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Circulating forms of human atrial natriuretic peptide in patients with congestive heart failure
1Second Department of Internal Medicine, Tokyo Medical and Dental University, Japan.
Insights
Plasma levels of human atrial natriuretic peptide (hANP) increase with congestive heart failure (CHF) severity. Specific forms, beta-hANP and gamma-hANP, are secreted by the failing heart and may indicate CHF severity.
Area of Science:
- Cardiology
- Endocrinology
- Biochemistry
Background:
- Congestive heart failure (CHF) is a complex syndrome characterized by the heart's inability to pump blood effectively.
- Human atrial natriuretic peptide (hANP) plays a crucial role in cardiovascular homeostasis.
- Understanding the circulating forms of hANP in CHF is essential for diagnosis and management.
Purpose of the Study:
- To investigate the different circulating forms of hANP in patients with varying degrees of CHF.
- To compare hANP profiles in CHF patients with those in healthy individuals.
- To assess the potential of specific hANP forms as biomarkers for CHF severity.
Main Methods:
- Plasma samples from 36 CHF patients and normal subjects were analyzed.
- hANP-like immunoreactivity (LI) was measured using radioimmunoassay (RIA).
- Reverse-phase HPLC and gel permeation chromatography were employed to identify circulating hANP forms.
Main Results:
- Plasma hANP-LI levels were significantly elevated in moderate to severe CHF (NYHA class II-IV) compared to mild CHF (NYHA class I) and normal subjects.
- Circulating hANP-LI in CHF patients comprised alpha-hANP, beta-hANP, and gamma-hANP, with alpha-hANP predominating in normal plasma.
- The proportion of beta-hANP increased with CHF severity and was significantly higher in severe CHF.
- Successful CHF treatment led to reduced total plasma hANP-LI and decreased beta-hANP levels.
Conclusions:
- The failing human heart secretes beta-hANP and gamma-hANP, potentially due to altered hANP precursor synthesis or processing.
- Circulating beta-hANP may serve as a valuable biomarker for assessing the severity of CHF.
- These findings contribute to a better understanding of hANP's role in CHF pathophysiology.
Abstract:
To elucidate the circulating forms of human atrial natriuretic peptide (hANP) in patients with congestive heart failure (CHF), plasma samples obtained from 36 patients with CHF were analyzed and compared with those from normal subjects. Plasma concentrations of hANP-like immunoreactivity (LI) from normal subjects and patients with mild CHF (class I), as classified by the New York Heart Association (NYHA) functional criteria, did not differ (15 +/- 1 vs. 16 +/- 1 pmol/L, mean +/- SE), whereas plasma levels of hANP-LI in patients with moderate and severe CHF significantly (P less than 0.01) increased in relation to the severity of CHF (class II, 44 +/- 4 pmol/L; class III, 116 +/- 24 pmol/L; class IV, 141 +/- 21 pmol/L). Reverse-phase HPLC and gel permeation chromatography coupled with RIA for hANP revealed that the circulating forms of hANP-LI consisted of alpha-hANP, beta-hANP, and gamma-hANP in CHF, whereas alpha-hANP predominated in normal plasma. The percentage of beta-hANP in total hANP-LI as calculated from the chromatograms by gel filtration was greater in severe CHF (NYHA class III and IV) than those in mild CHF (NYHA class I and II), and apparently exceeded those of other forms. Successful medical treatment for CHF resulted in a marked reduction of total plasma hANP-LI levels with a concomitant disappearance or reduction of beta-hANP in 14 patients examined. These data suggest that beta-hANP and gamma-hANP are secreted from the failing human heart, possibly resulting from the augmented synthesis and/or the altered processing of hANP precursor in cardiocytes, and that circulating beta-hANP may serve as a potential marker for the severity of CHF in man.