Evidence mapPaperPMID 41369834Full record

ReviewCardiovascular drugs and therapy2026

Natriuretic Peptides as Multisystem Regulators: From Clinical Biomarkers to Therapeutic Targets in Cardio-immunology.

Jathniel Panneflek, Mahmoud Barbarawi, Yasitha Kakarlapudi, Zaid Barbarawi, Béatrice Lauzea, Manolo Meraz-Torres

Abstract readReview
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In one paragraph

Review in Cardiovascular drugs and therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jathniel PanneflekDoctors Hospital at Renaissance in affiliation with the University of Houston Tilman J. Fertitta College of Medicine, Edinburg, TX, USA. j.panneflek@dhr-rgv.com.
Mahmoud BarbarawiDoctors Hospital at Renaissance in affiliation with the University of Houston Tilman J. Fertitta College of Medicine, Edinburg, TX, USA.
Yasitha KakarlapudiDoctors Hospital at Renaissance in affiliation with the University of Houston Tilman J. Fertitta College of Medicine, Edinburg, TX, USA.
Zaid BarbarawiJordan University of Science and Technology, Ar-Ramtha, Jordan.
Béatrice LauzeaDHR Health Department of Internal Medicine, Edinburg, TX, USA.
Manolo Meraz-TorresDHR Health Department of Internal Medicine, Edinburg, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNatriuretic peptides (NPs) ANP, BNP, and CNP extend beyond biomarkers of wall stress to regulators of cardiovascular, renal, metabolic, and immune pathways via cGMP-PKG signaling. We synthesize mechanistic and translational evidence, highlight NP "resistance," and appraise therapeutic strategies that augment NP signaling.

methodsNarrative review integrating human physiology, preclinical studies, and key trials (e.g., PARADIGM-HF, PARAGON-HF, EMPEROR-Preserved), plus emerging agents (ARNIs, designer peptides, NPR-C modulation, receptor sensitizers).

resultsNPs exert natriuretic, vasodilatory, antifibrotic, and immunomodulatory effects. Resistance via neprilysin degradation, NPR-C-mediated clearance, and receptor desensitization blunts efficacy in advanced disease. ARNIs improve outcomes in HFrEF; benefits in HFpEF are subgroup-dependent. NP biology intersects with metabolic and inflammatory circuits, suggesting potential synergy with SGLT2 inhibitors and other modulators.

conclusionsNPs are promising therapeutic targets across cardio-renal-metabolic spectra, but for many strategies, the evidence remains preclinical or early-phase. We propose a translational roadmap emphasizing mechanistic validation, responder phenotyping, and rigorously powered trials to test NP augmentation (and combinations) in HFrEF, obesity-related HFpEF, pulmonary vascular disease, and immune-cardiometabolic syndromes.

Indexed as

Heart FailureNatriuretic PeptidesAnimalsBiomarkersHumansSignal TransductionBiomarkersNatriuretic PeptidesAngiotensin receptor neprilysin inhibitor (ARNI)Arrhythmia suppressionAtrial fibrillationAtrial natriuretic peptide (ANP)B-type natriuretic peptide (BNP)Cannabidiol (CBD)Cardio-immunologyCardiorenal syndromecGMP-PKG signalingCrosstalk in cardiometabolic diseaseC-type natriuretic peptide (CNP)Designer natriuretic peptidesFibrosisGLP-1 synergyHeart failure with preserved ejection fraction (HFpEF)Heart failure with reduced ejection fraction (HFrEF)Immunomodulatory hormone therapyInflammation and cardiac remodelingMetabolic heart diseaseMusclinNatriuretic peptidesNeprilysin inhibitionNP-based therapeuticsNPR-ANP-RAAS interactionNPR-BNPR-CNP receptor modulationNP resistancePrecision heart failure therapyPulmonary hypertensionRenal dysfunctionSGLT2 inhibitorsSystemic vascular resistance modulationVasoprotective pharmacology

Identifiers

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.