A trial natriuretic factor, a new peptide hormone with potent natriuretic and vasodilatory properties that was originally characterized from cardiac atrial tissue by Debold et al, is increased in the plasma of patients with congestive heart failure. Two peptides consisting of amino acids 1-30 and 31-67 of the amino-(N)-terminal end of the 126 aa prohormone of atrial natriuretic factor have also been found to have vasodilatory and natriuretic properties. The N-terminus of the prohormone, as well as the carbcxy (C)-terminus (ie, ANF consisting of aa 99-126) circulates normally in humans. The circulating concentrations of the N-terminus and the C-terminus in persons with congestive heart failure increase proportionately to the severity of the abnormality of salt and water metabolism. Recently, atrial natriuretic factor has been demonstrated to be present in the pleural fluid of congestive heart failure patients. The present investigation was designed to determine if patients with congestive heart failure secrete the N-terminus, containing the natriuretic peptides pro ANF 1-30 and pro ANF 31-67, into their pleural fluid in an attempt to rid their lungs of the excess fluid that is present in this condition. In this preliminary investigation, the whole N-terminus (ie, aa 1-98), the midportion of the N-terminus consistent with aa 31-67, and the C-terminus (ie, ANF) were found in the pleural fluid of all patients with congestive heart failure. Whether or not these newly described peptide hormones in the pleural fluid help the lung clear the fluid present in congestive heart failure could not be determined from the present investigation. buy diabetes drugs
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