Cardiac Natriuretic Hormones as Markers of Cardiovascular Disease

Prof. Dr. Heikki Ruskoaho is Professor of Molecular Pharmacology at the University of Oulu, Finland. He was the Dean of Faculty of Medicine in 2001–2006 and now serves as the Vice-President for Science and Research at the University of Oulu. Heikki Ruskoaho received his doctorate in 1983, after which he performed postdoctoral training with Professor Detlev Ganten in Heidelberg, Germany 1984–1985. After postdoctoral training, he joined Department of Pharmacology and Toxicology at University of Oulu, and became associate professor 1989 and full professor 1996. He received an honorary doctorate in Semmelweis Medical School 1996 and is an Honorary Member of Hungarian Academy of Sciences, section Medical Sciences, since 2001. Dr. Ruskoaho’s honors include the State Medal by the President of Hungary in 2004. His research group is a member of Finnish Center of Excellence for Cardiovascular and Type 2 Diabetes Research, funded by the Academy of Finland for 2008–2013. Dr. Ruskoaho has published over 200 original articles and reviews. His research program continues to focus on the identification of signaling pathways and targets for the treatment of cardiac hypertrophy and heart failure.

Abstract

Three mammalian natriuretic peptides have been identified, including atrial natriuretic peptide (ANP), B-type natriuretic peptide (BNP) and C-type natriuretic peptide (CNP). These peptides are structurally similar and they consist of a 17-amino-acid core ring and acysteine bridge. In patients with heart failure, plasma levels of ANP, BNP, and the N-terminal fragments of their prohormones (NT-proANP and NT-proBNP) are elevated, becausethe cardiac hormonal system is activated by increased wall stretch due to increased volume and pressure overload. Patients suspected of having heart failure can be selected for further investigations on the basis of having an elevated plasma concentration of NT-proANP, BNP, and NT-proBNP. High levels of cardiac hormones identify those at greatest risk for future serious cardiovascular events. Moreover, adjusting heart failure treatment to reduce plasma levels of NT-proBNP may improve outcome. Natriuretic peptides are most useful clinically as a rule-out test. Measurement of cardiac hormones in patients with heart failure may reduce the need for hospitalizations and for more expensive investigations such as echocardiography.