Natriuretic peptides and their actions of natriuresis, diuresis, and vasodilation have been described in the scientific literature for more than 20 years.11,22 Only recently though, a more complete understanding of the actions of natriuretic peptides, their receptors, and their applications has been achieved. With this understanding, new classes of medications have been developed that can target different pathophysiological events in heart failure and offer further treatment options. In this article, we introduce a new drug, human B-type natriuretic peptide (Natrecor or nesiritide), indicated for intravenous treatment of patients with acutely decompensated heart failure who have dyspnea at rest or with minimal activity.33 

Currently, 3 natriuretic peptides have been identified. Atrial natriuretic peptide (ANP) is produced and released by the atria in response to stretching of the myocardium due to increased intravascular volume. B-type...

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