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Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications

The incidence of heart failure with preserved ejection fraction (HFpEF) is increasing and its challenging diagnosis and management combines clinical, imagistic and biological data. Natriuretic peptides (NPs) are hormones secreted in response to myocardial stretch that, by increasing cyclic guanosine...

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Autores principales: Tanase, Daniela Maria, Radu, Smaranda, Al Shurbaji, Sinziana, Baroi, Genoveva Livia, Florida Costea, Claudia, Turliuc, Mihaela Dana, Ouatu, Anca, Floria, Mariana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600439/
https://www.ncbi.nlm.nih.gov/pubmed/31142058
http://dx.doi.org/10.3390/ijms20112629
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author Tanase, Daniela Maria
Radu, Smaranda
Al Shurbaji, Sinziana
Baroi, Genoveva Livia
Florida Costea, Claudia
Turliuc, Mihaela Dana
Ouatu, Anca
Floria, Mariana
author_facet Tanase, Daniela Maria
Radu, Smaranda
Al Shurbaji, Sinziana
Baroi, Genoveva Livia
Florida Costea, Claudia
Turliuc, Mihaela Dana
Ouatu, Anca
Floria, Mariana
author_sort Tanase, Daniela Maria
collection PubMed
description The incidence of heart failure with preserved ejection fraction (HFpEF) is increasing and its challenging diagnosis and management combines clinical, imagistic and biological data. Natriuretic peptides (NPs) are hormones secreted in response to myocardial stretch that, by increasing cyclic guanosine monophosphate (cGMP), counteract myocardial fibrosis and hypertrophy, increase natriuresis and determine vasodilatation. While their role in HFpEF is controversial, most authors focused on b-type natriuretic peptides (BNPs) and agreed that patients may show lower levels. In this setting, newer molecules with an increased specificity, such as middle-region pro-atrial natriuretic peptide (MR-proANP), emerged as promising markers. Augmenting NP levels, either by NP analogs or breakdown inhibition, could offer a new therapeutic target in HFpEF (already approved in their reduced EF counterparts) by increasing the deficient cGMP levels found in patients. Importantly, these peptides also retain their prognostic value. This narrative review focuses on NPs’ physiology, diagnosis, therapeutic and prognostic implication in HFpEF.
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spelling pubmed-66004392019-07-16 Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications Tanase, Daniela Maria Radu, Smaranda Al Shurbaji, Sinziana Baroi, Genoveva Livia Florida Costea, Claudia Turliuc, Mihaela Dana Ouatu, Anca Floria, Mariana Int J Mol Sci Review The incidence of heart failure with preserved ejection fraction (HFpEF) is increasing and its challenging diagnosis and management combines clinical, imagistic and biological data. Natriuretic peptides (NPs) are hormones secreted in response to myocardial stretch that, by increasing cyclic guanosine monophosphate (cGMP), counteract myocardial fibrosis and hypertrophy, increase natriuresis and determine vasodilatation. While their role in HFpEF is controversial, most authors focused on b-type natriuretic peptides (BNPs) and agreed that patients may show lower levels. In this setting, newer molecules with an increased specificity, such as middle-region pro-atrial natriuretic peptide (MR-proANP), emerged as promising markers. Augmenting NP levels, either by NP analogs or breakdown inhibition, could offer a new therapeutic target in HFpEF (already approved in their reduced EF counterparts) by increasing the deficient cGMP levels found in patients. Importantly, these peptides also retain their prognostic value. This narrative review focuses on NPs’ physiology, diagnosis, therapeutic and prognostic implication in HFpEF. MDPI 2019-05-28 /pmc/articles/PMC6600439/ /pubmed/31142058 http://dx.doi.org/10.3390/ijms20112629 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Tanase, Daniela Maria
Radu, Smaranda
Al Shurbaji, Sinziana
Baroi, Genoveva Livia
Florida Costea, Claudia
Turliuc, Mihaela Dana
Ouatu, Anca
Floria, Mariana
Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title_full Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title_fullStr Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title_full_unstemmed Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title_short Natriuretic Peptides in Heart Failure with Preserved Left Ventricular Ejection Fraction: From Molecular Evidences to Clinical Implications
title_sort natriuretic peptides in heart failure with preserved left ventricular ejection fraction: from molecular evidences to clinical implications
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600439/
https://www.ncbi.nlm.nih.gov/pubmed/31142058
http://dx.doi.org/10.3390/ijms20112629
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