The Endocrine Heart and Burns: Release of Natriuretic Peptides in Response to Burn Injuries

Abstract

ABSTRACT

In addition to being a pump, the heart also has an endocrine function. The peptides synthesized and secreted from the heart may exert endocrine, autocrine, and paracrine effects. The natriuretic peptides are a family of vasoactive hormones that play a dominant role in the regulation of cardiovascular and renal homeostasis. The 2 major hormones synthesized by the heart are the atrial and the brain natriuretic peptides, and elevated circulating levels of these substances have important prognostic and therapeutic implications. Although plasma natriuretic peptide measurements are helpful in excluding chronic heart failure in the ambulatory setting, many factors independent of heart failure may influence their levels. During the acute phase response of severe burn injuries, the severity of the cardiac stress can determine the postburn outcomes, and the pleiotropic effects exerted by the natriuretic peptide system play a key role in this process by activating compensatory mechanisms that promote systemic arterial dilatation, diuresis, natriuresis, and renin inhibition. Natriuretic peptides may also play a role in the wound healing process, which could be of clinical utility to reduce apparent scar formation in burn patients.