Atrial natriuretic factor

The discovery of the first well-defined natriuretic hormone, the
Atrial Natriuretic Factor (ANF), has prompted research on its
impact on volume regulation in health and disease. The natriuretic,
diuretic, and smooth muscle-relaxing properties suggest an
important role of this novel hormone in pathophysiological states
with sodium or volume retention, such as congestive heart failure
or cirrhosis of the liver. Investigations on the implications of
ANF in liver disease have been performed for little more than 1
year, and results are still controversial in many respects. At
present, it seems very likely that there is no absolute deficiency
of plasma ANF in patients with cirrhosis. Moreover, elevated plasma
levels in cirrhotics with ascites have been reported by several
groups. However, as yet, a molecular characterization of this
increased immunoreactivity is still lacking. There is disagreement
on the reduced release of and renal response to ANF in subgroups of
cirrhotics; however, stimulus-response-coupling might be impaired.
Further studies are needed to elucidate the pathophysiological
implications and therapeutical potential of ANF in patients with
chronic liver disease.