The Role of Atrial Natriuretic Peptide (ANP) in Cardiopulmonary Diseases

Atrial natriuretic peptide (ANP) is a peptide hormone that has potent natriuretic, diuretic, vasodilator, sympatholytic, and renin - and aldos-terone - suppressing activities and is involved in the regulation of volume and electrolyte balance and blood pressure. Further, ANP has also been shown to inhibit cellular growth, proliferation and induce apoptosis in a variety of cell lines, including vascular smooth muscle cells and cardiac myocytes. Recent studies have demonstrated that ANP is not only involved in blood pressure and volume homeostasis but also in the direct regulation of cardiac growth. We and other investigators have demonstrated the existence of natriuretic peptide receptors in the heart and cardiac cells, suggesting that ANP has direct actions on cardiac tissue. Several recent in vivo studies have suggested that statement of ANP is inversely related to cardiac growth/hypertrophy. Transgenic mice overexpressing ANP have lower heart weight and blood pressure than wild type mice. Conversely, we demonstrated that transgenic mice with homozygous disruption of the pro - ANP gene (Nppa) (ANP -/- mice) have no circulating or tissue ANP and exhibit significant cardiac hypertrophy and increased blood pressure. Further, transgenic mice lacking a functional natriuretic peptide receptor A (NPR-A) gene display elevated blood pressure and marked cardiac hypertrophy. The role of ANP in the development of cardiac hypertrophy in response to hemodynamic stress has not previously been studied. Our previous studies demonstrated that ANP - / -mice with hypoxia - induced pulmonary hypertension and high salt diet - induced systemic hypertension develop greater cardiac enlargement than their wild type controls under same experimental conditions, suggest-ing that cardiac enlargement in ANP -/- mice might, at least in part, be related to increased afterload. In a recent study, we used ANP -/- mice to further test the hypothesis that ANP plays an important role in protecting against the development of cardiac enlargement induced by volume overload stress. Adult (8-10 wk old) male ANP -/- and wild type ANP+/+ mice underwent an aorto - caval fistula (ACF) or sham surgery and were subjected to echocardiographic examination at 2 wks. Mean arterial pressure (MAP) and atrial, left ventricular (LV) and right ventricular (RV) mass were greater in sham - operated ANP-/-mice than in ANP+/+mice. MAP decreased following ACF to a similar extent in both genotypes. ACF induced significant concentric cardiac enlargement in both genotypes. Cardiac enlargement and lung weight increased to a greater extent in ANP - / - mice than in ANP+/ + mice, indicating that disrupted ANP statement worsens ACF- induced cardiac enlargement and pulmonary congestion. LV function (velocity of circumferential shortening [VCFr], circumferential stress, fraction shortening, fraction shortening, and e-jection time and fraction) assessed by echocardiography did not differ between sham - operated ANP + / + and ANP - / - mice and remained unchanged after ACF. These findings indicate that ANP deletion results in biventricular enlargement and an exaggerated response to the stress of volume overload. This support the hypothesis that ANP has direct antihypertrophic and car-dioprotective actions in heart. Further study is needed to dissect the contributions of increased afterload from those of removing the antihypertrophic effects of ANP to basal and stress induced cardiac enlargement in this animal model.

Anxiety disorders in patients with cardiopulmonary diseases:A brief review

This manuscript reviews the current literature involving clinical anxiety and cardiopulmonary disease,considers the hypothesized physiological mechanisms for anxiety,and discusses the use of exercise as a treatment for both anxiety and cardiopulmonary diseases.The literature summary consists of original investigations,meta-analysis,commentaries,and review publications in order to better understand the biological and psychological mechanisms for using exercise as treatment and to provide details specific to cardiopulmonary disease and anxiety management.A gap in the literature exists concerning the anxiolytic effects of exercise as a psychological and physical treatment in cardiopulmonary populations.The findings from this review support further investigation into the use of exercise to ameliorate the burden of anxiety in cardiopulmonary disease patients.This review evaluates the current literature surrounding cardiopulmonary disease and anxiety.A systematic literature search identified articles discussing the prevalence,association,and risk of anxiety in cardiopulmonary patients.Though depression is often studied in this population,recent investigation supports a need for further research regarding anxiety in cardiopulmonary patients.Treatment to manage patients’psychological profile can reduce exacerbations of known disease,reduce hospital readmission,and improve functional capacity,and overall quality of life.

Evidences on adaptive mechanisms for cardiorespiratory diseases regarding extreme temperatures and air pollution:A comparative systematic review

The negative cardiorespiratory health outcomes due to extreme temperatures and air pollution are widely stud-ied,but knowledge about the effectiveness of the implementation of adaptive mechanisms remains unclear.The objective of this paper is to explore the evidence of adaptive mechanisms for cardiorespiratory diseases regard-ing extreme temperatures and air pollution by comparing the results of two systematic literature review(SLR)processes sharing the same initial research question but led by two research groups with different academic back-grounds working in the same multidisciplinary team.We start by presenting the methodological procedures and the results of the SLR triggered by the research group mainly composed by researchers with a background in ge-ography(named geographical strategy).We then compare these results with those achieved in the SLR led by the research group with a background in epidemiology(named epidemiological strategy).Both SLR were developed under the EU Horizon 2020 Project“EXHAUSTION”.The results showed:1)the lack of evidence regarding the effectiveness of adaptation measures,namely due to the limited number of studies about the topic,the prepon-derance of studies dedicated to heat extremes or the unbalance between different adaptation measures;2)that the choice of search terms in the geographical strategy,despite being more comprehensive at first sight,ended up retrieving less results,but it brought new studies that can complement the results of the epidemiological strategy.Therefore,it is suggested that to strengthen the empirical evidence of the effectiveness of adaptation measures,powerful multidisciplinary teams should work together in the preparation of SLR in topics of great complexity,such as the one presented in this paper.

Ambient fine particulate matter and cardiopulmonary health risks in China

In China, the level of ambient fine particulate matter (PM_(2.5)) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM_(2.5) exposure have become a major public health issue. More than half of PM_(2.5)-related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM_(2.5) pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM_(2.5) on cardiopulmonary diseases in China, including studies relating to the effects of PM_(2.5) on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM_(2.5) across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM_(2.5) and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved;this may help us to take steps to reduce PM_(2.5) pollution and reduce the incidence of cardiopulmonary disease.

Coronary bypass grafting in Chinese patients dependent on maintenance dialysis

End stage renal disease （ESRD） is defined as treatment ＇of renal dysfunction dependent on maintenance renalreplacement therapy. It is estimated that the number of ESRD patients is about one million in China and is still fast growing. Patients with chronic kidney diseases are susceptible to cardiovascular disease because impaired glomerular filtration rate contributes independently to atherosclerosis in addition to the other usual risk factors.