Natriuretic Peptides as Biomarkers: Narrative Review and Considerations in Cardiovascular and Respiratory Dysfunctions.

IF 2.5 3区 工程技术 Q2 BIOLOGY
Mohammad Samad, Sreekar Malempati, Carolina B A Restini
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引用次数: 3

Abstract

Natriuretic peptides (NPs) encompass a family of structurally related hormone/paracrine factors acting through the natriuretic peptide system regulating cell proliferation, vessel tone, inflammatory processes, neurohumoral pathways, fluids, and electrolyte balance. The three most studied peptides are atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-Type natriuretic peptide (CNP). ANP and BNP are the most relevant NPs as biomarkers for the diagnosis and prognosis of heart failure and underlying cardiovascular diseases, such as cardiac valvular dysfunction, hypertension, coronary artery disease, myocardial infarction, persistent arrhythmias, and cardiomyopathies. Cardiac dysfunctions related to cardiomyocytes stretching in the atria and ventricles are primary elicitors of ANP and BNP release, respectively. ANP and BNP would serve as biomarkers for differentiating cardiac versus noncardiac causes of dyspnea and as a tool for measuring the prognosis of patients with heart failure; nevertheless, BNP has been shown with the highest predictive value, particularly related to pulmonary disorders. Plasma BNP has been reported to help differentiate cardiac from pulmonary etiologies of dyspnea in adults and neonates. Studies have shown that COVID-19 infection also increases serum levels of N-terminal pro b-type natriuretic peptide (NT-proBNP) and BNP. This narrative review assesses aspects of ANP and BNP on their physiology, and predictive values as biomarkers. We present an overview of the NPs' synthesis, structure, storage, and release, as well as receptors and physiological roles. Following, considerations focus on ANP versus BNP, comparing their relevance in settings and diseases associated with respiratory dysfunctions. Finally, we compiled data from guidelines for using BNP as a biomarker in dyspneic patients with cardiac dysfunction, including its considerations in COVID-19.

Abstract Image

Abstract Image

利钠肽作为生物标志物:心血管和呼吸功能障碍的叙述回顾和考虑。
利钠肽(NPs)包括一系列结构相关的激素/旁分泌因子,通过利钠肽系统调节细胞增殖、血管张力、炎症过程、神经体液通路、液体和电解质平衡。研究最多的三种肽是心房钠肽(ANP)、脑钠肽(BNP)和c型钠肽(CNP)。ANP和BNP是心衰和潜在心血管疾病(如心瓣膜功能障碍、高血压、冠状动脉疾病、心肌梗死、持续性心律失常和心肌病)诊断和预后最相关的NPs生物标志物。与心房和心室心肌细胞伸展相关的心功能障碍分别是ANP和BNP释放的主要诱发因子。ANP和BNP可作为区分心源性与非心源性呼吸困难的生物标志物,并可作为衡量心力衰竭患者预后的工具;然而,BNP已被证明具有最高的预测价值,特别是与肺部疾病有关。据报道,血浆BNP有助于区分成人和新生儿呼吸困难的心源性和肺源性病因。研究表明,COVID-19感染还会使血清n端前b型利钠肽(NT-proBNP)和BNP水平升高。这篇叙述性综述评估了ANP和BNP的生理方面,以及作为生物标志物的预测价值。我们介绍了NPs的合成、结构、储存和释放,以及受体和生理作用的概述。以下,重点关注ANP与BNP,比较它们在与呼吸功能障碍相关的环境和疾病中的相关性。最后,我们收集了使用BNP作为呼吸困难心功能障碍患者生物标志物的指南数据,包括其在COVID-19中的考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Yale Journal of Biology and Medicine
Yale Journal of Biology and Medicine Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.00
自引率
0.00%
发文量
41
期刊介绍: The Yale Journal of Biology and Medicine (YJBM) is a graduate and medical student-run, peer-reviewed, open-access journal dedicated to the publication of original research articles, scientific reviews, articles on medical history, personal perspectives on medicine, policy analyses, case reports, and symposia related to biomedical matters. YJBM is published quarterly and aims to publish articles of interest to both physicians and scientists. YJBM is and has been an internationally distributed journal with a long history of landmark articles. Our contributors feature a notable list of philosophers, statesmen, scientists, and physicians, including Ernst Cassirer, Harvey Cushing, Rene Dubos, Edward Kennedy, Donald Seldin, and Jack Strominger. Our Editorial Board consists of students and faculty members from Yale School of Medicine and Yale University Graduate School of Arts & Sciences. All manuscripts submitted to YJBM are first evaluated on the basis of scientific quality, originality, appropriateness, contribution to the field, and style. Suitable manuscripts are then subject to rigorous, fair, and rapid peer review.
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