti Journal: J Am Coll Cardiol Date: 2012-10-16 Impact factor: 24.094
Authors: Peder Langeland Myhre; Muthiah Vaduganathan; Brian Claggett; Milton Packer; Akshay S Desai; Jean L Rouleau; Michael R Zile; Karl Swedberg; Martin Lefkowitz; Victor Shi; John J V McMurray; Scott D Solomon Journal: J Am Coll Cardiol Date: 2019-03-04 Impact factor: 24.094
Authors: Camilla L Asferg; Søren J Nielsen; Ulrik B Andersen; Allan Linneberg; Daniel V Møller; Paula L Hedley; Michael Christiansen; Jens P Goetze; Murray Esler; Jørgen L Jeppesen Journal: Hypertension Date: 2013-05-13 Impact factor: 10.190
Authors: J C Burnett; P C Kao; D C Hu; D W Heser; D Heublein; J P Granger; T J Opgenorth; G S Reeder Journal: Science Date: 1986-03-07 Impact factor: 47.728
Authors: S Suga; K Nakao; K Hosoda; M Mukoyama; Y Ogawa; G Shirakami; H Arai; Y Saito; Y Kambayashi; K Inouye Journal: Endocrinology Date: 1992-01 Impact factor: 4.736
Authors: S Jeson Sangaralingham; Kanupriya Whig; Satyamaheshwar Peddibhotla; R Jason Kirby; Hampton E Sessions; Patrick R Maloney; Paul M Hershberger; Heather Mose-Yates; Becky L Hood; Stefan Vasile; Shuchong Pan; Ye Zheng; Siobhan Malany; John C Burnett Journal: Proc Natl Acad Sci U S A Date: 2021-12-28 Impact factor: 12.779
Authors: Andrea de la Fuente-Alonso; Marta Toral; Alvaro Alfayate; María Jesús Ruiz-Rodríguez; Elena Bonzón-Kulichenko; Gisela Teixido-Tura; Sara Martínez-Martínez; María José Méndez-Olivares; Dolores López-Maderuelo; Ileana González-Valdés; Eusebio Garcia-Izquierdo; Susana Mingo; Carlos E Martín; Laura Muiño-Mosquera; Julie De Backer; J Francisco Nistal; Alberto Forteza; Arturo Evangelista; Jesús Vázquez; Miguel R Campanero; Juan Miguel Redondo Journal: Nat Commun Date: 2021-05-11 Impact factor: 14.919
Authors: Gustavo Jose Justo da Silva; Raffaele Altara; George W Booz; Alessandro Cataliotti Journal: Front Physiol Date: 2021-07-08 Impact factor: 4.566
Authors: Xiao Ma; Yang Chen; Shawn H Reginauld; Christopher G Scott; Seethalakshmi R Iyer; Jacob J Schaefer; Tomoko Ichiki; Horng H Chen; Andrew D Rule; John C Burnett; S Jeson Sangaralingham Journal: JACC Heart Fail Date: 2021-07-07 Impact factor: 12.544
Authors: Eric J Hall; Soumojit Pal; Michael S Glennon; Puneeth Shridhar; Sidney L Satterfield; Beth Weber; Qinkun Zhang; Guy Salama; Hind Lal; Jason R Becker Journal: Cardiovasc Res Date: 2022-07-20 Impact factor: 13.081
Authors: Alexandra Petraina; Cristian Nogales; Thomas Krahn; Hermann Mucke; Thomas F Lüscher; Rodolphe Fischmeister; David A Kass; John C Burnett; Adrian J Hobbs; Harald H H W Schmidt Journal: Cardiovasc Res Date: 2022-07-20 Impact factor: 13.081