Phd YW, V Moreira MD, Heringer-Walther S, Schultheiss HP, Siems WE, Wessel N, Walther T
NT-proCNP And CNP Do Not Correlate In Patients With Chagas' Disease: Role For Neutral Endopeptidase. [JOURNAL ARTICLE]
J Cardiovasc Pharmacol 2009 Oct 23.
Atrial and B-type natriuretic peptides (ANP, BNP), but not C-type natriuretic peptide (CNP), have been identified to be diagnostic and prognostic markers in Chagas' disease (CD). Although ANP and BNP excessively rise in CD patients, increase in CNP is just minor. Our study aimed to investigate the mechanisms leading to CNP insensitivity to heart failure (HF) stimuli.Amino-terminal fragment of CNP precursor (NT-proCNP) and activity of neutral endopeptidase (NEP) were quantified to monitor CNP generation and degradation, respectively. Blood samples were collected from Chagasic patients and control healthy subjects.NT-proCNP concentrations were significantly lower in CD patients without systolic dysfunction compared to healthy subjects. Despite a trend towards increase with rising heart failure clinical severity, it was significantly correlated with left ventricular ejection fraction and other echocardiographic parameters. As shown for CNP before, NT-proCNP could not predict mortality and heart transplant. Importantly, it had no statistical correlation with CNP. Additionally, NEP activity was significantly increased in NYHA III-IV HF patients, but was positively correlated with CNP concentration.Our data demonstrates that generation of CNP is not enhanced under HF condition like CD; severe HF-induced CNP rise is caused by its less degradation, that is independent of NEP activity.
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