CLINICAL USE OF NATRIURETIC PEPTIDES. A REVIEW
DOI:
https://doi.org/10.5457/ams.v37i2.19Keywords:
natriuretic peptides, heart failure, clinical usesAbstract
The most significant discoveries in the area of heart failure are the recognition of natriuretic peptide system and its multiple effects on cardiac structure and function with special effect on its natriuretic and hemodynamic processes. First information's that heart, beside its function as a mechanical pump also has an important endocrine functions, exists for over 50 years. Chemical structure of atrial natriuretic peptide has been identified in 1984. and four years later a brain natriuretic peptide has been discovered owning its name because it has been identified in pig brain. Primary site of brain natriuretic peptide synthesis in heart has been identified in 1991. Natriuretic peptides are neither neurohormones that influence body fluid homeostasis through natriuretic and diuretic effect; regulate vascular tone by decreasing angiotensine II level and they inhibit nor epinephrine synthesis and increase parasympathetic tone. They are natural antagonists of renin-angiotensine-aldosteron system, and they have a great role in inhibition of ventricular hypertrophy and remodeling, protective effects in endothelial dysfunction are important; they increase effects of nitrite oxide, inhibit lipid deposition in vascular wall and inhibit thrombocyte activation, regulate coagulation and fibrinolytic processes as well. Natriuretic peptides clinical use is in early evaluation of heart failure, prognostic stratification and detection of systolic and diastolic dysfunction of left ventricle, assessment of prognosis during patient monitoring period, differential diagnosis of dyspnea, treatment adjustment and dosage titration, assessment during hospital admittance and discharge and forecast and reduction of coronary events.
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