Skip to content
Research Only Cardiovascular & Renal

ANP

also known as: Atrial Natriuretic Peptide, Atrial Natriuretic Factor, ANF, Atriopeptin

The atrial pressure sensor — the first discovered natriuretic peptide, maintaining blood pressure and fluid balance through renal sodium excretion and vasodilation.

A 28-amino-acid cyclic peptide hormone released from atrial granules during atrial distension, activating NPR-A to produce natriuresis, vasodilation, and RAAS suppression.

Mechanism of action

Binds NPR-A (natriuretic peptide receptor A), a transmembrane guanylyl cyclase, increasing intracellular cGMP in kidney, vasculature, and adrenal glands. Effects: afferent arteriolar dilation + efferent constriction (increases GFR), suppresses aldosterone secretion, relaxes vascular smooth muscle, inhibits cardiac fibrosis.

Primary uses

  • Blood pressure and volume regulation (physiological)
  • Acute heart failure (carperitide, Japan)
  • Cardiac physiology research
  • Renal hemodynamics studies

Typical dosing

Not established

Endogenous hormone. Carperitide (Japan) dosed at 0.025–0.05 mcg/kg/min IV infusion.

Regulatory status

Native ANP not FDA-approved. Carperitide (recombinant ANP, marketed as Hanp) is approved in Japan for acute heart failure. Anaritide (synthetic ANP analog) was studied in US trials but not approved.

References

  1. [pubmed] de Bold AJ, et al. "A rapid and potent natriuretic response to intravenous injection of atrial myocardial extract in rats." Life Sci, 1981;28:89-94.
  2. [review] Potter LR, et al. "Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions." Endocr Rev, 2006;27:47-72.

Related peptides

BNP

The heart failure biomarker — an endogenous cardiac peptide whose blood levels are the gold standard for diagnosing and monitoring heart failure severity.

Nesiritide

Natrecor — the first recombinant natriuretic peptide drug for acute heart failure. FDA-approved August 2001 based on short-term dyspnea relief, became one of the most controversial drugs of the 2000s after 2005 meta-analyses raised safety concerns; ASCEND-HF (2010, n=7,141) eventually settled the safety debate but demonstrated only marginal clinical benefit. Janssen discontinued manufacturing February 2018; no longer commercially available in the US.

Carperitide

⚠ Approved in Japan only (1995). The Daiichi Sankyo recombinant hANP has been used in >30,000 pooled patients with acute heart failure in Japanese registries, but its overall mortality effect remains contested — 2024 meta-analyses suggest a possible increase in in-hospital mortality, while other pooled analyses suggest benefit at low doses.

Ularitide

⚠ Phase 3 failure. Cardiorentis's ularitide was the most recent Western attempt to develop an IV natriuretic peptide for acute heart failure. TRUE-AHF (NEJM 2017, n=2,157) failed both the mortality and hemodynamic co-primary endpoints; development was discontinued shortly after. Reinforced a now-consistent pattern of IV natriuretic peptides showing biochemical and hemodynamic effects but failing to improve clinical outcomes.
Disclaimer

This entry is for educational purposes only and does not constitute medical advice. Dosing information reflects published regulatory or research data and is not a recommendation. Many compounds described here are not approved for human use in the United States. Consult a licensed medical professional before considering any peptide therapy.