your limit has been reached. plz Donate us to allow your ip full access, Email: sshnevis@outlook.com
Uptodate Reference Title
Natriuretic peptides in heart failure
Natriuretic peptides in heart failure
Representation of the effects of elevated plasma atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in severe heart failure. ANP and BNP may increase (+) the rate of sodium excretion and reduce (-) the effects of the renin-angiotensin (RAS), sympathetic nervous systems (NS), and endothelin (ET)-1; the net effect of these actions is reduced preload and afterload. A similar elevation in inducible nitric oxide synthase (iNOS) is seen in humans with severe heart failure. These initially homeostatic mechanisms paradoxically contribute to the pathophysiology of the failing myocardium.