Atrial Natriuretic factor in heart failure

pp 595-601

Abstract

The purpose of this review is to analyse the physiologic properties of the arterial natriuretic factor as well as its prognostic and therapeutic value. The arterial natriuretic factor is a peptide released in response to an increase in atrial pressure, volume or rate. It has a peripheral and coronary vasodilator effect. It also increases sodium and water excretion which results in higher values of glomerular filtration rate, filtration fraction and renal ultra-filtration coefficient. Elevation of arterial natriuretic factor levels are observed in early phases of heart failure whereas in chronic stages levels are relatively lower. No benefits are obtained after the administration of arterial natriuretic factor during advanced stages of heart failure, probably due to hormone conter regulation, greater release of antidiuretic hormone or enhanced degradation of the peptide. Higher mortality rares have been shown to correlate with increased arterial natriuretic factor plasma levels. The potentially beneficial effects of the arterial natriuretic factor disappear in advanced stages of heart failure. Its therapeutic value has not been demonstrated. The role of degradation inhibitors is being evaluated in ongoing trials.