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.

Guides & tools

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.