The natriuretic peptides in heartfailure

Abstract. Synthesis and release of the natriuretic peptides risesincrementally with increasing degrees of cardiac dysfunction.The prime stimulus is intracardiac distending pressures withmodulating inuences including age, gender, renal function andother aspects of neurohormonal status. Measurements of plasmanatriuretic peptide concentrations and of B-type natriureticpeptide and amino-terminal pro-B-type natriuretic peptide, inparticular, show promise in diagnosis of heart failure, riskstratication in those with known heart disease, and inadjustment of therapy. Recombinant B-type natriuretic peptideitself can be administered as a treatment. These diagnostic,prognostic and therapeutic applications of B-type natriureticpeptide require a considerable expansion beyond currentevidence, but it appears likely that the true role of plasmapeptide measurements and peptide administration will becomermly established within the coming 5 year period.