The heart regulates the endocrine response to heart failure: cardiac contribution to circulating neprilysin

Abstract Aims Heart failure (HF) is accompanied by major neuroendocrine changes including the activation of the natriuretic peptide (NP) pathway. Using the unique model of patients undergoing implantation of the CARMAT total artificial heart and investigating regional differences in soluble neprilys...

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Published in:European heart journal 2018-05, Vol.39 (20), p.1794-1798
Main Authors: Arrigo, Mattia, Vodovar, Nicolas, Nougué, Hélène, Sadoune, Malha, Pemberton, Chris J, Ballan, Pamela, Ludes, Pierre-Olivier, Gendron, Nicolas, Carpentier, Alain, Cholley, Bernard, Bizouarn, Philippe, Cohen-Solal, Alain, Singh, Jagmeet P, Szymonifka, Jackie, Latremouille, Christian, Samuel, Jane-Lise, Launay, Jean-Marie, Pottecher, Julien, Richards, A Mark, Truong, Quynh A, Smadja, David M, Mebazaa, Alexandre
Format: Article
Language:English
Subjects:
Aged
Biomarkers - blood
EHJ Brief Communication
Female
Heart - physiopathology
Heart Failure - blood
Heart Failure - physiopathology
Heart Failure - surgery
Heart, Artificial
Humans
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Natriuretic Peptides - physiology
Neprilysin - blood
Neprilysin - genetics
Neprilysin - physiology
Peptide Fragments - blood
Postoperative Period
RNA, Messenger - genetics
Signal Transduction - physiology
Systole - physiology
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Summary:Abstract Aims Heart failure (HF) is accompanied by major neuroendocrine changes including the activation of the natriuretic peptide (NP) pathway. Using the unique model of patients undergoing implantation of the CARMAT total artificial heart and investigating regional differences in soluble neprilysin (sNEP) in patients with reduced or preserved systolic function, we studied the regulation of the NP pathway in HF. Methods and results Venous blood samples from two patients undergoing replacement of the failing ventricles with a total artificial heart were collected before implantation and weekly thereafter until post-operative week 6. The ventricular removal was associated with an immediate drop in circulating NPs, a nearly total disappearance of circulating glycosylated proBNP and furin activity and a marked decrease in sNEP. From post-operative week 1 onwards, NP concentrations remained overall unchanged. In contrast, partial recoveries in glycosylated proBNP, furin activity, and sNEP were observed. Furthermore, while in patients with preserved systolic function (n = 6), sNEP concentrations in the coronary sinus and systemic vessels were similar (all P > 0.05), in patients with reduced left-ventricular systolic function, sNEP concentration, and activity were ∼three-fold higher in coronary sinus compared to systemic vessels (n = 21, all P 
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehx679