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Jeppe Skov Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark
Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark

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Jens Juul Holst Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark

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Jens Peter Gøtze Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark

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Jørgen Frøkiær Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark
Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark

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Jens Sandahl Christiansen Department of Endocrinology and Internal Medicine, Novo Nordisk A/S, NNF center for Basic Metabolic Research, Department of Clinical Biochemistry, Department of Clinical Physiology and Molecular Imaging, Department of Clinical Medicine, Aarhus University Hospital, Norrebrogade 44, DK-8000 Aarhus, Denmark

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from atrial cardiomyocytes and that GLP1 exclusively acts via ANP to induce vasodilatation and natriuresis (8) . The findings, therefore, define a novel GLP1–ANP axis and expand our view on GLP1-induced cardiovascular and renal actions. To explore

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Signe Frøssing Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Malin Nylander Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Caroline Kistorp Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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Sven O Skouby Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
Department of Obstetrics & Gynecology, Herlev Gentofte Hospital, Copenhagen, Denmark

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Jens Faber Department of Internal Medicine, Center of Endocrinology and Metabolism, Herlev Gentofte Hospital, Copenhagen, Denmark
Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark

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failure, as well as during sympathetic stimulation ( 7 ). The NPs induce vasodilation and natriuresis, and reduce the renin–angiotensin–aldosterone system as well as the sympathetic nervous system, both activated in heart failure ( 7 ). Besides these main

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Hugo R Ramos Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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Andreas L Birkenfeld Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina
Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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Adolfo J de Bold Department of Internal Medicine, Section of Metabolic Vascular Medicine, Division of Diabetes and Nutritional Sciences, Cardiovascular Endocrinology Laboratory, Faculty of Medicine, Hospital de Urgencias, National University of Córdoba, X5000 Córdoba, Argentina

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related hypertension. Interestingly, in lean subjects, application of a sodium load induces myocardial cNP secretion and stimulates natriuresis (91, 92, 93, 94) , a response which is blunted in patients with obesity (95) . Together, these data argue that

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Julie Smith Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Jan Fahrenkrug Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Henrik L Jørgensen Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Christina Christoffersen Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark
Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Jens P Goetze Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark
Department of Clinical Biochemistry (KB3014), Department of Technology, Department of Clinical Biochemistry, Department of Biomedical Sciences, Department of Clinical Medicine, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark

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Introduction Mammalian hearts release natriuretic hormones that regulate renal natriuresis and intravascular fluid homeostasis (1, 2) . More recently, an effect on adipose tissue has also been established in which hormone binding to the

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Sayaka Kawano Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan
Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Yukiko Kawagoe Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Kenji Kuwasako Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Satoshi Shimamoto Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Koji Igarashi Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Mariko Tokashiki Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Kazuo Kitamura Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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Johji Kato Frontier Science Research Center, Circulatory and Body Fluid Regulation, AIA Research Group, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan

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vessels, kidneys, and adipose tissues (1, 2, 3) . A number of functional analysis studies have been carried out since its discovery, revealing that AM has pleiotropic actions, including blood pressure-lowering effects, natriuresis, cardiovascular

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Bettina Winzeler Department of Endocrinology, Diabetology and Metabolismus, University Hospital Basel, Basel, Switzerland
Department Clinical Research, University of Basel, Basel, Switzerland

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Michelle Steinmetz Department of Endocrinology, Diabetology and Metabolismus, University Hospital Basel, Basel, Switzerland
Department Clinical Research, University of Basel, Basel, Switzerland

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Julie Refardt Department of Endocrinology, Diabetology and Metabolismus, University Hospital Basel, Basel, Switzerland
Department Clinical Research, University of Basel, Basel, Switzerland

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Nicole Cesana-Nigro Department of Endocrinology and Diabetology, Bürgerspital Solothurn, Solothurn, Switzerland

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Milica Popovic Department of Endocrinology, Diabetology and Metabolismus, University Hospital Basel, Basel, Switzerland
Department Clinical Research, University of Basel, Basel, Switzerland

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Wiebke Fenske Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany
Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany

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Mirjam Christ-Crain Department of Endocrinology, Diabetology and Metabolismus, University Hospital Basel, Basel, Switzerland
Department Clinical Research, University of Basel, Basel, Switzerland

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antidiuresis (SIAD), characterized by water retention and secondary natriuresis ( 4 , 5 ). SIAD can be caused by a variety of conditions (infections, CNS disorders, drugs, pain or stress ( 6 )) and to large degree by cancers, whereby it is postulated that

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Tsuneo Ogawa Cardiovascular Endocrinology Laboratory, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7

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Adolfo J de Bold Cardiovascular Endocrinology Laboratory, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario, Canada K1Y 4W7

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investigative techniques (3, 4, 5, 6, 7, 8) , de Bold and colleagues demonstrated that injection of atrial muscle extracts to bioassay rats produced a strong natriuresis and diuresis as well as hypotension accompanied by an increase in haematocrit (9

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Christine Rode Andreasen Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Andreas Andersen Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark

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Filip Krag Knop Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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Tina Vilsbøll Steno Diabetes Center Copenhagen, Gentofte, Denmark
Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

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pressure, which seem independent of GLP-1RA-induced weight loss ( 34 ). This effect is thought to be mediated by increasing natriuresis ( 35 ) and vasorelaxation in the renal vasculature ( 36 ). In addition, GLP-1RAs increase heart rate in humans, most

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Susanna Cirera
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Sophia G Moesgaard Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Nora E Zois Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Nathja Ravn Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Jens P Goetze Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Signe E Cremer Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Tom Teerlink Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Páll S Leifsson Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Jesper L Honge Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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J Michael Hasenkam Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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Lisbeth H Olsen Department of Veterinary Clinical and Animal Sciences, Novo Nordisk A/S, Department of Clinical Biochemistry, Department of Cardiothoracic and Vascular Surgery, Department of Clinical Biochemistry, Department of Veterinary Disease Biology, Department of Clinical Chemistry, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark

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involved in the integrated control of renal and cardiovascular function (21) . Natriuretic peptides decrease cardiac preload, suppress renin and aldosterone secretion, and exert natriuresis. ANP and BNP are released by myocardial tissue primarily in

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Espen Nordheim Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway

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Trond Geir Jenssen Department of Transplantation Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
Faculty of Medicine, University of Oslo, Oslo, Norway
Metabolic and Renal Research Group, Faculty of Health Sciences, UiT- The Arctic University of Norway, Tromsø

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natriuresis, probably by inhibiting sodium/hydrogen isoform 3 (NHE3) in the renal tubules ( 43 ), but the renal haemodynamic effects seem neutral as the drug also causes glomerular vasodilatation ( 44 ). Weight loss, another known effect of GLP-1 RA leading to

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