PMID- 19799566
OWN - NLM
STAT- MEDLINE
DCOM- 20100222
LR  - 20211020
IS  - 1470-8736 (Electronic)
IS  - 0143-5221 (Print)
IS  - 0143-5221 (Linking)
VI  - 118
IP  - 5
DP  - 2010 Mar
TI  - Activation of a novel natriuretic endocrine system in humans with heart failure.
PG  - 367-74
LID - 10.1042/CS20090338 [doi]
AB  - Proguanylin and prouroguanylin are the inactive precursors of guanylin and 
      uroguanylin, natriuretic peptides involved in the regulation of sodium balance. 
      Urinary uroguanylin levels have been found previously to be elevated in patients 
      with HF (heart failure). The aim of the present study was to investigate whether 
      plasma proguanylin and prouroguanylin levels are increased in patients with HF 
      and to evaluate their relationship with cardiac and renal function. In this 
      prospective observational study, we recruited 243 patients with HF (151 men) and 
      72 healthy controls. In patients with HF, plasma levels of proguanylin [median, 
      7.2 (range, 0.9-79.0) microg/l] and prouroguanylin [8.3 (1.7-53.0 microg/l)] were 
      both significantly (P<0.0005) higher compared with levels in healthy controls 
      [5.5 (0.4-22.3 microg/l) for proguanylin and 6.3 (2.5-16.9) microg/l for 
      prouroguanylin]. In patients with HF, increased age, a history of hypertension, 
      diabetes and atrial fibrillation, use of diuretics, a higher NYHA (New York Heart 
      Association) class and a lower eGFR (estimated glomerular filtration rate) were 
      significant univariate predictors of proguanylin and prouroguanylin levels. In 
      multivariate analysis, a history of hypertension and low eGFR both had strong 
      independent associations with proguanylin and prouroguanylin levels. Proguanylin 
      and prouroguanylin varied significantly between NYHA class with a trend of 
      increasing plasma concentrations with worsening severity of symptoms. In 
      conclusion, plasma proguanylin and prouroguanylin are elevated in patients with 
      HF. Elevated plasma proguanylin and prouroguanylin levels are associated with 
      hypertension, renal impairment and increasing severity of HF. This novel 
      endocrine system may contribute to the pathophysiology of HF.
FAU - Narayan, Hafid
AU  - Narayan H
AD  - Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences 
      Building, Leicester Royal Infirmary, LeicesterLE2 7LX, UK.
FAU - Mohammed, Noor
AU  - Mohammed N
FAU - Quinn, Paulene A
AU  - Quinn PA
FAU - Squire, Iain B
AU  - Squire IB
FAU - Davies, Joan E
AU  - Davies JE
FAU - Ng, Leong L
AU  - Ng LL
LA  - eng
GR  - FS/09/040/British Heart Foundation/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Clin Sci (Lond)
JT  - Clinical science (London, England : 1979)
JID - 7905731
RN  - 0 (Diuretics)
RN  - 0 (Gastrointestinal Hormones)
RN  - 0 (Protein Precursors)
RN  - 0 (preproguanylin)
RN  - 0 (prouroguanylin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/blood
MH  - Diabetes Mellitus/blood
MH  - Diuretics/therapeutic use
MH  - Female
MH  - Gastrointestinal Hormones/*blood
MH  - Glomerular Filtration Rate
MH  - Heart Failure/*blood/physiopathology
MH  - Humans
MH  - Hypertension/blood
MH  - Male
MH  - Middle Aged
MH  - Natriuresis/physiology
MH  - Prospective Studies
MH  - Protein Precursors/*blood
MH  - Severity of Illness Index
MH  - Young Adult
PMC - PMC2789435
EDAT- 2009/10/06 06:00
MHDA- 2010/02/23 06:00
PMCR- 2009/12/01
CRDT- 2009/10/06 06:00
PHST- 2009/06/24 00:00 [received]
PHST- 2009/09/18 00:00 [revised]
PHST- 2009/09/23 00:00 [accepted]
PHST- 2009/10/06 06:00 [entrez]
PHST- 2009/10/06 06:00 [pubmed]
PHST- 2010/02/23 06:00 [medline]
PHST- 2009/12/01 00:00 [pmc-release]
AID - CS20090338 [pii]
AID - cs1180367 [pii]
AID - 10.1042/CS20090338 [doi]
PST - ppublish
SO  - Clin Sci (Lond). 2010 Mar;118(5):367-74. doi: 10.1042/CS20090338.