ANP snížení

Deficit ANP / snížená senzitivita na ANP

• Atriální natriuretický peptid
• Dělá exkreci sodíku a vody
• Zvýšením glomerulární filtrace
• Inhibicí resorpce Na v proximálním tubulu
• Inhibuje vyplavení reninu-aldosteronu

Akutní kardiální dekompenzace - ADHF

• 74% of patients showed elevated ANP and BNP
• 26% of patients were characterized as having normal ANP
• (21% of this subgroup had normal ANP and elevated BNP).
• Cyclic GMP was lowest in the ADHF group with normal levels of ANP (p < 0.001)
• BMI and EF were inversely related to ANP levels (p = 0.003).
• Presence of an ANP deficiency
• Differential regulation of ANP and BNP
• Existence of a potentially compromised compensatory cardiac endocrine response
• pubmed.ncbi.nlm.nih.gov/31521687/

• Cardiac natriuretic peptide deficiency sensitizes the heart to stress-induced ventricular arrhythmias via impaired CREB signalling
• ANP and BNP act in a non-redundant fashion to maintain myocardial cGMP levels to regulate cardiomyocyte p38 MAPK and CREB activity.
• Cardiac natriuretic peptide deficiency leads to a reduction in CREB signalling which sensitizes the heart to stress-induced ventricular arrhythmias.
• pubmed.ncbi.nlm.nih.gov/34329394/

Chronické srdeční selhání

• CHF a single intravenous digoxin injection increases ANP, BNP and cGMP plasma level.
• Oral digoxin administration supports this beneficial neurohumoral effect and improves hemodynamic parameters of left ventricle as well as reduces left atrium diameter.
• pubmed.ncbi.nlm.nih.gov/11865578/