2019 Fiscal Year Final Research Report
Evaluation of determinants and prognostic significance of Neprilysin in patients with heart failure
| Project/Area Number |
17K16015
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Cardiovascular medicine
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| Research Institution | Kumamoto University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2020-03-31
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| Keywords | ネプリライシン / 心不全 / バイオマーカー |
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| Outline of Final Research Achievements |
The concentration of neprilysin (NEP), which prevents the degradation of natriuretic peptide with cardioprotective effect, was measured in patients with heart failure cases. We evaluated 1. Factors affecting NEP level, 2. prognostic significance of NEP levels, and 3. the relationship between NEP release in the coronary circulation and hemodynamics. There was no correlation with left ventricular ejection fraction or brain natriuretic peptide which are surrogate markers indicating the severity of heart failure. NEP levels was not a prognostic factor. The quantitative analysis of NEP released in the coronary circulation was difficult to evaluate the NEP concentration in the coronary circulation due to the large variation in the values. This study could not show the clinical utility and usefulness of NEP concentration measurement in patients with heart failure.
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| Free Research Field |
心不全
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| Academic Significance and Societal Importance of the Research Achievements |
ネプリライシンは心不全に対して保護的に働くナトリウム利尿ペプチド分解を抑制する。今後上市される心不全治療薬：アンジオテンシン受容体ネプリライシン阻害薬（ARNI）はネプリライシンを阻害し、ナトリウム利尿ペプチドを上昇させることで心不全改善をもたらすが、どのような患者においてより効果が得られるかを検討することは重要であると考えている。ネプリライシン濃度測定は心不全の重症度や既存の重症度と相関するバイオマーカーと関連は確認されず、どのような患者群においてネプリライシンが上昇しているかを明らかにすることはできなかった。今後さらなる臨床研究が進み、心不全治療に個別化診療が浸透していくことを期待したい。
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