Atrial Natriuretic Peptide vs Adrenomedullin
Side-by-Side Comparison
| Attribute | Anp | Adrenomedullin |
|---|---|---|
| Category | Cardiovascular / Natriuretic | Cardiovascular / Vasoactive |
| Mechanism | ANP binds to natriuretic peptide receptor A (NPR-A), a transmembrane guanylyl cyclase receptor, stimulating intracellular cGMP production. | Adrenomedullin signals through the calcitonin receptor-like receptor (CLR) complexed with receptor activity-modifying protein 2 or 3 (RAMP2/RAMP3), forming the AM1 and AM2 receptors respectively. |
| Evidence Rating | B — Approved in Japan / Established Biomarker | D — Biomarker / Early Research |
| Clinical Status | Carperitide (recombinant hANP) approved in Japan (1995) for acute heart failure. Not approved in the US, EU, or other Western markets. | Research stage. MR-proADM used as prognostic biomarker in sepsis and heart failure. No approved therapeutic use of adrenomedullin peptide. |
| Safety Profile | Hypotension is the primary adverse effect and is dose-dependent; Japanese post-marketing surveillance reported increased in-hospital mortality in the higher-dose groups (ATTEND registry analysis, Mebazaa et al., Eur J Heart Fail 2015, PMID: 25684603) | No human safety data from controlled therapeutic trials; Experimental IV infusion in healthy volunteers caused hypotension and reflex tachycardia |
| Route | Intravenous infusion | Intravenous infusion (research only) |
| Dose Range | 0.025–0.05 mcg/kg/min (carperitide, Japan) | 10–50 ng/kg/min in human physiological studies |
| Frequency | Continuous | Continuous or bolus infusion |
| Molecular Weight | ~3080 g/mol | ~6028 g/mol |
| Half-Life | ~2-5 minutes | ~22 minutes (plasma) |
Overview
Atrial Natriuretic Peptide and Adrenomedullin are both research peptides studied across multiple applications. This comparison examines their mechanisms, evidence base, dosing protocols, and safety profiles to help researchers understand the key differences and overlaps.
Atrial Natriuretic Peptide — Mechanism & Evidence
Atrial natriuretic peptide (ANP) is a 28-amino-acid hormone (MW ~3080 g/mol) secreted primarily by atrial cardiomyocytes in response to atrial stretch from volume overload. It is a key regulator of blood volume, sodium balance, and blood pressure. A recombinant form, carperitide (hANP), is approved in Japan for acute heart failure but is not approved in Western markets.
Key claims: Reduces pulmonary congestion and dyspnea in acute heart failure; Promotes natriuresis and diuresis; Cardioprotective effects in perioperative setting.
Adrenomedullin — Mechanism & Evidence
Adrenomedullin is a 52-amino-acid vasodilatory peptide (MW ~6028 g/mol) originally isolated from human pheochromocytoma tissue. It is widely expressed in the cardiovascular system, lungs, kidneys, and adrenal glands, with potent vasodilatory, natriuretic, and cardioprotective properties. It is currently investigated as a biomarker (MR-proADM) for sepsis and heart failure prognosis, with no approved therapeutic use of the peptide itself.
Key claims: MR-proADM is a strong prognostic biomarker in sepsis; MR-proADM predicts mortality in acute heart failure; Adrenomedullin has potent vasodilatory effects in humans.
Shared Research Applications
Both peptides are studied for: Cardiovascular Research.
Atrial Natriuretic Peptide is also researched for: Acute Heart Failure (Japan), Cardiac Biomarker.
Adrenomedullin is also researched for: Sepsis Prognostication, Heart Failure Biomarker.
Safety Considerations
Atrial Natriuretic Peptide: Hypotension is the primary adverse effect and is dose-dependent Japanese post-marketing surveillance reported increased in-hospital mortality in the higher-dose groups (ATTEND registry analysis, Mebazaa et al., Eur J Heart Fail 2015, PMID: 25684603) Bradycardia may occur due to vagal stimulation
Adrenomedullin: No human safety data from controlled therapeutic trials Experimental IV infusion in healthy volunteers caused hypotension and reflex tachycardia Theoretical risk of excessive vasodilation and hemodynamic instability
