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Master Thesis

Relation entre taux sériques de néprilysine et paramètres de volumes et de fonction cardiaque après un syndrome coronarien aigu avec sus décalage du segment ST

Abstract : Background: Left ventricular remodeling (LVR) following ST-elevation myocardial infarction (STEMI) is associated with poor outcome. Neprilysin inhibition leads to improved outcome in patients with altered left ventricular ejection fraction (LVEF). Methods: We aimed to assess the association between serum levels of neprilysin and left ventricular (LV) volumes, function and LVR in STEMI patients with successful myocardial reperfusion and no clinical sign of HF. Sixty-eight patients were admitted for STEMI and had both plasma neprilysin measurement at baseline and 3D transthoracic echocardiogram at baseline and after a median follow-up of 7 months. We compared 3 groups: one group with a low-level of neprilysin (<125 pg/mL, n=38) and the two others were defined as being below or above the median value of the remaining samples (126-450 pg/mL, n=15 and >450 pg/mL, n=15). Results: Median age was 58.5±12.8 years and 56 (82.4%) were men. Median LVEF was 45.0±8.5%. At baseline there was a non-significant trend towards lower end-diastolic volume (p=0.07) but significantly lower LVEF in the high neprilysin group (46.4±8.3%, 47.1±8.1% and 39.1±6.9%, p < 0.01). At follow-up, the magnitude of LVEF increase was significantly more important in the high neprilysin group compared to the other groups (p=0.022 for relative change in LVEF and 6.6±7.3%, 3.6±9.0% and 11.3±8.4%, p=0.031 for absolute change in LVEF) resulting in similar LVEF levels at follow-up between all groups (53.0±8.9%, 50.6±9.7% and 50.4±9.9%, p=0.55). Conclusions: Initial high neprilysin levels may identify patients with stunned myocardium early after STEMI, with a recovery of contractility at follow-up.
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https://dumas.ccsd.cnrs.fr/dumas-03592658
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Submitted on : Tuesday, March 1, 2022 - 2:56:07 PM
Last modification on : Wednesday, April 13, 2022 - 3:44:51 AM

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  • HAL Id : dumas-03592658, version 1

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Clémence Macquaire. Relation entre taux sériques de néprilysine et paramètres de volumes et de fonction cardiaque après un syndrome coronarien aigu avec sus décalage du segment ST. Médecine humaine et pathologie. 2021. ⟨dumas-03592658⟩

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