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Atrial Natriuretic Factor

Drugs and Chemicals · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 3 min read

A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight peptides derived from a common precursor and secreted mainly by the heart atrium.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (635 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight peptides derived from a common precursor and secreted mainly by the heart atrium. All these peptides share a sequence of about 20 amino acids.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: ANP; Atrial Natriuretic Peptide; Natriuretic Peptide, Atrial; Peptide, Atrial Natriuretic; Atriopeptins; ANF; Atrial Natriuretic Peptides; Peptides, Atrial Natriuretic.

Where it fits in the MeSH classification

Broader topics
Natriuretic Peptides
See also
Receptors, Atrial Natriuretic Factor

Related concepts

  • Peptides
  • Heart Atrium
  • Amino Acids

Research landscape

PubMed indexes 15,660 records tagged with the MeSH heading “Atrial Natriuretic Factor” (counts retrieved 2026-10-31). 509 of them (3.3%) were published from 2020 onward, and the busiest period so far is through 1999 with 10,154 records.

Reviews account for 1,449 records (9.3%) and meta-analyses for 24. Randomized controlled trials number 676 (4.3%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 10,154 records; 2000-2009: 3,256 records; 2010-2019: 1,741 records; 2020 onward: 509 records10,154through 19993,2562000-20091,7412010-20195092020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 199910,154
2000-20093,256
2010-20191,741
2020 onward509
Share of records by publication typeReviews: 9.3 percent; Meta-analyses: 0.2 percent; Randomized controlled trials: 4.3 percentReviews9.3% (1,449)Meta-analyses0.2% (24)Randomized controlled trials4.3% (676)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 15,660 PubMed records
TypeRecordsShare
Reviews1,4499.3%
Meta-analyses240.2%
Randomized controlled trials6764.3%

Method: PubMed query "Atrial Natriuretic Factor"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in drugs and chemicals

Studies of a chemical or drug can answer very different questions: what it is and how it behaves in cells and animals, how the body handles it, and whether it changes outcomes in people. Laboratory and animal findings often do not carry over to patients, and observational studies of exposures are confounded by who uses a substance and why. Nothing on this page is a recommendation to use, avoid, start or stop any substance or medicine; talk to a qualified clinician or pharmacist about your own situation. Check the dose, the species, the comparison group and whether a patient-relevant outcome was measured.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx
Chappell D, Bruegger D, Potzel J, Jacob M, Brettner F, Vogeser M, et al.
2014Research article
Design not recorded in structured metadata
245cc by
PMID 25497357 · DOI · PMC4201669
Structure and function of the Nppa-Nppb cluster locus during heart development and disease
Man J, Barnett P, Christoffels VM
2018Review article
Design not recorded in structured metadata
108cc by
PMID 29302701 · DOI · PMC5852170
Role of Cardiac Natriuretic Peptides in Heart Structure and Function
Sarzani R, Allevi M, Di Pentima C, Schiavi P, Spannella F, Giulietti F
2022Review article
Design not recorded in structured metadata
66cc by
PMID 36430893 · DOI · PMC9697447
Single intramuscular injection of self-amplifying RNA of Nppa to treat myocardial infarction
Zhang K, Tao H, Zhu D, Yue Z, Hu S, Wu Y, et al.
2026Research article
Design not recorded in structured metadata
14cc by
PMID 41785353 · DOI · PMC13124201

Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx [1]

Research article Chappell D, Bruegger D, Potzel J, Jacob M, Brettner F, Vogeser M, et al. · · 2014 · cited 245 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
IntroductionAcute normovolemic hemodilution (ANH) and volume loading (VL) are standard blood-sparing procedures.
Closing excerpt
This perturbation must be expected to impair the vascular barrier, implying that VL may not be as safe as generally assumed and that it should be critically evaluated.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (210 words)

IntroductionAcute normovolemic hemodilution (ANH) and volume loading (VL) are standard blood-sparing procedures. However, VL is associated with hypervolemia, which may cause tissue edema, cardiopulmonary complications and a prolonged hospital stay. The body reacts to hypervolemia with release of atrial natriuretic peptide (ANP) from the heart. ANP has been shown to deteriorate the endothelial glycocalyx, a vital part of the vascular permeability barrier. The aim of the present study was to evaluate and compare ANP release and damage to the glycocalyx during ANH and VL.MethodsANH or VL with 6% hydroxyethyl starch 130/0.4 was administered prior to elective surgery in patients of good cardiopulmonary health (n =9 in each group). We measured concentrations of ANP in plasma and of three main constituent parts of the glycocalyx (hyaluronan, heparan sulfate and syndecan 1) in serum before and after ANH or VL. Heparan sulfate and syndecan 1 levels in urine were also determined.ResultsIn contrast to ANH, VL (20 ml/kg) induced a significant release of ANP (approximately +100%, P ConclusionThese data suggest that hypervolemia increases the release of ANP and causes enhanced shedding of the endothelial glycocalyx. This perturbation must be expected to impair the vascular barrier, implying that VL may not be as safe as generally assumed and that it should be critically evaluated.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 25497357 · DOI · PMC4201669

Structure and function of the Nppa-Nppb cluster locus during heart development and disease [2]

Review article Man J, Barnett P, Christoffels VM · · 2018 · cited 108 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Atrial natriuretic factor and brain natriuretic peptide are two important biomarkers in clinical cardiology.
Closing excerpt
In this review, we will provide recent insights into the dynamic and complex regulation of Nppa and Nppb during heart development and hypertrophy, and the association of this gene cluster with the cardiomyocyte-intrinsic program of heart regeneration.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (146 words)

Atrial natriuretic factor and brain natriuretic peptide are two important biomarkers in clinical cardiology. These two natriuretic peptide hormones are encoded by the paralogous genes Nppa and Nppb, which are evolutionary conserved. Both genes are predominantly expressed by the heart muscle during the embryonic and fetal stages, and in particular Nppa expression is strongly reduced in the ventricles after birth. Upon cardiac stress, Nppa and Nppb are strongly upregulated in the ventricular myocardium. Much is known about the molecular and physiological ques inducing Nppa and Nppb expression; however, the transcriptional regulatory mechanisms of the Nppa-Nppb cluster in vivo has proven to be quite complex and is not well understood. In this review, we will provide recent insights into the dynamic and complex regulation of Nppa and Nppb during heart development and hypertrophy, and the association of this gene cluster with the cardiomyocyte-intrinsic program of heart regeneration.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 29302701 · DOI · PMC5852170

Role of Cardiac Natriuretic Peptides in Heart Structure and Function [3]

Review article Sarzani R, Allevi M, Di Pentima C, Schiavi P, Spannella F, Giulietti F · · 2022 · cited 66 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Cardiac natriuretic peptides (NPs), atrial NP (ANP) and B-type NP (BNP) are true hormones produced and released by cardiomyocytes, exerting several systemic effects.
Closing excerpt
This narrative review is focused on the direct activities of this molecule family on the heart, reporting both experimental and human studies that are clinically relevant for physicians.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (148 words)

Cardiac natriuretic peptides (NPs), atrial NP (ANP) and B-type NP (BNP) are true hormones produced and released by cardiomyocytes, exerting several systemic effects. Together with C-type NP (CNP), mainly expressed by endothelial cells, they also exert several paracrine and autocrine activities on the heart itself, contributing to cardiovascular (CV) health. In addition to their natriuretic, vasorelaxant, metabolic and antiproliferative systemic properties, NPs prevent cardiac hypertrophy, fibrosis, arrhythmias and cardiomyopathies, counteracting the development and progression of heart failure (HF). Moreover, recent studies revealed that a protein structurally similar to NPs mainly produced by skeletal muscles and osteoblasts called musclin/osteocrin is able to interact with the NPs clearance receptor, attenuating cardiac dysfunction and myocardial fibrosis and promoting heart protection during pathological overload. This narrative review is focused on the direct activities of this molecule family on the heart, reporting both experimental and human studies that are clinically relevant for physicians.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 36430893 · DOI · PMC9697447

Single intramuscular injection of self-amplifying RNA of Nppa to treat myocardial infarction [4]

Research article Zhang K, Tao H, Zhu D, Yue Z, Hu S, Wu Y, et al. · · 2026 · cited 14 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Self-amplifying RNA (saRNA) enables sustained protein expression from a single administration.
Closing excerpt
Together, these results demonstrate that one-shot saNppa-LNP therapy offers durable cardioprotection, supporting the broader potential of saRNA-LNP-based approaches for cardiac therapy.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (131 words)

Self-amplifying RNA (saRNA) enables sustained protein expression from a single administration. In this study, we developed an intramuscular saRNA-lipid nanoparticle (saNppa-LNP) therapy encoding natriuretic peptide type A (Nppa) for cardioprotection. A single injection induced sustained pro-atrial natriuretic peptide (pro-ANP) secretion for 4 weeks; pro-ANP was subsequently cleaved by the cardiac protease corin into active ANP, producing robust cardioprotection in mouse and swine myocardial infarction models. At equivalent doses, saNppa achieved greater efficacy than conventional mRNA. Single-nucleus transcriptomics identified natriuretic peptide receptor 1-positive (Npr1+) endothelial and epicardial cells as primary effectors, with saNppa-LNPs reshaping their paracrine profile to promote cardiomyocyte regeneration and suppress fibrosis. Longitudinal biosafety assessments revealed no systemic toxicity. Together, these results demonstrate that one-shot saNppa-LNP therapy offers durable cardioprotection, supporting the broader potential of saRNA-LNP-based approaches for cardiac therapy.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 41785353 · DOI · PMC13124201

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Natriuretic peptides [5]
    Levin ER, Gardner DG, Samson WK · N Engl J Med · 1998 · cited 1,611 times (Europe PMC)
  • Research article Natriuretic peptides [6]
    Daniels LB, Maisel AS · J Am Coll Cardiol · 2007 · cited 779 times (Europe PMC)
  • Research article Cardiac natriuretic peptides [7]
    Goetze JP, Bruneau BG, Ramos HR, Ogawa T, de Bold MK, de Bold AJ · Nat Rev Cardiol · 2020 · cited 445 times (Europe PMC)
  • Research article Atrial natriuretic peptide: synthesis, release, and metabolism [8]
    Ruskoaho H · Pharmacol Rev · 1992 · cited 295 times (Europe PMC)
  • Research article The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting [9]
    Roberts E, Ludman AJ, Dworzynski K, Al-Mohammad A, Cowie MR, McMurray JJ, et al. · BMJ · 2015 · cited 260 times (Europe PMC)
  • Research article Receptors of atrial natriuretic factor [10]
    Maack T · Annu Rev Physiol · 1992 · cited 197 times (Europe PMC)

References

  1. Chappell D, Bruegger D, Potzel J, Jacob M, Brettner F, Vogeser M, et al.. Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx. . 2014. PMID 25497357 · DOI · PMC4201669
  2. Man J, Barnett P, Christoffels VM. Structure and function of the Nppa-Nppb cluster locus during heart development and disease. . 2018. PMID 29302701 · DOI · PMC5852170
  3. Sarzani R, Allevi M, Di Pentima C, Schiavi P, Spannella F, Giulietti F. Role of Cardiac Natriuretic Peptides in Heart Structure and Function. . 2022. PMID 36430893 · DOI · PMC9697447
  4. Zhang K, Tao H, Zhu D, Yue Z, Hu S, Wu Y, et al.. Single intramuscular injection of self-amplifying RNA of Nppa to treat myocardial infarction. . 2026. PMID 41785353 · DOI · PMC13124201
  5. Levin ER, Gardner DG, Samson WK. Natriuretic peptides. N Engl J Med. 1998. PMID 9682046 · DOI
  6. Daniels LB, Maisel AS. Natriuretic peptides. J Am Coll Cardiol. 2007. PMID 18154959 · DOI
  7. Goetze JP, Bruneau BG, Ramos HR, Ogawa T, de Bold MK, de Bold AJ. Cardiac natriuretic peptides. Nat Rev Cardiol. 2020. PMID 32444692 · DOI
  8. Ruskoaho H. Atrial natriuretic peptide: synthesis, release, and metabolism. Pharmacol Rev. 1992. PMID 1480667 · DOI
  9. Roberts E, Ludman AJ, Dworzynski K, Al-Mohammad A, Cowie MR, McMurray JJ, et al.. The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting. BMJ. 2015. PMID 25740799 · DOI · PMC4353288
  10. Maack T. Receptors of atrial natriuretic factor. Annu Rev Physiol. 1992. PMID 1532887 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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At a glance

15,660
PubMed records on this heading
3%
published since 2020
1,449
review articles
676
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

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