Editorial Coronary artery disease, heart failure, and cardiac natriuretic peptides in the middle

This editorial refers to ‘Plasma N-terminal pro-brain natriuretic peptide concentration predicts coronary events in men at work: a report from the BELSTRESS study’ † by J. De Sutter et al., on page 2644 An experienced cardiologist recently reminded me that most heart failure patients have a medical history of arterio-sclerosis and coronary artery disease (CAD) (Figure 1). With or without myocardial infarction, the ventricular myocardium becomes hypoxic during increased workload, which, in turn, strangulates cardiac performance and initiates pathological remodelling of the myocardium. In the course of reduced left ventricular systolic function, the endocrine heart compensates with increased production and secretion of natriuretic hormones, that is, the cardiac natriuretic peptides. In fact, the association betwee