The concept of the heart as an endocrine organ has been attractive since the discovery of atrial natriuretic peptide. This review focuses on the second discovered natriuretic peptide from the heart—B-type natriuretic peptide (BNP), widely used as a tool in the diagnosis of heart failure (HF). Controversy remains regarding its use as a therapeutic agent in HF. This article places into perspective some of the debate and provides insights into the therapeutics of BNP and the importance of its second messenger 3′5′ cyclic guanosine monophosphate, which also is the second messenger for nitric oxide and is modulated by renal phosphodiesterases.
Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, USA
Corresponding author. Cardiorenal Research Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.
Funding resources: This manuscript was supported by grant support from the Mayo Foundation and grants from National Heart, Lung, and Blood Institute (PO1 HL76611, RO1 HL36634, and RO1 HL83231), the Mayo Foundation, and the Marriott Foundation.
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