TY - JOUR
T1 - Possible Enzymatic Downregulation of the Natriuretic Peptide System in Patients with Reduced Systolic Function and Heart Failure
T2 - A Pilot Study
AU - Zaidi, Syed S.
AU - Ward, Ryan D.
AU - Ramanathan, Kodangudi
AU - Yu, Xinhua
AU - Gladysheva, Inna P.
AU - Reed, Guy L.
N1 - Funding Information:
This work was supported in part by the National Institutes of Health (Grant nos. HL92750 and NS089707 to Guy L. Reed and HL115036 to Inna P. Gladysheva).
Publisher Copyright:
© 2018 Syed S. Zaidi et al.
PY - 2018
Y1 - 2018
N2 - Background. In patients with reduced systolic function, the natriuretic peptide system affects heart failure (HF) progression, but the expression of key activating (corin) and degrading enzymes (neprilysin) is not well understood. Methods and Results. This pilot study (n=48) compared plasma levels of corin, neprilysin, ANP, BNP, and cGMP in control patients with normal ejection fractions (mean EF 63 ± 3 %) versus patients with systolic dysfunction, with (EF 24 ± 8 %) and without (EF 27 ± 7 %) decompensated HF (dHF), as defined by Framingham and BNP criteria. Mean ages, use of beta blockers, and ACE-inhibitors-angiotensin receptor blockers were similar between the groups. Corin levels were depressed in systolic dysfunction patients (797 ± 346 pg/ml) versus controls (1188 ± 549, p<0.02), but levels were not affected by dHF (p=0.77). In contrast, levels of neprilysin (p<0.01), cGMP (p<0.001), and ANP (p<0.001) were higher in systolic dysfunction patients than controls and were the highest in patients with dHF. Conclusions. Levels of neprilysin, ANP, BNP, and cGMP increased in patients with reduced systolic function and were the highest in dHF patients. Conversely, corin levels were low in patients with reduced EF with or without dHF. This pattern suggests possible enzymatic downregulation of natriuretic peptide activity in patients with reduced EF, which may have diagnostic and prognostic implications.
AB - Background. In patients with reduced systolic function, the natriuretic peptide system affects heart failure (HF) progression, but the expression of key activating (corin) and degrading enzymes (neprilysin) is not well understood. Methods and Results. This pilot study (n=48) compared plasma levels of corin, neprilysin, ANP, BNP, and cGMP in control patients with normal ejection fractions (mean EF 63 ± 3 %) versus patients with systolic dysfunction, with (EF 24 ± 8 %) and without (EF 27 ± 7 %) decompensated HF (dHF), as defined by Framingham and BNP criteria. Mean ages, use of beta blockers, and ACE-inhibitors-angiotensin receptor blockers were similar between the groups. Corin levels were depressed in systolic dysfunction patients (797 ± 346 pg/ml) versus controls (1188 ± 549, p<0.02), but levels were not affected by dHF (p=0.77). In contrast, levels of neprilysin (p<0.01), cGMP (p<0.001), and ANP (p<0.001) were higher in systolic dysfunction patients than controls and were the highest in patients with dHF. Conclusions. Levels of neprilysin, ANP, BNP, and cGMP increased in patients with reduced systolic function and were the highest in dHF patients. Conversely, corin levels were low in patients with reduced EF with or without dHF. This pattern suggests possible enzymatic downregulation of natriuretic peptide activity in patients with reduced EF, which may have diagnostic and prognostic implications.
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U2 - 10.1155/2018/7279036
DO - 10.1155/2018/7279036
M3 - Article
C2 - 30148170
AN - SCOPUS:85051341572
SN - 2314-6133
VL - 2018
JO - BioMed Research International
JF - BioMed Research International
M1 - 7279036
ER -