Key result
Systolic dysfunction linked to ~33% lower plasma corin and elevated neprilysin, cGMP, and ANP.
Why the study?
Are plasma levels of natriuretic peptide system enzymes (corin, neprilysin) altered in patients with reduced systolic function and heart failure compared to controls?
Observational (n=48)
Are plasma levels of natriuretic peptide system enzymes (corin, neprilysin) altered in patients with reduced systolic function and heart failure compared to controls?
Absolute Event Rate: 797% vs 1188%
p-value: p=<0.02
Patients with reduced ejection fraction exhibit decreased corin and increased neprilysin levels, suggesting enzymatic downregulation of natriuretic peptide activity.
Suggests dysregulated natriuretic peptide processing in systolic dysfunction; hypothesis-generating and requires prospective validation before clinical use.
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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Zaidi et al. (2018) conducted an observational in Systolic dysfunction and heart failure (n=48). Systolic dysfunction vs. Normal ejection fraction was evaluated on Plasma corin levels (pg/ml) (p=<0.02). Patients with systolic dysfunction had lower plasma corin levels (797 vs 1188 pg/ml, p<0.02) and higher neprilysin, cGMP, and ANP levels compared to controls with normal ejection fractions.
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