Plasma pro-brain natriuretic peptides are strong biochemical markers in clinical cardiology

The cardiac natriuretic. peptides constitute a family of peptides that regu late fluid homeostasis as well as vascular tonus and growth. Following the fundamental establishment of the heart as an endocrine organ in the early 1 980's, the cardiac natriuretic. peptides have today been identified as pote nt biochemical tools in diverse aspects of clinical cardiology including as diagnostic, therapeutic and prognostic markers of cardiac dysfunction as w ell as potential drug targets. In man, Atrial Natriuretic. Peptide (ANP) an d Brain Natriuretic Peptide (BNP) are mainly synthesised and secreted by th e failing heart, whereas the closely related C-type Natriuretic Peptide (CN P) appears to be a local factor secreted by the endothelium and hence is no t considered as a cardiac natriuretic peptide. With the ongoing development of sensitive immunoassays, increased plasma concentrations of ANP and BNP peptides have been associated to a variety of cardiac diseases-but their cl inical usefulness as biochemical markers in congestive heart failure is the most promising. In contrast to the large quantity of clinical research on cardiac-derived peptides, the basic understanding of the molecular heteroge neity of these peptides. is however still insufficient. Since much clinical work on peptides derived from the proBNP precursor has been published rece ntly, this mini-review will focus on these novel peptides and their potenti al applications in the clinical setting.