Heart failure & cardiomyopathies
The heart regulates the endocrine response to heart failure: cardiac contribution to circulating neprilysin
Authors' conclusion
The heart plays a pivotal role as a regulator of the endocrine response in systolic dysfunction, not only by directly releasing NPs but also by contributing to circulating sNEP, which in turn determines the bioavailability of other numerous vasoactive peptides.
Study context
- Population
- Patients with heart failure (HF) undergoing CARMAT total artificial heart implantation, and patients with reduced or preserved systolic function
- Participants
- 2 / 6 / 21
- Comparison
- Regional soluble neprilysin (sNEP) in reduced vs preserved systolic function; Natriuretic peptide (NP) pathway before vs after total artificial heart implantation
- Total artificial heartn = 2
- Preserved systolic functionn = 6reference
- Reduced left-ventricular systolic functionn = 21
- Outcome
- Circulating NP-pathway markers (NPs, glycosylated proBNP, furin activity, sNEP) after ventricular removal; regional sNEP (coronary sinus vs systemic vessels)
Methodological detailsVenous blood sampled before implantation and weekly until post-operative week 6
- Venous blood sampled before implantation and weekly until post-operative week 6
Main finding
As reported in the abstract
Preserved systolic function: sNEP similar in coronary sinus and systemic vessels
all P > 0.05
Reduced left-ventricular systolic function: sNEP concentration and activity ∼three-fold higher in coronary sinus vs systemic vessels
all P < 0.0001
Reduced left-ventricular systolic function: trans-pulmonary sNEP gradient neutral (n = 5)
P = 1.0
Original publication
The heart regulates the endocrine response to heart failure: cardiac contribution to circulating neprilysin. Eur Heart J. Published 13 December 2017. doi:10.
Summarised from the published abstract; every number is checked against it