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. 2019 May 21;1(6):261-267.
doi: 10.1253/circrep.CR-19-0034.

Soluble Neprilysin - Cardiac Function and Outcome in Hypertrophic Cardiomyopathy

Akiomi Yoshihisa  1   2 , Tetsuro Yokokawa  1   3 , Yasuhiro Ichijo  1 , Yusuke Kimishima  1 , Yuki Kanno  1 , Tomofumi Misaka  1   2 , Takamasa Sato  1 , Masayoshi Oikawa  1 , Atsushi Kobayashi  1 , Takayoshi Yamaki  1 , Koichi Sugimoto  1   3 , Hiroyuki Kunii  1 , Yasuchika Takeishi  1
Affiliations

Soluble Neprilysin - Cardiac Function and Outcome in Hypertrophic Cardiomyopathy

Akiomi Yoshihisa et al. Circ Rep. .

Abstract

Background: Circulating soluble neprilysin (sNEP) predicts outcome in heart failure (HF) patients with reduced ejection fraction (EF), but not in those with preserved EF. We examined sNEP in patients with hypertrophic cardiomyopathy (HCM), and their correlations with other biomarkers, cardiac function, and clinical outcome. Methods and Results: We examined the associations between sNEP and the laboratory and echocardiography parameters in the HCM patients (n=93). Regarding the laboratory data, sNEP had a significant positive correlation with B-type natriuretic peptide (BNP; R=0.326, P=0.003), but not with troponin I. As for the echocardiographic parameters, sNEP negatively correlated with left ventricular EF (R=-0.283, P=0.009) and right ventricular fractional area change (R=-0.277, P=0.012), but not with left ventricular mass. Next, we prospectively followed up on the patients for cardiac events, including worsening HF or cardiac death, and all-cause mortality. On Kaplan-Meier analysis (mean follow-up, 1,021 days), the cardiac event rate and all-cause mortality were similar between the higher sNEP group (sNEP ≥median level of 1.43 ng/mL, n=46) and lower sNEP group (sNEP <1.43 ng/mL, n=47). On Cox proportional hazard analysis, sNEP was not a predictor of cardiac event or all-cause mortality. Conclusions: Soluble neprilysin appears to correlate with BNP and cardiac systolic function, but it is not significantly associated with prognosis in HCM patients.

Keywords: Echocardiography; Hemodynamics; Hypertrophic cardiomyopathy; Natriuretic peptide; Neprilysin.

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Conflict of interest statement

A.Y. and T.M. belong to the Department of Advanced Cardiac Therapeutics, supported by Fukuda-denshi. This company is not associated with the content of the current study. K.S. and T. Yokokawa. belong to the Department of Pulmonary Hypertension, supported by Acterion Pharmaceuticals Japan. This company is also not associated with the contents of the current study. The other authors declare no conflicts of interest. The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented, and for the discussed interpretation.

Figures

Figure 1.
Figure 1.
Log soluble neprilysin (log sNEP) vs. log B-type natriuretic peptide (logBNP), log troponin I, left ventricular ejection fraction (LVEF) and right ventricular fractional area change (RV-FAC).
Figure 2.
Figure 2.
Kaplan-Meier analysis for cardiac event rate and all-cause mortality between the low and high soluble neprilysin (sNEP) groups.
See this image and copyright information in PMC

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