Natriuretic peptides and salt sensitivity: endocrine cardiorenal integration in heart failure

Mammalian hearts contain a family of peptides with potent natriuretic, diuretic, and vasorelaxant actions. In addition to atrial natruretic peptide (ANP) and brain natriuretic peptide, recent studies in humans and animals have suggested that the N-terminal ANP prohormone fragment 31-67 may represent another adaptive mechanism to achieve body fluid homeostasis. Furthermore, these investigations have also suggested that via different mechanisms of action on target organisms, the C-terminal hormone ANP 99-126 and pro-ANP 31-67 may coordinate and contribute to the regulation of hemodynamic and renal function in pathophysiologic situations, such as heart failure.