|
1
|
Koceva A, Janež A, Jensterle M. The Impact of Hydration on Metabolic Outcomes: From Arginine-Vasopressin Signaling to Clinical Implications. MEDICINA (KAUNAS, LITHUANIA) 2025; 61:838. [PMID: 40428796 PMCID: PMC12113523 DOI: 10.3390/medicina61050838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2025] [Revised: 04/22/2025] [Accepted: 04/29/2025] [Indexed: 05/29/2025]
Abstract
Arginine-vasopressin peptide (AVP) plays a critical role in water balance and osmoregulation. However, emerging evidence suggests that AVP's actions may expand beyond its traditional role, significantly influencing metabolic regulation, including glucose homeostasis, insulin sensitivity, lipid metabolism and energy balance. Elevated AVP levels are seen in various metabolic conditions, such as insulin resistance, metabolic syndrome, type 2 diabetes (T2D) and obesity, further highlighting its potential role as a metabolic regulator. As AVP levels are regulated by hydration status, studies have proposed that chronic hypohydration and persistently elevated AVP levels may contribute to metabolic dysfunction, where increased hydration and therefore AVP suppression may lead to potential metabolic improvements. By analyzing data from animal studies, human observational research and interventional trials, this review evaluates the current evidence on the potential causal relationships and impact of AVP on metabolic regulation, as well as exploring the role of hydration in AVP-mediated metabolic outcomes.
Collapse
Affiliation(s)
- Andrijana Koceva
- Department of Endocrinology and Diabetology, Clinic of Internal Medicine, University Medical Center Maribor, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Mojca Jensterle
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| |
Collapse
|
|
2
|
Samuelsson S, Engerström L, Holm J. Copeptin Levels During Cardiac Surgery. J Cardiothorac Vasc Anesth 2025; 39:1197-1204. [PMID: 40023700 DOI: 10.1053/j.jvca.2025.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 01/19/2025] [Accepted: 02/08/2025] [Indexed: 03/04/2025]
Abstract
OBJECTIVES To investigate copeptin levels during the full perioperative course in open, adult cardiac surgery with cardiopulmonary bypass (CPB). DESIGN Prospective cohort study. SETTING A single-center study conducted in a tertiary care hospital. PARTICIPANTS We included 61 patients undergoing various cardiac surgical procedures. In the final analysis, 57 patients were evaluated. Patients were divided into 2 subgroups based on preoperative copeptin levels, either above or below the reference level of 10 pmol/L. INTERVENTIONS No intervention. MEASUREMENTS AND MAIN RESULTS Copeptin levels were measured at multiple time points preoperatively, perioperatively, and postoperatively. Copeptin levels significantly increased from a preoperative median of 6.6 pmol/L (interquartile range [IQR], 3.9-11.0) to 27 pmol/L (IQR, 15.0-66.0 pmol/L) after sternotomy (p ≤ 0.001). Peak levels occurred 60 minutes after CPB initiation, reaching 286 pmol/L (IQR, 163-446 pmol/L). After this, the copeptin levels did not drop significantly until CPB termination at 179.5 pmol/L (IQR, 136.0-346.0 pmol/L) (p ≤ 0.001). Subsequent decreases were observed upon arrival in the intensive care unit and throughout the postoperative period. However, at 4 days postoperatively, copeptin levels remained significantly higher (11.5 pmol/L; IQR,7.2-19.0 pmol/L; p ≤ 0.001), than preoperative levels. CONCLUSIONS This study describes copeptin levels during the perioperative course in adult cardiac surgery. The elevated levels during CPB suggest a strong activation of the arginine vasopressin system, with peak levels exceeding those seen in septic shock. This knowledge will enable further targeted clinical studies on copeptin as a prognostic marker in the field of cardiac surgery.
Collapse
Affiliation(s)
- Selma Samuelsson
- Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital and Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Medicine, Linköping University, Linköping, Sweden.
| | - Lars Engerström
- Department of Cardiothoracic and Vascular Anesthesiology and Intensive Care, Linköping University Hospital, Department of Anesthesia and Intensive Care, Norrköping Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Jonas Holm
- Department of Cardiothoracic and Vascular Surgery, Linköping University Hospital and Department of Health, Medicine and Caring Sciences, Unit of Cardiovascular Medicine, Linköping University, Linköping, Sweden
| |
Collapse
|
|
3
|
Gunt C, Çekmen N. Perioperative Variation of Plasma Copeptin and Its Association With Vasopressor Need During Liver Transplantation. Transplant Proc 2025; 57:277-283. [PMID: 39848860 DOI: 10.1016/j.transproceed.2024.11.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 10/25/2024] [Accepted: 11/19/2024] [Indexed: 01/25/2025]
Abstract
BACKGROUND Vasopressor usage during liver transplant is related to decreased hepatic flow, graft failure, and mortality. We measured plasma Copeptin levels in liver transplant patients based on vasopressor requirements. We hypothesize that preoperative plasma copeptin measurement helps predict the vasopressor infusion requirement during liver transplantation in preoperative evaluation. METHODS The plasma Copeptin of 40 patients was measured 5 times: before the operation, 15 minutes before and after reperfusion, and postoperative 12th and 24th hours. Patients were categorized into 2 groups based on vasopressor infusion for comparison. RESULTS There was a statistically significant rise in median serum Copeptin concentration between the preoperative phase and before reperfusion (11.2 [7.3-20.9] vs 178.5 [121.5-243.0], P < .001), as well as a statistically substantial decline between after reperfusion and postoperative 12th hours (190.6 [127-276.3] vs 74.7 [42.0-124.9], P < .001). The vasopressor-taking group had significantly higher plasma copeptin at postoperative 12th hours (96.6 [71.4-191.7] vs 55.0 [31.8-82.5], P = .030) and 24th (133.7 [72.2-175.5] vs 51.1 [24.8-85.8], P = .037). A tendency above 11.85 pmol/L of plasma Copeptine level was observed between increasing preoperative plasma Copeptin and the odds of vasopressor use. CONCLUSION High preoperative plasma Copeptin levels may be an indicator of vasopressor need during liver transplantation. Further studies with more samples, including a higher range of preoperative plasma Copeptin levels, are required to provide more generalizable findings and to determine thresholds applicable to LT candidates.
Collapse
Affiliation(s)
- Ceren Gunt
- Ankara Güven Hospital, Department of Anaesthesiology and Reanimation Çankaya/Ankara, Turkey.
| | - Nedim Çekmen
- Nişantaşı University Health Services Vocational School, Department of Anesthesia, Turkey
| |
Collapse
|
|
4
|
Shi Z, Qian C. Copeptin and the prognosis of patients with coronary artery disease: a meta-analysis. Ir J Med Sci 2023; 192:2129-2141. [PMID: 36719516 DOI: 10.1007/s11845-023-03276-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/03/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Copeptin, the C-terminal portion of provasopressin, has been regarded as a marker of non-specific stress response and a potentially prognostic biomarker of cardiovascular diseases. This systematic review and meta-analysis was conducted to summarize the predictive role of baseline copeptin for the prognosis of patients with coronary artery disease (CAD). METHODS Relevant observational studies with longitudinal follow-up were obtained by comprehensive search of PubMed, Embase, and Web of Science databases. A random-effects model was used to pool the results. RESULTS Twenty-two studies with 19,821 patients with CAD were enrolled. Results of the meta-analyses revealed that a high copeptin at baseline was associated with a higher mortality risk (risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.49 to 2.09, p < 0.001; I2 = 70%) and an increased incidence of major adverse cardiovascular events (MACEs, RR: 1.49, 95% CI: 1.34 to 1.65, p < 0.001; I2 = 28%) in patients with CAD. Further results of sensitivity and subgroup analyses showed consistent associations between high copeptin with increased risks of mortality and MACEs in studies of patients with different ages, proportion of men, subtypes of CAD, study design, follow-up durations, and quality scores (p for subgroup effect all < 0.05). CONCLUSIONS A high plasma level of copeptin is associated with higher risks of mortality and MACEs in patients with CAD. Measuring copeptin may be helpful for risk stratification in patients with CAD.
Collapse
Affiliation(s)
- Zhewei Shi
- Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, 311800, China.
| | - Caizhen Qian
- Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, 311800, China
| |
Collapse
|
|
5
|
Katsioupa M, Kourampi I, Oikonomou E, Tsigkou V, Theofilis P, Charalambous G, Marinos G, Gialamas I, Zisimos K, Anastasiou A, Katsianos E, Kalogeras K, Katsarou O, Vavuranakis M, Siasos G, Tousoulis D. Novel Biomarkers and Their Role in the Diagnosis and Prognosis of Acute Coronary Syndrome. Life (Basel) 2023; 13:1992. [PMID: 37895374 PMCID: PMC10608753 DOI: 10.3390/life13101992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
The burden of cardiovascular diseases and the critical role of acute coronary syndrome (ACS) in their progression underscore the need for effective diagnostic and prognostic tools. Biomarkers have emerged as crucial instruments for ACS diagnosis, risk stratification, and prognosis assessment. Among these, high-sensitivity troponin (hs-cTn) has revolutionized ACS diagnosis due to its superior sensitivity and negative predictive value. However, challenges regarding specificity, standardization, and interpretation persist. Beyond troponins, various biomarkers reflecting myocardial injury, neurohormonal activation, inflammation, thrombosis, and other pathways are being explored to refine ACS management. This review article comprehensively explores the landscape of clinically used biomarkers intricately involved in the pathophysiology, diagnosis, and prognosis of ACS (i.e., troponins, creatine kinase MB (CK-MB), B-type natriuretic peptides (BNP), copeptin, C-reactive protein (CRP), interleukin-6 (IL-6), d-dimers, fibrinogen), especially focusing on the prognostic role of natriuretic peptides and of inflammatory indices. Research data on novel biomarkers (i.e., endocan, galectin, soluble suppression of tumorigenicity (sST2), microRNAs (miRNAs), soluble oxidized low-density lipoprotein receptor-1 (sLOX-1), F2 isoprostanes, and growth differentiation factor 15 (GDF-15)) are further analyzed, aiming to shed light on the multiplicity of pathophysiologic mechanisms implicated in the evolution of ACS. By elucidating the complex interplay of these biomarkers in ACS pathophysiology, diagnosis, and outcomes, this review aims to enhance our understanding of the evolving trajectory and advancements in ACS management. However, further research is necessary to establish the clinical utility and integration of these biomarkers into routine practice to improve patient outcomes.
Collapse
Affiliation(s)
- Maria Katsioupa
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Islam Kourampi
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Evangelos Oikonomou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Vasiliki Tsigkou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Panagiotis Theofilis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| | - Georgios Charalambous
- Department of Emergency Medicine, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - George Marinos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Ioannis Gialamas
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Zisimos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Artemis Anastasiou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Efstratios Katsianos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Konstantinos Kalogeras
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Ourania Katsarou
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Manolis Vavuranakis
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Gerasimos Siasos
- 3rd Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.K.); (I.K.); (E.O.); (V.T.); (I.G.); (K.Z.); (A.A.); (E.K.); (K.K.); (O.K.); (M.V.)
| | - Dimitris Tousoulis
- 1st Department of Cardiology, “Hippokration” General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece; (P.T.); (D.T.)
| |
Collapse
|
|
6
|
Stătescu C, Anghel L, Tudurachi BS, Leonte A, Benchea LC, Sascău RA. From Classic to Modern Prognostic Biomarkers in Patients with Acute Myocardial Infarction. Int J Mol Sci 2022; 23:9168. [PMID: 36012430 PMCID: PMC9409468 DOI: 10.3390/ijms23169168] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Despite all the important advances in its diagnosis and treatment, acute myocardial infarction (AMI) is still one of the most prominent causes of morbidity and mortality worldwide. Early identification of patients at high risk of poor outcomes through the measurement of various biomarker concentrations might contribute to more accurate risk stratification and help to guide more individualized therapeutic strategies, thus improving prognoses. The aim of this article is to provide an overview of the role and applications of cardiac biomarkers in risk stratification and prognostic assessment for patients with myocardial infarction. Although there is no ideal biomarker that can provide prognostic information for risk assessment in patients with AMI, the results obtained in recent years are promising. Several novel biomarkers related to the pathophysiological processes found in patients with myocardial infarction, such as inflammation, neurohormonal activation, myocardial stress, myocardial necrosis, cardiac remodeling and vasoactive processes, have been identified; they may bring additional value for AMI prognosis when included in multi-biomarker strategies. Furthermore, the use of artificial intelligence algorithms for risk stratification and prognostic assessment in these patients may have an extremely important role in improving outcomes.
Collapse
Affiliation(s)
- Cristian Stătescu
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
| | - Larisa Anghel
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
| | - Bogdan-Sorin Tudurachi
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Andreea Leonte
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Laura-Cătălina Benchea
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Radu-Andy Sascău
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
| |
Collapse
|