Heart Diseases

心脏病
  • 文章类型: Journal Article
    冠状病毒(CoV)属于RNA病毒家族。已知该家族中的病毒在人类中引起轻度呼吸道疾病。导致冠状病毒-19疾病(COVID-19)的新型SARS-COV2病毒的起源是中国武汉市,它从那里传播以引起全球大流行。尽管肺部是19型冠状病毒病(COVID-19)的主要靶器官,自从它爆发以来,已知这种疾病会影响心脏,血管,肾,肠,肝脏和大脑。本文旨在总结冠状病毒病-19对心脏和肝脏的灾难性影响及其发病机制。
    本评论中使用的信息来自PubMed上发表的相关文章,谷歌学者,Google,世卫组织网站,CDC和其他来源。使用与COVID-19相关的关键搜索语句和短语来检索信息。原创研究文章,审查文件,研究信函和病例报告被用作信息来源。
    除了造成严重的肺损伤,据报道,COVID-19还影响并导致许多其他器官的功能障碍。COVID-19感染可通过下调膜结合活性血管紧张素转换酶(ACE)来影响人。ACE2表达不足的人更容易感染COVID-19。患者预先存在的合并症是使个体易患严重COVID-19的主要危险因素。
    疾病的严重程度及其广谱表型是直接和间接致病因素综合作用的结果。因此,协调许多治疗偏好的方案应该是使疾病降级并避免由于疾病引起的多器官损伤和功能障碍而导致的死亡的最佳替代方案。
    UNASSIGNED: Coronaviruses (CoVs) belong to the RNA viruses family. The viruses in this family are known to cause mild respiratory disease in humans. The origin of the novel SARS-COV2 virus that caused the coronavirus-19 disease (COVID-19) is the Wuhan city in China from where it disseminated to cause a global pandemic. Although lungs are the predominant target organ for Coronavirus Disease-19 (COVID-19), since its outbreak, the disease is known to affect heart, blood vessels, kidney, intestine, liver and brain. This review aimed to summarize the catastrophic impacts of Coronavirus disease-19 on heart and liver along with its mechanisms of pathogenesis.
    UNASSIGNED: The information used in this review was obtained from relevant articles published on PubMed, Google Scholar, Google, WHO website, CDC and other sources. Key searching statements and phrases related to COVID-19 were used to retrieve information. Original research articles, review papers, research letters and case reports were used as a source of information.
    UNASSIGNED: Besides causing severe lung injury, COVID-19 has also been reported to affect and cause dysfunction of many other organs. COVID-19 infection can affect people by downregulating membrane-bound active angiotensin-converting enzyme (ACE). People who have deficient ACE2 expression are more vulnerable to COVID-19 infection. The patients\' pre-existing co-morbidities are major risk factors that predispose individuals to severe COVID-19.
    UNASSIGNED: The disease severity and its broad spectrum phenotype is a result of combined direct and indirect pathogenic factors. Therefore, protocols that harmonize many therapeutic preferences should be the best alternatives to de-escalate the disease and obviate deaths caused as a result of multiple organ damage and dysfunction induced by the disease.
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  • 文章类型: Journal Article
    药物剂量的生理决定因素(PDODD)是一种有前途的精确剂量方法。这项研究调查了PDODD在疾病中的变化,并评估了PDODD的变分自动编码器(VAE)人工智能模型。PDODD面板包含20个生物标志物,和13肾,肝,糖尿病,和心脏疾病状态变量。人口特征,人体测量(体重,体表面积,腰围),血液(血浆体积,白蛋白),肾(肌酐,肾小球滤过率,尿流,和尿白蛋白与肌酐的比率),和肝(R值,肝脂肪变性指数,药物性肝损伤指数),血细胞(全身炎症指数,红细胞,淋巴细胞,中性粒细胞,和血小板计数)生物标志物,纳入了国家健康和营养检查调查(NHANES)的医学问卷答复。表格VAE(TVAE)生成模型是使用合成数据库Python库实现的。生成数据的联合分布与测试数据使用图形单变量进行比较,双变量,以及多维投影方法和分布邻近测度。与疾病进展相关的PDODD生物标志物如预期的那样在肾脏发生改变,肝,糖尿病,和心脏疾病。由TVAE生成的连续PDODD面板变量令人满意地逼近了测试数据中的分布。一些离散变量的TVAE生成的分布偏离了测试数据分布。TVAE生成的连续变量的年龄分布与测试数据相似。TVAE算法展示了作为连续PDODD的AI模型的潜力,并且可以用于生成用于临床试验模拟的虚拟群体。
    Physiological determinants of drug dosing (PDODD) are a promising approach for precision dosing. This study investigates the alterations of PDODD in diseases and evaluates a variational autoencoder (VAE) artificial intelligence model for PDODD. The PDODD panel contained 20 biomarkers, and 13 renal, hepatic, diabetes, and cardiac disease status variables. Demographic characteristics, anthropometric measurements (body weight, body surface area, waist circumference), blood (plasma volume, albumin), renal (creatinine, glomerular filtration rate, urine flow, and urine albumin to creatinine ratio), and hepatic (R-value, hepatic steatosis index, drug-induced liver injury index), blood cell (systemic inflammation index, red cell, lymphocyte, neutrophils, and platelet counts) biomarkers, and medical questionnaire responses from the National Health and Nutrition Examination Survey (NHANES) were included. The tabular VAE (TVAE) generative model was implemented with the Synthetic Data Vault Python library. The joint distributions of the generated data vs. test data were compared using graphical univariate, bivariate, and multidimensional projection methods and distribution proximity measures. The PDODD biomarkers related to disease progression were altered as expected in renal, hepatic, diabetes, and cardiac diseases. The continuous PDODD panel variables generated by the TVAE satisfactorily approximated the distribution in the test data. The TVAE-generated distributions of some discrete variables deviated from the test data distribution. The age distribution of TVAE-generated continuous variables was similar to the test data. The TVAE algorithm demonstrated potential as an AI model for continuous PDODD and could be useful for generating virtual populations for clinical trial simulations.
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  • 文章类型: Journal Article
    生物性别是生理的重要调节剂,并影响许多疾病的病理生物学。虽然心脏病是全球男性和女性死亡的头号原因,在器官和细胞尺度上存在性别差异,影响临床表现,诊断,和治疗。在这篇评论中,我们强调了心脏结构的基线性别差异,函数,和细胞信号传导,并讨论性激素和染色体对这些特征的贡献。心脏是一个明显的可塑性器官,通过改变形式和功能对生理和病理线索迅速做出反应。响应这些刺激的心脏重塑的性质和程度通常取决于生物学性别。我们讨论了压力和容量超负荷在适应性生理重塑和病理性心脏重塑中的器官和分子水平的性别差异,缺血,和遗传性心脏病。最后,我们提供了心脏性别差异研究的关键未来方向的观点.
    Biological sex is an important modifier of physiology and influences pathobiology in many diseases. While heart disease is the number one cause of death worldwide in both men and women, sex differences exist at the organ and cellular scales, affecting clinical presentation, diagnosis, and treatment. In this Review, we highlight baseline sex differences in cardiac structure, function, and cellular signaling and discuss the contribution of sex hormones and chromosomes to these characteristics. The heart is a remarkably plastic organ and rapidly responds to physiological and pathological cues by modifying form and function. The nature and extent of cardiac remodeling in response to these stimuli are often dependent on biological sex. We discuss organ- and molecular-level sex differences in adaptive physiological remodeling and pathological cardiac remodeling from pressure and volume overload, ischemia, and genetic heart disease. Finally, we offer a perspective on key future directions for research into cardiac sex differences.
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  • 文章类型: Case Reports
    肝细胞癌(HCC)是全球癌症相关死亡率的重要贡献者。虽然局部晚期HCC的急性和通常致命的表现主要存在于腹部内,至关重要的是要认识到,由于肝脏在体内独特的解剖位置,呼吸和循环系统也可能成为受害者。这里,我们介绍了一例63岁男性最近诊断为局部晚期HCC伴血管侵犯的病例.在接受靶向治疗和局灶性放疗后不久,患者出现反复继发感染和持续性膈缺损.坏死组织侵入胸膜腔,随后出现了肿瘤到支气管和肿瘤到心脏的瘘,导致呼吸系统和心血管系统之间的异常连接,导致循环中大量的空气栓塞。本报告强调了HCC患者治疗后继发感染的膈肌并发症的风险,特别是倾向于发展为膈肌缺陷的患者。
    Hepatocellular carcinoma (HCC) stands as a significant contributor to cancer-related mortality globally. While the acute and often fatal manifestations of locally advanced HCC primarily present within the abdomen, it is crucial to recognize that the respiratory and circulatory systems can also fall victim due to the liver\'s unique anatomical position within the body. Here, we present the case of a 63-year-old male recently diagnosed with locally advanced HCC with vascular invasion. Shortly after receiving target therapy and focal radiotherapy, the patient developed repeated secondary infections and a persistent diaphragmatic defect. As the necrotic tissue invaded the pleural space, subsequent tumor-to-bronchial and tumor-to-cardiac fistulas emerged, resulting in an abnormal connection between the respiratory and cardiovascular systems, leading to massive air emboli in circulation. This report highlights the risk of supradiaphragmatic complications in HCC patients with post-treatment secondary infections, particularly in patients predisposed to developing diaphragmatic defects.
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  • 文章类型: Journal Article
    活动依赖性神经保护性同源盒(ADNP)基因杂合从头突变是Helsmoortel-VanderAa综合征(HVDAS)的基础.这些突变中的大多数位于最后一个外显子,我们先前通过检测患者血液中的突变ADNPmRNA证明了从无义介导的衰变中逃脱。在这项研究中,在蛋白质水平上研究野生型和ADNP突变体,因此需要蛋白质的最佳检测。通过蛋白质印迹法检测ADNP是模糊的,报道的抗体导致没有独特ADNP信号的非特异性条带。使用阻断肽竞争测定法验证N端ADNP抗体(Aviva系统),允许区分不同样品材料中的特异性和非特异性信号,导致ADNP在150kDa左右的独特波段信号,高于其124kDa的理论分子量。用不同的C-末端抗体检测证实了在150kDa的观察分子量下的信号。我们的抗体小组随后通过免疫印迹进行了测试,比较亲本和纯合CRISPR/Cas9内切核酸酶介导的Adnp敲除细胞系,并显示150kDa信号消失,指示完整的ADNP。通过与人ADNP表达载体融合的GFPSpark和Flag标签N末端,我们通过定点诱变在大肠杆菌表达系统中引入患者突变后检测到野生型ADNP和突变形式。此外,我们还能够在携带ADNP患者突变的杂合细胞系中使用我们的C端抗体组可视化内源性ADNP,而截短的ADNP突变体只能用表位标签特异性抗体检测,表明添加表位标签可能有助于稳定蛋白质。然而,患者来源的hiPSCs的蛋白质印迹,永生化的类淋巴母细胞细胞系和死后患者的大脑材料未能检测到天然突变的ADNP蛋白。此外,在过表达裂解物中富含N-末端免疫沉淀活性ADNP抗体的截短突变体,而相同方法的实施未能在永生化的患者来源的淋巴母细胞细胞系中富集可能的天然突变蛋白。这项研究旨在提高对Helsmoortel-VanderAa综合征中突变ADNP蛋白分析的关键评估的认识。
    Heterozygous de novo mutations in the Activity-Dependent Neuroprotective Homeobox (ADNP) gene underlie Helsmoortel-Van der Aa syndrome (HVDAS). Most of these mutations are situated in the last exon and we previously demonstrated escape from nonsense-mediated decay by detecting mutant ADNP mRNA in patient blood. In this study, wild-type and ADNP mutants are investigated at the protein level and therefore optimal detection of the protein is required. Detection of ADNP by means of western blotting has been ambiguous with reported antibodies resulting in non-specific bands without unique ADNP signal. Validation of an N-terminal ADNP antibody (Aviva Systems) using a blocking peptide competition assay allowed to differentiate between specific and non-specific signals in different sample materials, resulting in a unique band signal around 150 kDa for ADNP, above its theoretical molecular weight of 124 kDa. Detection with different C-terminal antibodies confirmed the signals at an observed molecular weight of 150 kDa. Our antibody panel was subsequently tested by immunoblotting, comparing parental and homozygous CRISPR/Cas9 endonuclease-mediated Adnp knockout cell lines and showed disappearance of the 150 kDa signal, indicative for intact ADNP. By means of both a GFPSpark and Flag-tag N-terminally fused to a human ADNP expression vector, we detected wild-type ADNP together with mutant forms after introduction of patient mutations in E. coli expression systems by site-directed mutagenesis. Furthermore, we were also able to visualize endogenous ADNP with our C-terminal antibody panel in heterozygous cell lines carrying ADNP patient mutations, while the truncated ADNP mutants could only be detected with epitope-tag-specific antibodies, suggesting that addition of an epitope-tag possibly helps stabilizing the protein. However, western blotting of patient-derived hiPSCs, immortalized lymphoblastoid cell lines and post-mortem patient brain material failed to detect a native mutant ADNP protein. In addition, an N-terminal immunoprecipitation-competent ADNP antibody enriched truncating mutants in overexpression lysates, whereas implementation of the same method failed to enrich a possible native mutant protein in immortalized patient-derived lymphoblastoid cell lines. This study aims to shape awareness for critical assessment of mutant ADNP protein analysis in Helsmoortel-Van der Aa syndrome.
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  • 文章类型: Journal Article
    心脏病是世界上主要的死亡原因。基于心电图(ECG)的诊断模型通常受到高质量数据的稀缺性和数据不平衡问题的限制。为了应对这些挑战,我们提出了一个条件生成对抗网络(CECG-GAN)。该策略使得能够产生紧密近似ECG数据分布的样本。此外,CECG-GAN解决波形抖动,处理速度较慢,和数据集不平衡问题,通过变压器架构的集成。我们使用两个数据集评估了这种方法:MIT-BIH和CSPC2020。实验结果表明,CECG-GAN具有出色的性能指标。值得注意的是,百分比均方根差异(PRD)达到55.048,表明生成的和实际的ECG波形之间的高度相似性。此外,Fréchet距离(FD)约为1.139,均方根误差(RMSE)记录为0.232,平均绝对误差(MAE)记录为0.166。
    Heart disease is the world\'s leading cause of death. Diagnostic models based on electrocardiograms (ECGs) are often limited by the scarcity of high-quality data and issues of data imbalance. To address these challenges, we propose a conditional generative adversarial network (CECG-GAN). This strategy enables the generation of samples that closely approximate the distribution of ECG data. Additionally, CECG-GAN addresses waveform jitter, slow processing speeds, and dataset imbalance issues through the integration of a transformer architecture. We evaluated this approach using two datasets: MIT-BIH and CSPC2020. The experimental results demonstrate that CECG-GAN achieves outstanding performance metrics. Notably, the percentage root mean square difference (PRD) reached 55.048, indicating a high degree of similarity between generated and actual ECG waveforms. Additionally, the Fréchet distance (FD) was approximately 1.139, the root mean square error (RMSE) registered at 0.232, and the mean absolute error (MAE) was recorded at 0.166.
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  • 文章类型: Dataset
    心脏磁共振成像(CMR)已成为心脏病的有价值的诊断工具。然而,CMR的一个显著缺点是成像速度慢,导致患者吞吐量低,临床诊断质量受损。有限的时间分辨率还会导致患者不适,并在图像中引入伪影。进一步降低其整体质量和诊断价值。人们对基于深度学习的CMR成像算法越来越感兴趣,该算法可以从高度欠采样的k空间数据中重建高质量的图像。然而,深度学习方法的发展需要大量的训练数据集,到目前为止,还没有公开提供给CMR。为了解决这个差距,我们发布了一个包含多对比度的数据集,多视图,来自300名受试者的多层和多线圈CMR成像数据。成像研究包括心脏电影和标测序列。“CMRxRecon”数据集包含原始k空间数据和自动校准线。我们的目标是通过引入标准化的评估标准并使研究社区可以自由访问数据集,从而促进最先进的CMR图像重建的进步。
    Cardiac magnetic resonance imaging (CMR) has emerged as a valuable diagnostic tool for cardiac diseases. However, a significant drawback of CMR is its slow imaging speed, resulting in low patient throughput and compromised clinical diagnostic quality. The limited temporal resolution also causes patient discomfort and introduces artifacts in the images, further diminishing their overall quality and diagnostic value. There has been growing interest in deep learning-based CMR imaging algorithms that can reconstruct high-quality images from highly under-sampled k-space data. However, the development of deep learning methods requires large training datasets, which have so far not been made publicly available for CMR. To address this gap, we released a dataset that includes multi-contrast, multi-view, multi-slice and multi-coil CMR imaging data from 300 subjects. Imaging studies include cardiac cine and mapping sequences. The \'CMRxRecon\' dataset contains raw k-space data and auto-calibration lines. Our aim is to facilitate the advancement of state-of-the-art CMR image reconstruction by introducing standardized evaluation criteria and making the dataset freely accessible to the research community.
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  • 文章类型: Journal Article
    心脏病已成为全球主要的死亡原因之一。及时识别不同类型的心脏病可显着降低死亡风险并提高治疗效果。然而,快速有效的识别需要持续的监控,不仅包括特定的临床条件,还包括不同的生活方式。因此,越来越多的研究正在努力使不同心脏病的识别自动化和进步。值得注意的是,心电图(ECG)的评估至关重要,鉴于它是患者的初始诊断测试,被证明是最简单和最具成本效益的工具。这项研究采用了卷积神经网络(CNN)的定制架构,通过分析三个电极带的图像以及来自四个不同患者类别的ECG的每个单个电极信号来预测心脏病。代表三种与心脏相关的疾病以及一系列健康对照。分析是在一个真实的数据集上进行的,提供值得注意的性能(对大多数考虑的疾病的召回率超过80%,有时甚至等于100%)以及一定程度的可解释性,这归功于对一条电极甚至单个ECG电极的重要性的理解。在检测特定心脏相关病理中可以有。
    Cardiopathy has become one of the predominant global causes of death. The timely identification of different types of heart diseases significantly diminishes mortality risk and enhances the efficacy of treatment. However, fast and efficient recognition necessitates continuous monitoring, encompassing not only specific clinical conditions but also diverse lifestyles. Consequently, an increasing number of studies are striving to automate and progress in the identification of different cardiopathies. Notably, the assessment of electrocardiograms (ECGs) is crucial, given that it serves as the initial diagnostic test for patients, proving to be both the simplest and the most cost-effective tool. This research employs a customized architecture of Convolutional Neural Network (CNN) to forecast heart diseases by analyzing the images of both three bands of electrodes and of each single electrode signal of the ECG derived from four distinct patient categories, representing three heart-related conditions as well as a spectrum of healthy controls. The analyses are conducted on a real dataset, providing noteworthy performance (recall greater than 80% for the majority of the considered diseases and sometimes even equal to 100%) as well as a certain degree of interpretability thanks to the understanding of the importance a band of electrodes or even a single ECG electrode can have in detecting a specific heart-related pathology.
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  • 文章类型: Journal Article
    心血管疾病(CVDs),尤其是心力衰竭,是全球早期死亡率的主要贡献者。心力衰竭是一个严重的公共卫生问题,患者长期结局持续不佳,总体预后不理想。传统上,心力衰竭的治疗方法主要集中在降低血压;然而,开发更有效的针对血液动力学参数的疗法面临挑战,包括耐受性和安全风险,这可能会限制其临床有效性。腺苷已经成为心血管疾病的关键中介,作为通过ATP代谢在细胞应激期间产生的报复性代谢产物,并作为调节各种生理过程的信号分子。腺苷通过与心脏细胞中表达的不同腺苷受体(AR)亚型相互作用而发挥功能,包括A1AR,A2AAR,A2BAR,A3AR除了A1AR,A3AR在心血管系统中具有多方面的作用,因为它的激活有助于减少各种病理状态下对心脏的损害,尤其是缺血性心脏病,心力衰竭,和高血压,尽管与其他AR亚型相比,其作用没有得到很好的证明。对A3AR信号传导的研究集中在通过各种途径识别参与CVD的复杂分子机制。包括Gi或Gq蛋白依赖性信号,ATP敏感性钾通道,MAPK,和G蛋白无关的信号。几种A3AR特异性激动剂,比如piclidenoson和namodenoson,在不同的心脏病动物模型中,在缺血期间发挥心脏保护作用。因此,调节A3AR作为一种潜在的治疗方法,激发了人们对开发靶向A3AR的化合物作为心脏病潜在治疗方法的极大兴趣。
    Cardiovascular diseases (CVDs), particularly heart failure, are major contributors to early mortality globally. Heart failure poses a significant public health problem, with persistently poor long-term outcomes and an overall unsatisfactory prognosis for patients. Conventionally, treatments for heart failure have focused on lowering blood pressure; however, the development of more potent therapies targeting hemodynamic parameters presents challenges, including tolerability and safety risks, which could potentially restrict their clinical effectiveness. Adenosine has emerged as a key mediator in CVDs, acting as a retaliatory metabolite produced during cellular stress via ATP metabolism, and works as a signaling molecule regulating various physiological processes. Adenosine functions by interacting with different adenosine receptor (AR) subtypes expressed in cardiac cells, including A1AR, A2AAR, A2BAR, and A3AR. In addition to A1AR, A3AR has a multifaceted role in the cardiovascular system, since its activation contributes to reducing the damage to the heart in various pathological states, particularly ischemic heart disease, heart failure, and hypertension, although its role is not as well documented compared to other AR subtypes. Research on A3AR signaling has focused on identifying the intricate molecular mechanisms involved in CVDs through various pathways, including Gi or Gq protein-dependent signaling, ATP-sensitive potassium channels, MAPKs, and G protein-independent signaling. Several A3AR-specific agonists, such as piclidenoson and namodenoson, exert cardioprotective impacts during ischemia in the diverse animal models of heart disease. Thus, modulating A3ARs serves as a potential therapeutic approach, fueling considerable interest in developing compounds that target A3ARs as potential treatments for heart diseases.
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  • 文章类型: Journal Article
    在哺乳动物心脏发育过程中,编码肽激素的成簇基因,利钠肽A(NPPA;ANP)和B(NPPB;BNP),主要在心房和心室小梁心肌细胞中转录共调节和共表达。出生后,NPPA和天然反义转录物NPPA-AS1的表达仅限于心房心肌细胞。NPPA和NPPB都是由心脏应激诱导的,并作为心血管功能障碍或损伤的标志物。NPPB基因产物被广泛用作各种心血管疾病的诊断和预后生物标志物。在整个身体的许多细胞类型上的膜定位的鸟苷酸环化酶受体通过产生细胞内cGMP介导利钠肽配体的信号传导,与cGMP激活的激酶和其他酶和离子通道相互作用并调节其活性。利钠肽系统在心肾稳态中起着基本作用,其有效的利尿和血管舒张作用为心脏病理生理状况和心力衰竭提供了代偿机制。此外,两种肽,还有CNP,在心脏发育和稳态过程中具有重要的心内作用,而与系统功能无关。心内功能的探索可能为利钠肽介导的信号传导在心脏病和节律紊乱中的治疗效用提供新的线索。这里,我们回顾了心脏发育过程中NPPA和NPPB的表达和心内功能调节的最新见解,稳态,和疾病。
    During mammalian heart development, the clustered genes encoding peptide hormones, Natriuretic Peptide A (NPPA; ANP) and B (NPPB; BNP), are transcriptionally co-regulated and co-expressed predominately in the atrial and ventricular trabecular cardiomyocytes. After birth, expression of NPPA and a natural antisense transcript NPPA-AS1 becomes restricted to the atrial cardiomyocytes. Both NPPA and NPPB are induced by cardiac stress and serve as markers for cardiovascular dysfunction or injury. NPPB gene products are extensively used as diagnostic and prognostic biomarkers for various cardiovascular disorders. Membrane-localized guanylyl cyclase receptors on many cell types throughout the body mediate the signaling of the natriuretic peptide ligands through the generation of intracellular cGMP, which interacts with and modulates the activity of cGMP-activated kinase and other enzymes and ion channels. The natriuretic peptide system plays a fundamental role in cardio-renal homeostasis, and its potent diuretic and vasodilatory effects provide compensatory mechanisms in cardiac pathophysiological conditions and heart failure. In addition, both peptides, but also CNP, have important intracardiac actions during heart development and homeostasis independent of the systemic functions. Exploration of the intracardiac functions may provide new leads for the therapeutic utility of natriuretic peptide-mediated signaling in heart diseases and rhythm disorders. Here, we review recent insights into the regulation of expression and intracardiac functions of NPPA and NPPB during heart development, homeostasis, and disease.
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