Plasma dipeptidyl-peptidase-4 activity is associated with left ventricular systolic function in patients with
Jing Wei Li1,2, Yun Dai Chen3, Yu Qi Liu1
1Department of Cardiology, PLA General Hospital, Beijing, China.
Insights
Low plasma dipeptidyl-peptidase-4 activity (DPP4a) is linked to impaired left ventricular systolic function in ST-segment elevation myocardial infarction (STEMI) patients. This suggests DPP4 may play a role in STEMI-related left ventricular systolic dysfunction.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Plasma dipeptidyl-peptidase-4 activity (DPP4a) is known to be inversely associated with left ventricular function in heart failure and diabetes.
- The relationship between DPP4a and left ventricular function in ST-segment elevation myocardial infarction (STEMI) patients remains uninvestigated.
Purpose of the Study:
- To investigate the association between DPP4a and left ventricular function in patients with STEMI.
Main Methods:
- A study involving 584 consecutive STEMI patients.
- Quantification of DPP4a and N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels using enzymatic assays.
- Analysis of left ventricular ejection fraction (LVEF) and multivariate logistic-regression to identify independent associations.
Main Results:
- Patients with the lowest DPP4a tertile had significantly higher NT-proBNP levels.
- STEMI patients in the lowest DPP4a tertile exhibited significantly lower LVEF.
- Increased DPP4a was independently associated with a decreased incidence of left ventricular systolic dysfunction (LVSD) (adjusted odds ratio: 0.90; p < 0.01).
Conclusions:
- Low DPP4a is independently associated with LVSD in STEMI patients.
- These findings suggest a potential role for DPP4 in the mechanisms underlying LVSD following STEMI.
Abstract:
Plasma dipeptidyl-peptidase-4 activity (DPP4a) is inversely associated with left ventricular function in patients with heart failure (HF) or diabetes. However, the association between DPP4a and left ventricular function in ST-segment elevation myocardial infarction (STEMI) patients has not been reported. We studied this association in 584 consecutive STEMI patients at a tertiary referral center from July 2014 to October 2015. DPP4a and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels were quantified by enzymatic assays. The median serum NT-proBNP levels were highest in patients of the lowest tertile (T1) of DPP4a compared with that of the highest tertile (T3) (p = 0.028). The STEMI patients in T1 exhibited lower left ventricular systolic function (T1 vs. T3: left ventricular ejection fraction (LVEF): 50.13 ± 9.12 vs. 52.85 ± 6.82%, p = 0.001). Multivariate logistic-regression analyses (adjusted for confounding variables) showed that a 1 U/L increase in DPP4a was associated with a decreased incidence of left ventricular systolic dysfunction (LVSD) (adjusted odds ratio: 0.90; 95% CI: 0.87-0.94; p < 0.01). In conclusion, low DPP4a is independently associated with LVSD in STEMI patients, which suggests that DPP4 may be involved in the mechanisms of LVSD in STEMI patients.
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