The Correlation Of Plasma Corin With Cardiac Dysfunction And Left Ventricular Remodeling & Effect Of Recombinant Human B-type Natriuretic Peptide On Heart Failure

Objective:The aim of the study was to evaluate the clinical value of serum corin,NEP and BNP in patients with Reduced Systolic Function and its correlation with left ventricle systolic function.Further the effect of rh BNP treatment was investigated.Methods:Patients who were treated in cardiology department of our hospital from January 2016 to January 2018 were selected as study subjects.Three groups were divided according to heart failure score and ejection fractions,that is,no HF and normal EF(n EF group),no HF and systolic dysfunction(r EF<50%)((r EF+n HF group),and HF with systolic dysfunction(r EF<50%)(r EF+d HF group).A detailed medical history was obtained from the patient.Other pertinent clinical data were obtained from the computerized patient record system.Using enzyme-linked immunoassays plasma corin,NEP and BNP level were investigated.An echocardiogram was carried out to acquire LVSD,EF,LV reconstruction indexs.Differences and correlations between the groups,as well as the changes of the above indicators after rh BNP treatment was compared.Results:1.Demographic data.A total of 96 patients enrolled in this study,32 cases in each group.No difference was found in sex,age,body mass index and the biochemical indicators among the three groups(P>0.05).There were significant differences in heart failure scores,n EF group < r EF+n HF group < r EF+d HF group(P<0.05).2.Echo data.The mean EFs(±SD)in controls were 63±3 %.Among subjects with r EFs,there was no signifcant diference between those with r EF alone(EF 27±7 %)and those with r EF+d HF(EF 24±8%).Patients with r EF+d HF differed from control patients in nearly every echocardiographic parameter.Mean LV dimensions(LVIDd=6.2,LVIDs=5.4 cm)were larger in the r EF groups versus controls(p<0.001),but there were no signifcant diferences between the r EF and r EF+d HF groups(p=0.88).3.Plasma corin,NEP,BNP level.Median corin levels were signifcantly lower in all patients with r EF,than in controls(p <0.05).In contrast,median neprilysin levels were signifcantly higher in all patients with r EF than in controls(p <0.01).As HF scores worsened,neprilysin levels appeared to increase,while corin levels appeared to dreased.There is a negative correlation between plasma corin and NEP levels(r-0.57,p<0.05).4.Regression analysis.The multiple linear regression was used to explain the relationship between LVEF and corin,NEP,BNP,age,TG,TC,HDL,LDL,Cr,BUN,ALT,AST,etc.Corin(0.002,P<0.05)and BNP(0.006,P<0.05)were enrolled.5.rhBNP treatment.The amount of urine was increased,serum Cr level was decreased,left ventricular diastolic diameter was reduced after treatment.Thus heart systolic function was improved.Moreover serum corin level was increased,and BNP and NEP level were decreased especially in patients with reduced systolic function.Conclusion:Serum corin,NEP and BNP levels were related to cardiac systolic function in patients with heart failure.Measuring serum corin level may provide new idea for the treatment of heart failure.