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Soluble Neprilysin in the General Population: Clinical Determinants and Its Relationship to Cardiovascular Disease. | LitMetric

AI Article Synopsis

  • * No significant correlations were found between neprilysin levels and factors like age, body mass index, or natriuretic peptide levels, but individuals with lower neprilysin had higher instances of smoking, hypertension, and diastolic dysfunction.
  • * Over a median follow-up of 10.7 years, neprilysin levels were not linked to death or heart failure, suggesting more research is needed to understand its role in cardiometabolic conditions.

Article Abstract

Background Neprilysin is a metalloprotease involved in proteolysis of numerous peptides, including natriuretic peptides, and is of prognostic and therapeutic importance in heart failure with reduced ejection fraction. No studies have investigated circulating neprilysin in the community, its clinical correlates, or its relationship to cardiovascular disease in the general population. Methods and Results Plasma neprilysin was measured in 1536 participants from Olmsted County, Minnesota, using a commercially available sandwich ELISA assay. Clinical and echocardiographic correlates and subsequent outcomes were determined. Soluble neprilysin is non-normally distributed in the community (median: 3.9 ng/mL; interquartile range: 1.0-43.0 ng/mL). There was no relationship between plasma neprilysin and age (Spearman correlation: -0.04, P=0.16); body mass index (Spearman correlation: -0.04, P=0.16); glomerular filtration rate (Spearman correlation: -0.007, P=0.8); or A-, B-, or C-type natriuretic peptides (Spearman correlation: 0.03, P=0.22; -0.001, P=0.96; 0.01, P=0.67, respectively). Among tertiles of neprilysin, the lowest tertile group had the highest prevalence of smokers (P<0.001), hypertension (P=0.04), dyslipidemia (P=0.03), and diastolic dysfunction (P=0.02). Soluble neprilysin was not prospectively associated with death or heart failure over a median of 10.7 years. Conclusions In a large community-based cohort, for the first time, we described the distribution of circulating neprilysin in the general community. We observed that neprilysin does not correlate with natriuretic peptide levels and is not independently associated with adverse outcomes. The novel associations observed between low soluble neprilysin levels and an adverse cardiometabolic and smoking profile requires further investigation.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6761669PMC
http://dx.doi.org/10.1161/JAHA.119.012943DOI Listing

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