Endocrine functions of the heart: from bench to bedside

被引:26
作者
Volpe, Massimo [1 ,2 ]
Gallo, Giovanna [1 ]
Rubattu, Speranza [1 ,3 ]
机构
[1] Sapienza Univ Rome, Dept Clin & Mol Med, Via Grottarossa 1035, I-00189 Rome, Italy
[2] IRCCS San Raffaele, Via Pisana 235, I-00163 Rome, Italy
[3] IRCCS Neuromed, Via Atinense 18, I-86077 Pozzilli, IS, Italy
关键词
Cardiac natriuretic peptides; Secretion; Epigenetics; Cardiovascular diseases; Biomarkers; Therapy; ATRIAL-NATRIURETIC-PEPTIDE; BLOOD-PRESSURE REGULATION; LONG-TERM SURVIVAL; HEMODYNAMIC-RESPONSES; NEPRILYSIN INHIBITION; CONVERTING ENZYME; GENETIC VARIANT; CARDIAC EVENTS; FACTOR RELEASE; DOUBLE-BLIND;
D O I
10.1093/eurheartj/ehac759
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heart has a recognized endocrine function as it produces several biologically active substances with hormonal properties. Among these hormones, the natriuretic peptide (NP) system has been extensively characterized and represents a prominent expression of the endocrine function of the heart. Over the years, knowledge about the mechanisms governing their synthesis, secretion, processing, and receptors interaction of NPs has been intensively investigated. Their main physiological endocrine and paracrine effects on cardiovascular and renal systems are mostly mediated through guanylate cyclase-A coupled receptors. The potential role of NPs in the pathophysiology of heart failure and particularly their counterbalancing action opposing the overactivation of renin-angiotensin-aldosterone and sympathetic nervous systems has been described. In addition, NPs are used today as key biomarkers in cardiovascular diseases with both diagnostic and prognostic significance. On these premises, multiple therapeutic strategies based on the biological properties of NPs have been attempted to develop new cardiovascular therapies. Apart from the introduction of the class of angiotensin receptor/neprilysin inhibitors in the current management of heart failure, novel promising molecules, including M-atrial natriuretic peptide (a novel atrial NP-based compound), have been tested for the treatment of human hypertension. The development of new drugs is currently underway, and we are probably only at the dawn of novel NPs-based therapeutic strategies. The present article also provides an updated overview of the regulation of NPs synthesis and secretion by microRNAs and epigenetics as well as interactions of cardiac hormones with other endocrine systems.
引用
收藏
页码:643 / 655
页数:13
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