Reginauld SH, Cannone V, Iyer S, et al. - In patients with acute decompensated heart failure (ADHF), researchers focused on the differential regulation of circulating atrial natriuretic peptide (ANP) and B-type natriuretic peptide (BNP) and examined if a subgroup of patients with ADHF has a relative deficiency of ANP. Participants were 112 in total, and elevated ANP and BNP were present in 74% of patients. This study also included 129 healthy people who were prospectively recruited. Normal ANP was detected in 26% of patients (21% of this subgroup exhibited normal ANP and high BNP). In the ADHF group with normal levels of ANP, they detected the lowest cyclic guanosine monophosphate, whereas an inverse link of BMI and ejection fraction with ANP levels was identified. Findings revealed that the presence of an ANP deficiency was consistent with differential regulation of ANP and BNP in a subgroup of patients hospitalized with ADHF, and was indicative of the presence of a potentially compromised compensatory cardiac endocrine response.