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Kyodo A, Nakada Y, Nogi M, Nogi K, Ishihara S, Ueda T, Tohyama T, Enzan N, Ide T, Matsushima S, Tsutsui H, Saito Y. Evaluation of the A 2B Score for Prediction of Survival in Patients With Heart Failure in a Nationwide Cohort in Japan. J Am Heart Assoc 2024; 13:e031104. [PMID: 38348810 PMCID: PMC11010077 DOI: 10.1161/jaha.123.031104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/05/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Although a tool for sharing patient prognosis among all medical staff is desirable in heart failure (HF) cases, only a few simple HF prognostic scores are available. We previously presented the A2B score, a simple user-friendly HF risk score, and validated it in a small single-center cohort. In the present study, we validated it in a larger nationwide cohort. METHODS AND RESULTS We examined the 2-year mortality in relation to the A2B scores in 3483 patients from a Japanese nationwide cohort and attempted to stratify their prognoses according to the scores. The A2B score was determined by assigning points for age, anemia, and brain natriuretic peptide (BNP) level at discharge: age (<65 years, 0; 65-74 years, 1; ≥75 years, 2), anemia (hemoglobin ≥12 g/dL, 0; 10-11.9 g/dL, 1; <10 g/dL, 2), and BNP (<200 pg/mL, 0; 200-499 pg/mL, 1; ≥500 pg/mL, 2). Hemoglobin and BNP levels were applied to the data at discharge. The 2-year survival rates for A2B scores 1, 2, 3, 4, 5, and 6 were 94.1%, 83.2%, 74.1%, 63.5%, 51.6%, and 41.5%, respectively; the mortality rate increased by ≈10% for each point increase (c-index, 0.702). The A2B score was applicable in HF cases with reduced or preserved ejection fraction and remained useful when BNP was substituted with N-terminal proBNP (c-index, 0.749, 0.676, and 0.682, respectively). CONCLUSIONS The A2B score showed a good prognostic value for HF in a large population even when BNP was replaced with N-terminal proBNP.
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Affiliation(s)
- Atsushi Kyodo
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Yasuki Nakada
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Maki Nogi
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Kazutaka Nogi
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Satomi Ishihara
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Tomoya Ueda
- Department of Cardiovascular MedicineNara Medical UniversityKashiharaJapan
| | - Takeshi Tohyama
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
| | - Nobuyuki Enzan
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
| | - Tomomi Ide
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
| | - Shouji Matsushima
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Faculty of Medical SciencesKyushu UniversityFukuokaJapan
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Karki KB, Towbin JA, Shah SH, Philip RR, West AN, Tadphale SD, Saini A. Elevated Copeptin Levels Are Associated with Heart Failure Severity and Adverse Outcomes in Children with Cardiomyopathy. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1138. [PMID: 37508636 PMCID: PMC10377870 DOI: 10.3390/children10071138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023]
Abstract
In children with cardiomyopathy, the severity of heart failure (HF) varies. However, copeptin, which is a biomarker of neurohormonal adaptation in heart failure, has not been studied in these patients. In this study, we evaluated the correlation of copeptin level with functional HF grading, B-type natriuretic peptide (BNP), and echocardiography variables in children with cardiomyopathy. Furthermore, we determined if copeptin levels are associated with adverse outcomes, including cardiac arrest, mechanical circulatory support, heart transplant, or death. In forty-two children with cardiomyopathy with a median (IQR) age of 13.1 years (2.5-17.2) and a median follow-up of 2.5 years (2.2-2.7), seven (16.7%) children had at least one adverse outcome. Copeptin levels were highest in the patients with adverse outcomes, followed by the patients without adverse outcomes, and then the healthy children. The copeptin levels in patients showed a strong correlation with their functional HF grading, BNP level, and left ventricular ejection fraction (LVEF). Patients with copeptin levels higher than the median value of 25 pg/mL had a higher likelihood of experiencing adverse outcomes, as revealed by Kaplan-Meier survival analysis (p = 0.024). Copeptin level was an excellent predictor of outcomes, with an area under the curve of 0.861 (95% CI, 0.634-1.089), a sensitivity of 86%, and a specificity of 60% for copeptin level of 25 pg/mL. This predictive value was superior in patients with dilated and restrictive cardiomyopathies (0.97 (CI 0.927-1.036), p < 0.0001, n = 21) than in those with hypertrophic and LV non-compaction cardiomyopathies (0.60 (CI 0.04-1.16), p = 0.7, n = 21).
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Affiliation(s)
- Karan B Karki
- Division of Pediatric Cardiology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Jeffrey A Towbin
- Division of Pediatric Cardiology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Samir H Shah
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Ranjit R Philip
- Division of Pediatric Cardiology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Alina N West
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Sachin D Tadphale
- Division of Pediatric Cardiology, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Arun Saini
- Section of Pediatric, Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine and Affiliated Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA
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Okwor CJ, Adedapo KS, Bello OO, Meka IA, Okwor CV, Uche CZ, Nwajiobi CE, Nto-Ezimah UA, Uchechukwu CE, Arum EJ. Assessment of brain natriuretic peptide and copeptin as correlates of blood pressure in chronic hypertensive pregnant women. Clin Hypertens 2022; 28:37. [PMID: 36517833 PMCID: PMC9753280 DOI: 10.1186/s40885-022-00221-6] [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: 03/31/2022] [Accepted: 08/01/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy including preexisting (or chronic) hypertension are the most common complication encountered during pregnancy that contribute significantly to maternal and perinatal morbidity and mortality. Brain natriuretic peptide (BNP) and copeptin have been investigated as biomarkers in various hypertensive disorders, but studies of their clinical value in chronic hypertensive pregnant women are sparce. This study aimed to assess the levels of BNP and copeptin in chronic hypertensive pregnant women and investigate their correlation with blood pressure (BP) in chronic hypertensive pregnant women in South Western Nigeria. METHODS One hundred and sixty consenting pregnant women in their third trimester of pregnancy, grouped into those with chronic hypertension (n = 80) and normotensive (n = 80), were recruited for this cross-sectional study. Age and clinical characteristics were obtained, and blood was aseptically drawn for BNP and copeptin measurement using enzyme-linked immunosorbent assay. Data was analyzed with IBM SPSS ver. 20.0. Data was analyzed using Student t-test, chi-square, and Pearson correlation test as appropriate. Statistical significance was set at P < 0.05. RESULTS The mean systolic BP (SBP) and diastolic BP (DBP) were significantly higher in pregnant women with chronic hypertension (158.30 ± 3.51 and 105.08 ± 2.47 mmHg, respectively) compared with normotensive pregnant women (100.72 ± 3.02 and 70.29 ± 1.96 mmHg, respectively). The mean levels of BNP and copeptin were higher in pregnant women with chronic hypertension (57.26 ± 3.65 pg/mL and 12.44 ± 1.02 pmol/L, respectively) compared with normotensive pregnant women (49.85 ± 2.44 pg/mL and 10.25 ± 1.50 pmol/L, respectively) though not statistically significant. Correlations observed between SBP and DBP with levels of BNP (r = 0.204, P = 0.200; r = 0.142, P = 0.478) and copeptin (r = - 0.058, P = 0.288; r = 0.045, P = 0.907) were not statistically significant. CONCLUSIONS There was no association between BP and the levels of BNP and copeptin in pregnant women with chronic hypertension who were already on antihypertensive treatment, with the implication that antihypertensive treatment may modulate BNP and copeptin release despite significantly elevated BP levels.
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Affiliation(s)
- Chika J. Okwor
- grid.412438.80000 0004 1764 5403Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
| | - Kayode S. Adedapo
- grid.412438.80000 0004 1764 5403Department of Chemical Pathology, University College Hospital, Ibadan, Nigeria
| | - Oluwasomidoyin O. Bello
- grid.412438.80000 0004 1764 5403Department of Obstetrics and Gynaecology, University College Hospital, Ibadan, Nigeria
| | - Ijeoma A. Meka
- grid.413131.50000 0000 9161 1296Department of Chemical Pathology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chukwuemeka V. Okwor
- grid.413131.50000 0000 9161 1296Department of Radiation Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chukwuemelie Z. Uche
- grid.10757.340000 0001 2108 8257Department of Medical Biochemistry & Molecular Biology, University of Nigeria, Enugu, Nigeria
| | - Chiebonam E. Nwajiobi
- grid.413131.50000 0000 9161 1296Department of Chemical Pathology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Uloaku A. Nto-Ezimah
- grid.413131.50000 0000 9161 1296Department of Chemical Pathology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Chisom E. Uchechukwu
- grid.413131.50000 0000 9161 1296Department of Chemical Pathology, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Ekene J. Arum
- grid.413131.50000 0000 9161 1296Department of Chemical Pathology, University of Nigeria Teaching Hospital, Enugu, Nigeria
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El Amrousy D, Abdelhai D, Nassar M. Predictive Value of Plasma Copeptin Level in Children with Acute Heart Failure. Pediatr Cardiol 2022; 43:1737-1742. [PMID: 35532808 PMCID: PMC9587970 DOI: 10.1007/s00246-022-02909-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/04/2022] [Indexed: 02/08/2023]
Abstract
We investigated the ability of copeptin level to predict adverse outcome in pediatric heart failure (HF) and correlated copeptin level with various clinical and echocardiographic data. This cohort study was carried out on forty children with clinical picture of acute HF as the patient group and forty healthy children of matched age and sex as the control group. Echocardiographic examination and plasma copeptin level were performed for all included children at admission. Patients were followed up for 6 months for mortality or readmission. Plasma copeptin level was significantly higher in the patient group (16.2 ± 5) pmol/L compared to the control group (4.1 ± 2.3) pmol/L, P ˂0.001. Moreover, copeptin level was positively correlated with Ross classification, being the highest in patients with class IV (19.6 ± 3.9) pmol/L compared to those with class III (15.2 ± 4) pmol/L and class II (10.4 ± 1.5) pmol/L. Copeptin levels were significantly higher in patients with bad prognosis (21.2 ± 4.1) pmol/L compared to those with good prognosis (14.5 ± 4.1) pmol/L, P ˂0.001. Copeptin level had a significant positive correlation with age, heart rate, respiratory rate, and ROSS classification. On the contrary, copeptin level had a significant negative correlation with left ventricular fraction shortening and diastolic function. Copeptin at cut-off value of ≥ 19.5 pmol/L yielded a sensitivity of 75% and a specificity of 93% to predict adverse outcome in children with HF. Plasma copeptin level has a good prognostic value to predict adverse outcome in pediatric heart failure. Moreover, copeptin correlate well with the severity of pediatric HF.
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Affiliation(s)
- Doaa El Amrousy
- grid.412258.80000 0000 9477 7793Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dina Abdelhai
- grid.412258.80000 0000 9477 7793Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohammed Nassar
- grid.412258.80000 0000 9477 7793Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Görkem Ü, Yıldırım E. Copeptin: A potential marker for the prediction of poor ovarian reserve in the ınfertile women. Turk J Obstet Gynecol 2022; 19:281-286. [DOI: 10.4274/tjod.galenos.2022.55856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Zimodro JM, Gasecka A, Jaguszewski M, Amanowicz S, Szkiela M, Denegri A, Pruc M, Duchnowski P, Peacock FW, Rafique Z, Szarpak L. Role of copeptin in diagnosis and outcome prediction in patients with heart failure: a systematic review and meta-analysis. Biomarkers 2022; 27:720-726. [PMID: 36083024 DOI: 10.1080/1354750x.2022.2123042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Introduction: This systematic review and meta-analysis of 19 studies, was conducted to evaluate the role of copeptin in diagnosis and outcome prediction in HF patients. Materials and Methods: A systematic literature search for clinical trials reporting copeptin levels in HF patients was performed using EMBASE, PubMed, Cochrane Register of Controlled Trials, and Google Scholar. Articles from databases published by January 2nd, 2022, that met the selection criteria were retrieved and reviewed. The random effects model was used for analyses. Results: Pooled analysis found higher mean copeptin levels in HF vs. non-HF populations (43.6 ± 46.4 vs. 21.4 ± 21.4; MD= 20.48; 95%CI: 9.22 to 31.74; p < 0.001). Pooled analysis of copeptin concentrations stratified by ejection fraction showed higher concentrations in HFrEF vs. HFpEF (17.4 ± 7.1 vs. 10.1 ± 5.5; MD= -4.69; 95%CI: -7.58 to -1.81; p = 0.001). Copeptin level was higher in patients with mortality/acute HF-related hospitalization vs. stable patients (31.3 ± 23.7 vs. 20.4 ± 12.8; MD= -13.06; 95%CI: -25.28 to -0.84; p = 0.04). Higher copeptin concentrations were associated with mortality and observed in all follow-up periods (p <0.05). Discussion and Conclusions: Present meta-analysis showed that elevated copeptin plasma concentrations observed in HF patients are associated with increased risk of all-cause mortality, thus copeptin may serve as predictor of outcome in HF.
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Affiliation(s)
- Jakub Michal Zimodro
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Milosz Jaguszewski
- 1st Department of Cardiology, Medical University of Gdansk, 80-211 Gdansk, Poland
| | - Sandra Amanowicz
- Students Research Club, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
| | - Marta Szkiela
- Students Research Club, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
| | - Andrea Denegri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41121 Modena, Italy
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Piotr Duchnowski
- Cardinal Wyszynski National Institute of Cardiology, 04-628 Warsaw, Poland
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, Poland
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Signs of Anxiety and Salivary Copeptin Levels in Dogs Diagnosed with Separation-Related Problems in a Short Separation Test. Animals (Basel) 2022; 12:ani12151974. [PMID: 35953963 PMCID: PMC9367405 DOI: 10.3390/ani12151974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/28/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
The need for faster diagnosis and more accurate treatment decisions in separation-related problems (SRPs) in dogs is urgent, and a more precise behavioral phenotyping and the development of biomarkers may be of great value. Vasopressin could be a potential non-invasive biomarker of anxiety in dogs with SRPs, but reliable measurement of its concentration is challenging. Here, we compared the behavior and salivary concentrations of copeptin, an arginine vasopressin surrogate, in dogs with SRPs (Case group, n = 13) and with no problems (Control group, n = 15) as they were introduced to a novel environment and subjected to a short episode of separation and reunion with the owner. Dogs in the Case group had greater odds of showing locomotory or oral behaviors during the pre- and post-separation than Controls, while the odds were significantly lower during separation. They also had greater odds of being persistent in seeking attention and proximity from the stranger during reunion. Overall, dogs with SRPs were more likely to express an anxiety-like state during the entire test than Controls, with separation from the owner, and even its anticipation, possibly accounting for this group difference. Although salivary copeptin concentrations did not differ between the two groups, a different trend was detected in Cases and Controls that is worth exploring in further validation studies involving a larger sample.
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Mu D, Cheng J, Qiu L, Cheng X. Copeptin as a Diagnostic and Prognostic Biomarker in Cardiovascular Diseases. Front Cardiovasc Med 2022; 9:901990. [PMID: 35859595 PMCID: PMC9289206 DOI: 10.3389/fcvm.2022.901990] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/07/2022] [Indexed: 12/11/2022] Open
Abstract
Copeptin is the carboxyl-terminus of the arginine vasopressin (AVP) precursor peptide. The main physiological functions of AVP are fluid and osmotic balance, cardiovascular homeostasis, and regulation of endocrine stress response. Copeptin, which is released in an equimolar mode with AVP from the neurohypophysis, has emerged as a stable and simple-to-measure surrogate marker of AVP and has displayed enormous potential in clinical practice. Cardiovascular disease (CVD) is currently recognized as a primary threat to the health of the population worldwide, and thus, rapid and effective approaches to identify individuals that are at high risk of, or have already developed CVD are required. Copeptin is a diagnostic and prognostic biomarker in CVD, including the rapid rule-out of acute myocardial infarction (AMI), mortality prediction in heart failure (HF), and stroke. This review summarizes and discusses the value of copeptin in the diagnosis, discrimination, and prognosis of CVD (AMI, HF, and stroke), as well as the caveats and prospects for the application of this potential biomarker.
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Affiliation(s)
- Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Jin Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xinqi Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Omran F, Kyrou I, Osman F, Lim VG, Randeva HS, Chatha K. Cardiovascular Biomarkers: Lessons of the Past and Prospects for the Future. Int J Mol Sci 2022; 23:ijms23105680. [PMID: 35628490 PMCID: PMC9143441 DOI: 10.3390/ijms23105680] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a major healthcare burden on the population worldwide. Early detection of this disease is important in prevention and treatment to minimise morbidity and mortality. Biomarkers are a critical tool to either diagnose, screen, or provide prognostic information for pathological conditions. This review discusses the historical cardiac biomarkers used to detect these conditions, discussing their application and their limitations. Identification of new biomarkers have since replaced these and are now in use in routine clinical practice, but still do not detect all disease. Future cardiac biomarkers are showing promise in early studies, but further studies are required to show their value in improving detection of CVD above the current biomarkers. Additionally, the analytical platforms that would allow them to be adopted in healthcare are yet to be established. There is also the need to identify whether these biomarkers can be used for diagnostic, prognostic, or screening purposes, which will impact their implementation in routine clinical practice.
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Affiliation(s)
- Farah Omran
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Sciences Research Laboratories, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Faizel Osman
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Ven Gee Lim
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Harpal Singh Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Sciences Research Laboratories, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK
| | - Kamaljit Chatha
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Biochemistry and Immunology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Correspondence:
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Christ-Crain M, Refardt J, Winzeler B. Approach to the Patient: "Utility of the Copeptin Assay". J Clin Endocrinol Metab 2022; 107:1727-1738. [PMID: 35137148 PMCID: PMC9113794 DOI: 10.1210/clinem/dgac070] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Indexed: 11/19/2022]
Abstract
Copeptin derives from the same precursor peptide preprovasopressin as arginine vasopressin (AVP). The secretion of both peptides is stimulated by similar physiological processes, such as osmotic stimulation, hypovolemia, or stress. AVP is difficult to measure due to complex preanalytical requirements and due to technical difficulties. In the last years, copeptin was found to be a stable, sensitive, and simple to measure surrogate marker of AVP release. Different immunoassays exist to measure copeptin. The 2 assays which have most often be used in clinical studies are the original sandwich immunoluminometric assay and its automated immunofluorescent successor. In addition, various enzyme-linked immunosorbent assay have been developed. With the availability of the copeptin assay, the differential diagnosis of diabetes insipidus was recently revisited. The goal for this article is therefore to first review the physiology of copeptin, and second to describe its use as marker for the differential diagnosis of vasopressin-dependent fluid disorders, mainly diabetes insipidus but also hyper- and hyponatremia. Furthermore, we highlight the role of copeptin as prognostic marker in other acute and chronic diseases.
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Affiliation(s)
- Mirjam Christ-Crain
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland
- Correspondence: Mirjam Christ-Crain, MD, PhD, Department of Endocrinology, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
| | - Julie Refardt
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland
| | - Bettina Winzeler
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland
- Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland
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Dumić J, Cvetko A, Abramović I, Šupraha Goreta S, Perović A, Njire Bratičević M, Kifer D, Sinčić N, Gornik O, Žarak M. Changes in Specific Biomarkers Indicate Cardiac Adaptive and Anti-inflammatory Response of Repeated Recreational SCUBA Diving. Front Cardiovasc Med 2022; 9:855682. [PMID: 35360010 PMCID: PMC8964121 DOI: 10.3389/fcvm.2022.855682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveRecreational SCUBA (rSCUBA) diving has become a highly popular and widespread sport. Yet, information on molecular events underlying (patho)physiological events that follow exposure to the specific environmental conditions (hyperbaric conditions, coldness, immersion, and elevated breathing pressure), in which rSCUBA diving is performed, remain largely unknown. Our previous study suggested that repeated rSCUBA diving triggers an adaptive response of cardiovascular and immune system. To elucidate further molecular events underlying cardiac and immune system adaptation and to exclude possible adverse effects we measured blood levels of specific cardiac and inflammation markers.MethodsThis longitudinal intervention study included fourteen recreational divers who performed five dives, one per week, on the depth 20–30 m that lasted 30 min, after the non-dive period of 5 months. Blood samples were taken immediately before and after the first, third, and fifth dives. Copeptin, immunoglobulins A, G and M, complement components C3 and C4, and differential blood count parameters, including neutrophil-to-lymphocyte ratio (NLR) were determined using standard laboratory methods. Cell-free DNA was measured by qPCR analysis and N-glycans released from IgG and total plasma proteins (TPP), were analyzed by hydrophilic interaction ultra-performance liquid chromatography.ResultsCopeptin level increased after the first dive but decreased after the third and fifth dive. Increases in immunoglobulins level after every dive and during whole studied period were observed, but no changes in C3, C4, and cfDNA level were detected. NLR increased only after the first dive. IgG and TPP N-glycosylation alterations toward anti-inflammatory status over whole studied period were manifested as an increase in monogalyctosylated and core-fucosylated IgG N-glycans and decrease in agalactosylated TPP N-glycans.ConclusionrSCUBA diving practiced on a regular basis promotes anti-inflammatory status thus contributing cardioprotection and conferring multiple health benefits.
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Affiliation(s)
- Jerka Dumić
- Department of Biochemistry and Molecular Biology, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Ana Cvetko
- Department of Biochemistry and Molecular Biology, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Irena Abramović
- Department of Medical Biology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Sandra Šupraha Goreta
- Department of Biochemistry and Molecular Biology, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Antonija Perović
- Department of Laboratory Diagnostics, Dubrovnik General Hospital, Dubrovnik, Croatia
| | | | - Domagoj Kifer
- Department of Biophysics, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Nino Sinčić
- Department of Medical Biology, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Olga Gornik
- Department of Biochemistry and Molecular Biology, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Marko Žarak
- Clinical Department of Laboratory Diagnostics, Dubrava University Hospital, Zagreb, Croatia
- *Correspondence: Marko Žarak,
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Nouri-Vaskeh M, Khalili N, Sadighi A, Yazdani Y, Zand R. Biomarkers for Transient Ischemic Attack: A Brief Perspective of Current Reports and Future Horizons. J Clin Med 2022; 11:jcm11041046. [PMID: 35207321 PMCID: PMC8877275 DOI: 10.3390/jcm11041046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 02/05/2023] Open
Abstract
Cerebrovascular disease is the leading cause of long-term disability in the world and the third-leading cause of death in the United States. The early diagnosis of transient ischemic attack (TIA) is of great importance for reducing the mortality and morbidity of cerebrovascular diseases. Patients with TIA have a high risk of early subsequent ischemic stroke and the development of permanent nervous system lesions. The diagnosis of TIA remains a clinical diagnosis that highly relies on the patient's medical history assessment. There is a growing list of biomarkers associated with different components of the ischemic cascade in the brain. In this review, we take a closer look at the biomarkers of TIA and their validity with a focus on the more clinically important ones using recent evidence of their reliability for practical usage.
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Affiliation(s)
- Masoud Nouri-Vaskeh
- Tropical and Communicable Diseases Research Centre, Iranshahr University of Medical Sciences, Iranshahr 7618815676, Iran;
- Network of Immunity in Infection, Malignancy and Autoimmunity, Universal Scientific Education and Research Network, Tehran 1419733151, Iran
| | - Neda Khalili
- School of Medicine, Tehran University of Medical Sciences, Tehran 1449614535, Iran;
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran 1419733151, Iran
| | - Alireza Sadighi
- Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA;
| | - Yalda Yazdani
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz 5165665931, Iran;
| | - Ramin Zand
- Neuroscience Institute, Geisinger Health System, Danville, PA 17822, USA;
- Neuroscience Institute, Pennsylvania State University, State College, PA 16801, USA
- Correspondence: or ; Tel.: +1-570-808-7330; Fax: +1-570-808-3209
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Gor Z, Bezen D, Turkmenoglu Y, Vurgun E, Irdem A, Dursun H. Serum copeptin as a biomarker of hypertension in children with obesity. Pediatr Int 2022; 64:e15355. [PMID: 36564342 DOI: 10.1111/ped.15355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/25/2022] [Accepted: 09/09/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hypertension (HT) in obesity has been reported frequently in children in recent years. The role of copeptin and uric acid here are not well known. We aimed to investigate the relationship between HT and serum copeptin and uric acid levels in children with obesity. METHODS We included 80 children with obesity who were admitted to our hospital between April 2018 and September 2018. The patients were separated into two groups: hypertensive and non-hypertensive. Serum copeptin levels were measured using the enzyme-linked immunosorbent assay. RESULTS Copeptin levels were significantly higher in patients with HT than in those without (p = 0.0001). In addition, serum uric acid levels in patients with HT were significantly higher, while the serum potassium levels were significantly lower (p = 0.01) than in those without HT (p = 0.001). In correlation analyses, a positive correlation was detected between blood sodium and copeptin levels (p = 0.037). CONCLUSIONS Hypertensive children with obesity had higher serum copeptin and uric acid and lower blood potassium levels. Moreover, copeptin levels were positively correlated with blood sodium levels. Thus, in addition to copeptin, serum uric acid, potassium, and sodium levels may be important in the diagnosis and follow-up of children with HT.
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Affiliation(s)
- Zeynep Gor
- Department of Pediatrics, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Digdem Bezen
- Department of Pediatric Endocrinology, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yelda Turkmenoglu
- Department of Pediatrics, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Eren Vurgun
- Department of Biochemistry, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Ahmet Irdem
- Department of Pediatric Cardiology, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Hasan Dursun
- Department of Pediatric Nephrology, Health Science University, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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Abstract
Vasopressin (AVP) and copeptin are released in equimolar amounts from the same precursor. Due to its molecular stability and countless advantages as compared with AVP, copeptin perfectly mirrors AVP presence and has progressively emerged as a reliable marker of vasopressinergic activation in response to osmotic and hemodynamic stimuli in clinical practice. Moreover, evidence highlighting the prognostic potential of copeptin in several acute diseases, where the activation of the AVP system is primarily linked to stress, as well as in psychologically stressful conditions, has progressively emerged. Furthermore, organic stressors induce a rise in copeptin levels which, although non-specific, is unrelated to plasma osmolality but proportional to their magnitude: suggesting disease severity, copeptin proved to be a reliable prognostic biomarker in acute conditions, such as sepsis, early post-surgical period, cardiovascular, cerebrovascular or pulmonary diseases, and even in critical settings. Evidence on this topic will be briefly discussed in this article.
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Ianoș RD, Pop C, Iancu M, Rahaian R, Cozma A, Procopciuc LM. Diagnostic Performance of Serum Biomarkers Fibroblast Growth Factor 21, Galectin-3 and Copeptin for Heart Failure with Preserved Ejection Fraction in a Sample of Patients with Type 2 Diabetes Mellitus. Diagnostics (Basel) 2021; 11:1577. [PMID: 34573919 PMCID: PMC8470703 DOI: 10.3390/diagnostics11091577] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 01/14/2023] Open
Abstract
More than half of the patients with heart failure have preserved ejection fraction (HFpEF), however evidence shows a mortality rate comparable to those with reduced ejection fraction. The aim of this study was to evaluate whether FGF21, galectin-3 and copeptin can be used as biomarkers to identify HFpEF in patients with confirmed type 2 diabetes mellitus (DM). Sixty-nine diabetic patients were enrolled and divided into two groups: patients with HFpEF (n = 40) and those without HFpEF (n = 29). The ability of the studied biomarkers to discriminate HFpEF cases from non-HFpEF subjects were evaluated by the area under the Receiver Operating Characteristics (ROC) curve and the 95% confidence interval (CI). Compared to patients without heart failure, those with HFpEF had significantly higher levels of FGF21 (mean 146.79 pg/mL vs. 298.98 pg/mL). The AUC value of FGF21 was 0.88, 95% CI: [0.80, 0.96], Se = 85% [70.2, 94.3], Sp = 79.3% [60.3, 92.0], at an optimal cut-off value of 217.40 pg/mL. There was no statistical significance associated with galectin-3 and copeptin between patient cohorts. In conclusion, galectin-3 and copeptin levels were not effective for detecting HFpEF, while FGF21 is a promising biomarker for diagnosing HFpEF in DM patients.
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Affiliation(s)
- Raluca D. Ianoș
- Department of Cardiology, Iuliu Hațieganu University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania;
| | - Călin Pop
- Department of Cardiology, Emergency County Hospital, 430031 Baia Mare, Romania
- Faculty of Medicine Arad, “Vasile Goldis” Western University, 310045 Arad, Romania
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania
| | - Rodica Rahaian
- Department of Immunology, Emergency County Hospital, 400006 Cluj-Napoca, Romania;
| | - Angela Cozma
- Department of Internal Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400015 Cluj-Napoca, Romania;
| | - Lucia M. Procopciuc
- Department of Medical Biochemistry, Iuliu Hațieganu University of Medicine and Pharmacy, 400349 Cluj-Napoca, Romania;
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A meta-analysis and trial sequential analysis of serum copeptin level in adult patients with Obstructive Sleep Apnoea Syndrome. Int Orthod 2021; 19:346-352. [PMID: 34305013 DOI: 10.1016/j.ortho.2021.06.005] [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: 06/13/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Copeptin can act as a stable biomarker in inflammation and stress response that obstructive sleep apnoea syndrome (OSAS), can induce oxidative stress and consequently promotes systemic inflammation. The purpose of the study is to appraise serum copeptin level in adult patients with OSAS compared to the controls. MATERIAL AND METHODS Electronic search was done in the databases of PubMed/Medline, Web of Science, Scopus, and Cochrane Library until June 2021, without any restrictions. For comparison of the serum copeptin level between groups, the mean difference (MD) and 95% confidence interval (CI) were calculated by the Review Manager 5.3 software. Trial sequential analysis (TSA) was used by applying TSA software. RESULTS Among the databases, five articles (involving 495 OSAS patients and 135 controls) were included. To report the serum copeptin level in OSAS patients compared to controls, the pooled OR became 12.21pg/mL (95%CI: 2.31 to 22.11; P=0.02) and also the pooled OR for comparison of serum copeptin level in severe versus moderate/mild OSAS patients was 5.96pg/mL (95%CI: 1.46 to 10.47; P=0.009). The results of TSA illustrated that the Z-curve has not crossed the monitoring boundary curves and did not reach the required information size. CONCLUSIONS The main findings recommended that copeptin had a significantly higher serum level in OSAS patients compared to controls, as well as a significantly higher level in severe patients compared to mild/moderate OSAS patients for the serum level of copeptin.
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Smaradottir MI, Andersen K, Gudnason V, Näsman P, Rydén L, Mellbin LG. Copeptin is associated with mortality in elderly people. Eur J Clin Invest 2021; 51:e13516. [PMID: 33569762 DOI: 10.1111/eci.13516] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 01/24/2021] [Accepted: 02/08/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Elevated copeptin, a marker for vasopressin release, has been associated with impaired prognosis in acute myocardial infarction (MI). The aim was to investigate whether this association extends beyond the acute phase and whether it is related to markers of stress (cortisol) and heart failure (NTproBNP). METHODS Copeptin, cortisol and NTproBNP were measured in 926 participants (age: 76.0; male: 48.5%) in the ICELAND MI study whereof 246 had a previous MI (91 recognizable (RMI) and 155 previously unrecognizable (UMI) detected by cardiac magnetic resonance imaging). The primary endpoint was cardiovascular events (CVEs), and secondary endpoints were total mortality, heart failure and MI (median follow-up was 9.1 years). The relation between copeptin and prognosis was assessed with the Cox proportional hazard regression (unadjusted, adjusted for cortisol and NTproBNP, respectively, and a multiple model: copeptin, cortisol, NTproBNP, age, sex, serum creatinine, heart failure). RESULTS Copeptin was higher in participants with MI (8.9 vs. 6.4 pmol/L; P < .01), with no difference between RMI vs. UMI. Increased copeptin correlated with evening cortisol (r = .11; P < .01) and NTproBNP (r = .07; P = .04). Copeptin was associated with CVE and total mortality after adjusting for cortisol and NTproBNP separately, and remained significantly associated with total mortality in the multiple model. CONCLUSIONS Copeptin was higher in subjects with previous MI regardless whether previously recognized or not. Copeptin correlated weakly with cortisol and NTproBNP, and was independently associated with total mortality. This indicates that the prognostic implications of copeptin are not only mediated by heart failure or stress, supporting the assumption that copeptin is a marker of general vulnerability.
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Affiliation(s)
| | - Karl Andersen
- Department of Health Sciences, Reykjavík, Iceland.,Icelandic Heart Association, Kópavogur, Iceland
| | - Vilmundur Gudnason
- Department of Health Sciences, Reykjavík, Iceland.,Icelandic Heart Association, Kópavogur, Iceland
| | - Per Näsman
- Center for Safety Research, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Lars Rydén
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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18
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Novel Biomarkers in Heart Failure: New Insight in Pathophysiology and Clinical Perspective. J Clin Med 2021; 10:jcm10132771. [PMID: 34202603 PMCID: PMC8268524 DOI: 10.3390/jcm10132771] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/18/2022] Open
Abstract
Heart failure (HF) is a complex clinical syndrome with a huge social burden in terms of cost, morbidity, and mortality. Brain natriuretic peptide (BNP) appears to be the gold standard in supporting the daily clinical management of patients with HF. Novel biomarkers may supplement BNP to improve the understanding of this complex disease process and, possibly, to personalize care for the different phenotypes, in order to ameliorate prognosis. In this review, we will examine some of the most promising novel biomarkers in HF. Inflammation plays a pivotal role in the genesis and progression of HF and, therefore, several candidate molecules have been investigated in recent years for diagnosis, prognosis, and therapy monitoring. Noncoding RNAs are attractive as biomarkers and their potential clinical applications may be feasible in the era of personalized medicine. Given the complex pathophysiology of HF, it is reasonable to expect that the future of biomarkers lies in the application of precision medicine, through wider testing panels and “omics” technologies, to further improve HF care delivery.
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Sedaghat G, Montazerifar F, Keykhaie MA, Karajibani M, Shourestani S, Dashipour A. Effect of pre-meal water intake on the serum levels of Copeptin, glycemic control, lipid profile and anthropometric indices in patients with type 2 diabetes mellitus: a randomized, controlled trial. J Diabetes Metab Disord 2021; 20:171-177. [PMID: 34178828 DOI: 10.1007/s40200-020-00724-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
Background Water pre-load affects insulin secretion by altering the level of copeptin (C-terminal component of the arginine vasopressin hormone (AVP)) and preventing obesity by reducing food intake. Aims The present randomized controlled trial (RCT) aimed to investigate the effects of pre-meal water intake on type 2 diabetes Mellitus (T2DM). Materials and methods In this study, 40 patients with T2DM were randomly assigned to two intervention groups for 8 weeks; a) drinking 1 liter of water per day before each main meal (PW group)., and b) no water consumption before any meal (NPW group). At the beginning and at the end of the study, blood samples were taken to assess glycemic indices, lipid profile, copeptin and anthropometric indices. Results Pre-meal water intake was associated with lower energy intake, BMI, waist circumference (WC) and greater weight loss, in compared with the controls (P < 0.0001) after 8 weeks. At the end of the trial, the concentrations of fasting blood sugar (FBS) (P < 0.0001), triglyceride (TG) (P < 0.05), low-density lipoprotein cholesterol (LDL-C) (P < 0.05) and copeptin (P < 0.05) were significantly reduced following water drinking before meals. Conclusion To sum up, the present study revealed that pre-meal water intake is associated with lower BMI, body weight, WC, FBS, TG, LDL-C and copeptin levels in patients with T2DM.
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Affiliation(s)
- Gohar Sedaghat
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farzaneh Montazerifar
- Pregnancy Health Research Center, Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mahmood Ali Keykhaie
- Genetics of Non-Communicable Disease Research Center, Department of Internal, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mansour Karajibani
- Health Promotion Research Center, Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Shadi Shourestani
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Dashipour
- Cellular and Molecular Research Center, Department of Food and Technology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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Fujimori S, Sunada K. Effects of vasopressin on anesthetic response time and circulatory dynamics of lidocaine. Odontology 2021; 109:632-638. [PMID: 33449245 PMCID: PMC8178135 DOI: 10.1007/s10266-020-00585-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/15/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to investigate the hypothesis that vasopressin extends the anesthetic response time of lidocaine and does not affect the circulatory dynamics. Rats were sedated with isoflurane; subsequently, breathing was maintained through mechanical ventilation. We infiltrated the first molar area of the upper left jaw with saline (NS, test solution), 2% lidocaine (L), 0.025 IU vasopressin-supplemented 2% lidocaine, 0.05 IU vasopressin-supplemented 2% lidocaine, 0.1 IU vasopressin-supplemented 2% lidocaine, and 0.2 IU vasopressin-supplemented 2% lidocaine (VL4). Further, anesthetic response times were measured up to 30 min using electric pulp testing methods (n = 4). The anesthetic response times of NS, L, and VL4 were measured up to 45 min with the aforementioned results as reference values (n = 7). The circulatory dynamics of NS, L, VL4, and 0.2 IU vasopressin (V) were measured up to 45 min using a non-invasive blood pressure measuring device. VL4 extended the anesthetic response times of lidocaine compared to L (p < 0.05). Further, V and VL4 significantly increased the systolic and diastolic blood pressure and significantly decreased the pulse rate (p < 0.05). VL4 is not a suitable addition to the local anesthetic solution used in dentistry. Further study is needed to determine vasopressin concentration that extends the anesthetic effect without affecting the circulatory dynamics.
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Affiliation(s)
- Shoko Fujimori
- Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan.
| | - Katsuhisa Sunada
- Department of Dental Anesthesiology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
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21
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Zampino R, Iossa D, Ursi MP, Bertolino L, Andini R, Molaro R, Fabrazzo O, Leonardi S, Atripaldi L, Durante-Mangoni E. Prognostic value of pro-adrenomedullin and copeptin in acute infective endocarditis. BMC Infect Dis 2021; 21:23. [PMID: 33413127 PMCID: PMC7791699 DOI: 10.1186/s12879-020-05655-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022] Open
Abstract
Background Infective endocarditis (IE) is a life-threatening disease whose prognosis is often difficult to predict based on clinical data. Biomarkers have been shown to favorably affect disease management in a number of cardiac disorders. Aims of this retrospective study were to assess the prognostic role of procalcitonin (PCT), pro-adrenomedullin (pro-ADM) and copeptin in IE and their relation with disease characteristics and the traditional biomarker C-reactive protein (CRP). Methods We studied 196 patients with definite IE. Clinical, laboratory and echocardiography parameters were analyzed, with a focus on co-morbidities. PCT, pro-ADM and copeptin were measured on stored plasma samples obtained on admission during the acute phase of the disease. Results Pro-ADM and copeptin were significantly higher in older patients and associated with prior chronic kidney disease. Pro-ADM was an independent predictor of hospital mortality (OR 3.29 [95%C.I. 1.04–11.5]; p = 0.042) whilst copeptin independently predicted 1-year mortality (OR 2.55 [95%C.I. 1.18–5.54]; p = 0.017). A high PCT value was strictly tied with S. aureus etiology (p = 0.001). CRP was the only biomarker associated with embolic events (p = 0.003). Conclusions Different biomarkers correlate with distinct IE outcomes. Pro-ADM and copeptin may signal a worse prognosis of IE on admission to the hospital and could be used to identify patients who need more aggressive treatment. CRP remains a low-cost marker of embolic risk. A high PCT value should suggest S. aureus etiology. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05655-7.
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Affiliation(s)
- Rosa Zampino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.,Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Naples, Italy
| | - Domenico Iossa
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Maria Paola Ursi
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lorenzo Bertolino
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Roberto Andini
- Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Naples, Italy
| | - Rosa Molaro
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Oriana Fabrazzo
- Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvia Leonardi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Naples, Italy
| | - Luigi Atripaldi
- Unit of Clinical Biochemistry, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Naples, Italy
| | - Emanuele Durante-Mangoni
- Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli - Ospedale Monaldi, Naples, Italy. .,Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Koseoglu M, Ozben S, Gozubatik-Celik G, Tutuncu M, Kucuksayan E, Hanikoğlu A, Atakli D, Ozben T. Plasma copeptin levels in patients with multiple sclerosis. J Clin Neurosci 2020; 78:143-146. [DOI: 10.1016/j.jocn.2020.04.095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 01/24/2023]
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Sloane C, Mash DC, Chan TC, Kolkhorst F, Neuman T, Castillo EM, Lasoff D, Wardi G, Xie X, Vilke GM. Assessment of stress markers in restrained individuals following physical stress with and without sham CED activation. J Forensic Leg Med 2020; 74:101982. [PMID: 32658765 DOI: 10.1016/j.jflm.2020.101982] [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: 07/12/2019] [Revised: 01/23/2020] [Accepted: 05/16/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Law enforcement and pre-hospital care personnel often confront individuals who must be physically restrained. Many are under the influence of illicit substances, and law enforcement officers may need to use a controlled electrical device (CED) to gain control of the individual and they are often placed into the prone maximum restraint (PMR) position. These techniques have previously been evaluated for their physiologic effects. The purpose of this study was to investigate the psychological effects of anticipating and experiencing a sham CED activation in healthy human subjects who were exercised and restrained compared with no sham activation by assessing the differences in a panel of several known biomarkers of stress. METHODS We performed a randomized, crossover controlled human subject trial to study the stress associated with exercise, physical exhaustion, and restraint with and without an added psychological stress simulating the field use of a CED. Twenty five total subjects; each subject performed two different trials each consisting of a brief period of intense exercise on a treadmill to exhaustion followed by placement in the PMR with and without induced psychological stress. Blood samples were collected for analysis pre and post exercise, as well as 10 min after completion of the exercise. A panel of hormones and stress markers were measured. RESULTS We found no significant differences in any of the stress biomarkers measured between the two study groups. A trend towards higher levels of copeptin was measured in the sham CED activation arm. CONCLUSION During a brief period of intense exercise followed by the psychological stress of anticipated CED application, there did not appear to be statistically significant changes in the stress panel of biomarkers measured, only a trend towards significance for higher copeptin levels in the patients exposed to the psychological stress.
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Affiliation(s)
- Christian Sloane
- Department of Emergency Medicine, University of California, San Diego, CA, USA.
| | - Deborah C Mash
- Department of Neurology, Molecular and Cellular Pharmacology, University of Miami, Miami, FL, USA
| | - Theodore C Chan
- Department of Emergency Medicine, University of California, San Diego, CA, USA
| | - Fred Kolkhorst
- School of Exercise and Nutritional Sciences, San Diego State University San Diego, CA, USA
| | - Tom Neuman
- Department of Emergency Medicine, University of California, San Diego, CA, USA
| | - Edward M Castillo
- Department of Emergency Medicine, University of California, San Diego, CA, USA
| | - Daniel Lasoff
- Department of Emergency Medicine, University of California, San Diego, CA, USA
| | - Gabriel Wardi
- Department of Emergency Medicine, University of California, San Diego, CA, USA; Division of Pulmonary, Critical Care, and Sleep Medicine, University of California, San Diego, San Diego, CA, USA
| | - Xiaobin Xie
- Department of Neurology, Molecular and Cellular Pharmacology, University of Miami, Miami, FL, USA
| | - Gary M Vilke
- Department of Emergency Medicine, University of California, San Diego, CA, USA
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Usul E, Ozkan S, Höke MH, Kaya AE, Ucar F, Cimen T. Relationship between right ventricular dilatation and blood copeptin levels in patients with acute pulmonary embolism. CLINICAL RESPIRATORY JOURNAL 2020; 14:965-972. [PMID: 32568449 DOI: 10.1111/crj.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/12/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE In this study, we aimed to investigate the importance of copeptin in the diagnosis of acute pulmonary embolism, detection of right ventricular dilatation and clinical severity and prognosis of pulmonary embolism. MATERIALS AND METHODS In the study three groups were created; Group 1: Pulmonary embolism patients with right ventricular dilatation in echocardiography, Group 2: Pulmonary embolism patients without right ventricular dilatation in echocardiography, Group 3: Healthy people. Five mL of venous blood was collected for the measurement of serum copeptin from the patients and control group. D-dimer and troponin were studied with routine blood samples. Complaints, symptom and physical examination findings, tomography and echocardiography results, laboratory results of patients and treatments they received were recorded for the statistical analysis. RESULTS Copeptin levels of acute pulmonary embolism patients were significantly higher than healthy individuals (P < 0.001). Copeptin values of Group 1 patients were significantly higher than Group 2 patients and Group 3 patients (P < 0.001). There was a statistically significant difference the levels of copeptin, D-dimer and troponin between patients with right ventricular dilatation and patients without right ventricular dilatation (P < 0.05). AUC value in detecting right ventricular dilatation of copeptin was found to be 0.82, while specificity was 83.3% and sensitivity was 69.6%. Copeptin, D-dimer and troponin levels of patients with increased pulmonary artery pressure were statistically significantly higher than patients with normal pulmonary artery pressure (P < 0.05). CONCLUSION Copeptin can be used in the diagnosis of acute pulmonary embolism and in the detection of right ventricular dilatation in pulmonary embolism.
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Affiliation(s)
- Eren Usul
- Department of Emergency Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Seda Ozkan
- Department of Emergency Medicine, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Hilmi Höke
- Department of Emergency Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Aynur Ecevit Kaya
- Department of Emergency Medicine, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Fatma Ucar
- Department of Biochemistry, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Tolga Cimen
- Department of Cardiology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Asgardoon MH, Vasheghani-Farahani A, Sherafati A. Usefulness of Biomarkers for Predicting Response to Cardiac Resynchronization Therapy. Curr Cardiol Rev 2019; 16:132-140. [PMID: 31822259 PMCID: PMC7460709 DOI: 10.2174/1573403x15666191206163846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/08/2019] [Accepted: 11/16/2019] [Indexed: 01/08/2023] Open
Abstract
Cardiac Resynchronization Therapy (CRT) is an effective treatment strategy for heart failure. It significantly improves clinical symptoms and decreases mortality and long-term morbidity. However, some patients do not respond properly to this treatment. In this review, the role of different biomarkers in predicting response to CRT is discussed. Some biomarkers, including natriuretic peptides and inflammatory markers have promising results but further trials are needed for more evaluation.
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Affiliation(s)
- Mohammad H Asgardoon
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Iranian Student Society for Immunodeficiencies, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Vasheghani-Farahani
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiac Electrophysiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alborz Sherafati
- Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Cardiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Kanbay M, Yilmaz S, Dincer N, Ortiz A, Sag AA, Covic A, Sánchez-Lozada LG, Lanaspa MA, Cherney DZI, Johnson RJ, Afsar B. Antidiuretic Hormone and Serum Osmolarity Physiology and Related Outcomes: What Is Old, What Is New, and What Is Unknown? J Clin Endocrinol Metab 2019; 104:5406-5420. [PMID: 31365096 DOI: 10.1210/jc.2019-01049] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/25/2019] [Indexed: 12/16/2022]
Abstract
CONTEXT Although the physiology of sodium, water, and arginine vasopressin (AVP), also known as antidiuretic hormone, has long been known, accumulating data suggest that this system operates as a more complex network than previously thought. EVIDENCE ACQUISITION English-language basic science and clinical studies of AVP and osmolarity on the development of kidney and cardiovascular disease and overall outcomes. EVIDENCE SYNTHESIS Apart from osmoreceptors and hypovolemia, AVP secretion is modified by novel factors such as tongue acid-sensing taste receptor cells and brain median preoptic nucleus neurons. Moreover, pharyngeal, esophageal, and/or gastric sensors and gut microbiota modulate AVP secretion. Evidence is accumulating that increased osmolarity, AVP, copeptin, and dehydration are all associated with worse outcomes in chronic disease states such as chronic kidney disease (CKD), diabetes, and heart failure. On the basis of these pathophysiological relationships, an AVP receptor 2 blocker is now licensed for CKD related to polycystic kidney disease. CONCLUSION From a therapeutic perspective, fluid intake may be associated with increased AVP secretion if it is driven by loss of urine concentration capacity or with suppressed AVP if it is driven by voluntary fluid intake. In the current review, we summarize the literature on the relationship between elevated osmolarity, AVP, copeptin, and dehydration with renal and cardiovascular outcomes and underlying classical and novel pathophysiologic pathways. We also review recent unexpected and contrasting findings regarding AVP physiology in an attempt to explain and understand some of these relationships.
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Affiliation(s)
- Mehmet Kanbay
- Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Sezen Yilmaz
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Neris Dincer
- Department of Medicine, Koc University School of Medicine, Istanbul, Turkey
| | - Alberto Ortiz
- Dialysis Unit, School of Medicine, IIS-Fundacion Jimenez Diaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Alan A Sag
- Division of Vascular and Interventional Radiology, Department of Radiology, Duke University Medical Center, Durham, North Carolina
| | - Adrian Covic
- Nephrology Department, Dialysis and Renal Transplant Center, "Dr. C. I. Parhon" University Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania
| | - Laura G Sánchez-Lozada
- Laboratory of Renal Physiopathology, Department of Nephrology, INC Ignacio Chávez, Mexico City, Mexico
| | - Miguel A Lanaspa
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora, Colorado
| | - David Z I Cherney
- Department of Medicine, Division of Nephrology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Richard J Johnson
- Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Baris Afsar
- Division of Nephrology, Department of Medicine, Suleyman Demirel University School of Medicine, Isparta, Turkey
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Darden D, Nishimura M, Sharim J, Maisel A. An update on the use and discovery of prognostic biomarkers in acute decompensated heart failure. Expert Rev Mol Diagn 2019; 19:1019-1029. [PMID: 31539485 DOI: 10.1080/14737159.2019.1671188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction: Acute decompensated heart failure (ADHF) remains a significant health care burden as evidenced by high readmission rates and mortality. Over the years, the care of patients with ADHF has been transformed by the use of biomarkers, specifically to aid in the diagnosis and prognosis. Patients with HF follow a variable course given the complex and heterogenous pathophysiological processes, thus it is imperative for clinicians to have tools to predict short and long-term outcomes in order to educate patients and optimize management. Areas Covered: The natriuretic peptides, including B-type natriuretic peptide and N-terminal pro-B-type natriuretic peptide, are considered the gold standard biomarkers. Yet, other emerging biomarkers such as suppression of tumerogenicity-2, cardiac troponin, galectin-2, mid-regional pro-adrenomedullin, copeptin, cystatin, and neutrophil gelatinase-associated lipocalin have increasingly shown promise in evaluating prognosis in patients with ADHF. This article reviews the pathophysiology and utility of both established and emerging biomarkers for the prognostication of patients with ADHF. Expert Opinion: As of 2019, the most validated biomarkers for use in decompensated heart failure include natriuretic peptides, high sensitivity troponin, and sST2. These biomarkers are involved in the underlying pathophysiology of disease and as such provide added information to that of exam, x-ray, and echocardiography.
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Affiliation(s)
- Douglas Darden
- Division of Cardiology, Department of Internal Medicine, University of California , San Diego , CA , USA
| | - Marin Nishimura
- Division of Cardiology, Department of Internal Medicine, University of California , San Diego , CA , USA
| | - Justin Sharim
- Department of Internal Medicine, University of California , San Diego , CA , USA
| | - Alan Maisel
- Division of Cardiology, Department of Internal Medicine, University of California , San Diego , CA , USA
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Abstract
Arginine Vasopressin (AVP) and copeptin derive from the same precursor molecule. Due to the equimolar secretion, copeptin responds as rapidly as AVP to osmotic, hemodynamic and unspecific stress-related stimuli and both peptides show a very strong correlation. The physiological functions of AVP are homeostasis of fluid balance, vascular tonus and regulation of the endocrine stress response. In contrast, the exact function of copeptin remains unknown. Since copeptin, in contrast to AVP, can easily be measured with a sandwich immunoassay, its main function so far that it indirectly indicates the amount of AVP in the circulation. Copeptin has emerged as a useful measure in different diseases. On one hand, through its characteristics as a marker of stress, it provides a unique measure of the individual stress burden. As such, it is a prognostic marker in different acute diseases such as ischemic stroke or myocardial infarction. On the other side, it has emerged as a promising marker in the diagnosis of AVP-dependent fluid disorders. Copeptin reliably differentiates various entities of the polyuria polydipsia syndrome; baseline levels >20 pmol/L without prior fluid deprivation identify patients with nephrogenic diabetes insipidus, whereas levels measured upon osmotic stimulation with hypertonic saline or upon non-osmotic stimulation with arginine differentiate primary polydipsia from central diabetes insipidus. In patients with hyponatremia, low levels of copeptin together with low urine osmolality identify patients with primary polydipsia, but copeptin levels overlap in all other causes of hyponatremia, limiting its diagnostic use in hyponatremia. Copeptin has also been put forward as predictive marker for autosomal dominant polycystic kidney disease and for diabetes mellitus, but more studies are needed to confirm these findings.
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Affiliation(s)
- Mirjam Christ-Crain
- Department of Endocrinology, University hospital Basel, University of Basel, Basel, Switzerland.
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Vilke GM, Mash DC, Pardo M, Bozeman W, Hall C, Sloane C, Wilson MP, Coyne CJ, Xie X, Castillo EM. EXCITATION study: Unexplained in-custody deaths: Evaluating biomarkers of stress and agitation. J Forensic Leg Med 2019; 66:100-106. [PMID: 31252195 DOI: 10.1016/j.jflm.2019.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 06/05/2019] [Accepted: 06/16/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Law enforcement personnel often confront violent and dangerous individuals suffering from Excited Delirium Syndrome (ExDS) who need emergent medical evaluation and treatment to optimize the best outcomes for this potentially lethal medical emergency. These subjects typically require physical restraint and use of force measures to control them. We sought to determine if stress-related biomarkers can differentiate ExDS subjects when compared with agitation and stress under other circumstances, including agitation and extreme physical exhaustion and restraint coupled with emotional stressors. METHODS This was a prospective multi-center study enrolling a convenience sample of patients who presented with agitation or ExDS. Patients were enrolled from three academic emergency departments (ED), two in the United States and one in Canada. Three study groups (SG) included: SG1) patients brought to the ED with ExDS based on the use of standardized clinical criteria; SG2) ED patients with acute agitation who were not in a clinical state of ExDS but required sedation; SG3) a laboratory control group of subjects exercised to physical exhaustion, restrained, and psychologically stressed with threat of Conducted Energy Device (CED) activation. We examined a panel of stress-related biomarkers, including norepinephrine (NE), cortisol, copeptin, orexin A, and dynorphin (Dyn) from the blood of enrolled subjects. RESULTS A total of 82 subjects were enrolled: 31 in the agitation group, 21 in the ExDS group, and 30 in the laboratory control group. Data were analyzed, comparing the findings between ExDS and the two other groups to determine if specific stress-related biomarkers are associated with ExDS. Biomarker comparisons between subjects identified with ExDS, agitation, and control groups demonstrated that cortisol levels were more elevated in the ExDS group compared with the other groups. Orexin was only significant in ExDs (with Agitated tendency but lot of variability in the group). NE and Dyn increased as response to stress in Agitated and ExDS. CONCLUSIONS Cortisol levels were more elevated in subjects in the ExDS group compared with the other comparison groups and orexin was elevated in ExDS compared to controls, a trend that did not reach statistical significance in the agitated group. The clinical or diagnostic significance of these difference have yet to be defined and warrants further study.
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Affiliation(s)
- Gary M Vilke
- University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, CA, USA.
| | - Deborah C Mash
- University of Miami Miller School of Medicine, Department of Neurology and Molecular and Cellular Pharmacology, Miami, FL, USA
| | - Marta Pardo
- University of Miami Miller School of Medicine, Department of Neurology and Molecular and Cellular Pharmacology, Miami, FL, USA
| | - William Bozeman
- Wake Forest University School of Medicine, Department of Emergency Medicine, Winston Salem, NC, USA
| | - Christine Hall
- University of British Columbia, Department of Emergency Medicine, Island Health, Victoria, Canada
| | - Christian Sloane
- University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, CA, USA
| | | | - Christopher J Coyne
- University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, CA, USA
| | - Xiaobin Xie
- University of Miami Miller School of Medicine, Department of Neurology and Molecular and Cellular Pharmacology, Miami, FL, USA
| | - Edward M Castillo
- University of California, San Diego Medical Center, Department of Emergency Medicine, San Diego, CA, USA
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Acanfora D, Fuschillo S, Provitera V, Motta A, Maniscalco M. Biomarkers in cardiac rehabilitation: can they be applied in clinical practice? Biomark Med 2019; 13:701-705. [PMID: 31157979 DOI: 10.2217/bmm-2019-0185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Domenico Acanfora
- Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Benevento, Italy
| | - Salvatore Fuschillo
- Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Benevento, Italy
| | - Vincenzo Provitera
- Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Benevento, Italy
| | - Andrea Motta
- Institute of Biomolecular Chemistry, National Research Council, 80078 Pozzuoli, Naples, Italy
| | - Mauro Maniscalco
- Pulmonary Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, Benevento, Italy
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Enhörning S, Brunkwall L, Tasevska I, Ericson U, Persson Tholin J, Persson M, Lemetais G, Vanhaecke T, Dolci A, Perrier ET, Melander O. Water Supplementation Reduces Copeptin and Plasma Glucose in Adults With High Copeptin: The H2O Metabolism Pilot Study. J Clin Endocrinol Metab 2019; 104:1917-1925. [PMID: 30566641 PMCID: PMC6541888 DOI: 10.1210/jc.2018-02195] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 12/13/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Because elevated copeptin, a marker of vasopressin, is linked to low water intake and high diabetes risk, we tested the effect of water supplementation on copeptin and fasting glucose. DESIGN, SETTING, AND PARTICIPANTS Thirty-one healthy adults with high copeptin (>10.7 pmol · L-1 in men and >6.1 pmol·L-1 in women) identified in a population-based survey from 2013 to 2015 and with a current 24-hour urine osmolality of >600 mOsm · kg-1 were included. INTERVENTION Addition of 1.5 L water daily on top of habitual fluid intake for 6 weeks. MAIN OUTCOME MEASURE Pre- and postintervention fasting plasma copeptin concentrations. RESULTS Reported mean water intake increased from 0.43 to 1.35 L · d-1 (P < 0.001), with no other observed changes in diet. Median (interquartile range) urine osmolality was reduced from 879 (705, 996) to 384 (319, 502) mOsm · kg-1 (P < 0.001); urine volume increased from 1.06 (0.90, 1.20) to 2.27 (1.52, 2.67) L · d-1 (P < 0.001); and baseline copeptin decreased from 12.9 (7.4, 21.9) pmol · L-1 to 7.8 (4.6;11.3) pmol · L-1 (P < 0.001). Water supplementation reduced fasting plasma glucose from a mean (SD) of 5.94 (0.44) to 5.74 (0.51) (P = 0.04). The water-associated reduction of both fasting copeptin and glucose concentration in plasma was most pronounced in participants in the top tertile of baseline copeptin. CONCLUSIONS Water supplementation in persons with habitually low water consumption and high copeptin levels is effective in lowering copeptin. It appears a safe and promising intervention with the potential of lowering fasting plasma glucose and thus reducing diabetes risk. Further investigations are warranted to support these findings.
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Affiliation(s)
- Sofia Enhörning
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
- Correspondence and Reprint Requests: Sofia Enhörning, MD, PhD, Clinical Sciences, Clinical Research Center, Jan Waldenströms gata 35, 91:12, Skåne University Hospital, 214 28 Malmö, Sweden. E-mail:
| | - Louise Brunkwall
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Irina Tasevska
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ulrika Ericson
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Jenny Persson Tholin
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | | | | | - Alberto Dolci
- Hydration and Health Department, Danone Research, Palaiseau, France
| | - Erica T Perrier
- Hydration and Health Department, Danone Research, Palaiseau, France
| | - Olle Melander
- Department of Clinical Science, Lund University, Skåne University Hospital, Malmö, Sweden
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
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Abstract
INTRODUCTION The term cardiorenal syndrome (CRS) describes the progressive pathology and interactions that develop upon heart and kidney failure. The definition of CRS is not firmly established and has evolved gradually during the last decade. The main clinical challenges associated with CRS are the lack of tools for early disease diagnosis and the inability to predict the development of cardiorenal pathophysiology. Currently several biomarkers have been proposed for improving CRS patient management. However, validation studies are needed to implement these initial findings to the clinical setting. Areas covered: In this review the database PubMed was used for a literature search on the definition and classification of CRS as well as biomarkers for CRS diagnosis and prognosis. Expert opinion: A universally acceptable classification system for CRS is not available. Thus, acquiring mechanistic insights relative to the pathophysiology of the disease is challenging. Reported biomarkers include well-established markers for heart/renal dysfunction and inflammation. Some proteins expressed in both organs have also been associated with CRS, yet their link to disease pathophysiology and organ cross-talk is missing. Establishing the link between deregulated molecular pathways and CRS phenotypes is required to define biological relevance of existing findings and ultimately biology-driven markers and targets.
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Affiliation(s)
- Eleni Petra
- a Biotechnology Division, Biomedical Research Foundation , Academy of Athens (BRFAA) , Athens , Greece
| | - Jerome Zoidakis
- a Biotechnology Division, Biomedical Research Foundation , Academy of Athens (BRFAA) , Athens , Greece
| | - Antonia Vlahou
- a Biotechnology Division, Biomedical Research Foundation , Academy of Athens (BRFAA) , Athens , Greece
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Yoshikawa Y, Shiomi H, Kuwahara K, Sowa N, Yaku H, Yamashita Y, Tazaki J, Imai M, Kato T, Saito N, Shizuta S, Ono K, Kimura T. Utility of copeptin for predicting long-term clinical outcomes in patients with heart failure. J Cardiol 2018; 73:379-385. [PMID: 30591319 DOI: 10.1016/j.jjcc.2018.11.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/04/2018] [Accepted: 11/22/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Copeptin, a surrogate marker of pro-arginine vasopressin, is expected to be a marker in cardiovascular diseases. Its utility for predicting long-term clinical outcomes in heart failure (HF), however, has not been adequately evaluated in daily clinical practice in Japan. METHODS To assess the relationship of serum copeptin at admission with long-term clinical outcomes, we evaluated serum copeptin at admission in consecutive 107 patients hospitalized for HF between April 2011 and July 2012. The primary outcome measure was defined as a composite of all-cause death and re-admission for HF (all-cause death/HF). RESULTS In this study population, median serum copeptin at admission was 15.5 (6.7-32.0)pmol/L. As compared with the low-copeptin group (<18pmol/L, N=60), the high-copeptin group (≥18pmol/L, N=47) included more male patients and those with prior myocardial infarction, prior HF, low left ventricular ejection fraction, and chronic kidney disease. During median 4.5 (1.0-5.5) years of clinical follow-up, the cumulative incidence of all-cause death/HF was significantly higher in the high-copeptin than in the low-copeptin group (63.4% versus 33.0% at 1 year, and 85.2% versus 77.2% at 5 years, log-rank p=0.03). After adjusting for confounders, high-copeptin was still an independent predictor for all-cause death/HF [hazard ratio (95% confidence interval): 1.77 (1.04-3.01), p=0.03]. CONCLUSION Copeptin was suggested as a useful marker for predicting long-term clinical outcomes in patients with HF.
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Affiliation(s)
- Yusuke Yoshikawa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroki Shiomi
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoya Sowa
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hidenori Yaku
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yugo Yamashita
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Junichi Tazaki
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masao Imai
- Division of Cardiology, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Japan
| | - Takao Kato
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Naritatsu Saito
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Shizuta
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koh Ono
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takeshi Kimura
- Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Lyngbakken MN, Myhre PL, Røsjø H, Omland T. Novel biomarkers of cardiovascular disease: Applications in clinical practice. Crit Rev Clin Lab Sci 2018; 56:33-60. [DOI: 10.1080/10408363.2018.1525335] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Magnus Nakrem Lyngbakken
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Peder Langeland Myhre
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Helge Røsjø
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
| | - Torbjørn Omland
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Center for Heart Failure Research, University of Oslo, Oslo, Norway
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Cvetinovic N, Sekularac N, Von Haehling S, Tahirovic E, Inkrot S, Lainscak M, Apostolovic S, Putnikovic B, Waagstein F, Gelbrich G, Aleksic A, Loncar G, Düngen HD. The β-blocker uptitration in elderly with heart failure regarding biomarker levels: CIBIS-ELD substudy. Biomark Med 2018; 12:1261-1270. [PMID: 30450925 DOI: 10.2217/bmm-2018-0136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
AIM We investigated if the baseline value of mid-regional pro-atrial natriuretic peptide (NP), N-terminal pro-B-type NP and copeptin may be helpful in optimizing β-blocker uptitration in elderly patients with heart failure. PATIENTS & METHODS According to the biomarkers' levels, 457 patients were divided into three subgroups and compared with each other at baseline and 3 months after. RESULTS All mid-regional pro-atrial NP and N-terminal pro-B-type NP subgroups had significant amelioration of left ventricle ejection fraction and New York Heart Association (NYHA) class after 3 months of β-blocker uptitration (p < 0.001). More prominent improvement of left ventricle ejection fraction and New York Heart Association class was observed in subgroups with lower versus higher NPs levels. CONCLUSION NPs levels, unlike copeptin levels, might be useful tool for objective selection of elderly heart failure patients who could have the greatest benefit of forced uptitration.
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Affiliation(s)
- Natasa Cvetinovic
- Department of Cardiology, University Clinical Center Zvezdara, Belgrade, Serbia
| | - Nikola Sekularac
- Department of Cardiology, University Clinical Center Zvezdara, Belgrade, Serbia
| | - Stephan Von Haehling
- Innovative Clinical Trials, Department of Cardiology & Pneumology, University of Medicine Göttingen, Germany
| | - Elvis Tahirovic
- Department of Cardiology, Charite -Campus Virchow-Klinikum, Berlin, Germany
| | - Simona Inkrot
- Department of Cardiology, Charite -Campus Virchow-Klinikum, Berlin, Germany
| | - Mitja Lainscak
- Departments of Cardiology & Research & Education, General Hospital Celje, Celje, Slovenia
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Biljana Putnikovic
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Department of Cardiology, University Hospital Zemun, Belgrade, Serbia
| | - Finn Waagstein
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Goetz Gelbrich
- Coordination Centre for Clinical Trials Leipzig (KKSL), University of Leipzig, Leipzig, Germany
| | - Andja Aleksic
- School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Loncar
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Cardiology Department, Cardiovascular Institute Dedinje, Belgrade, Serbia
| | - Hans-Dirk Düngen
- Department of Cardiology, Charite -Campus Virchow-Klinikum, Berlin, Germany
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Eckart A, Hausfater P, Amin D, Amin A, Haubitz S, Bernard M, Baumgartner A, Struja T, Kutz A, Christ-Crain M, Huber A, Mueller B, Schuetz P. Hyponatremia and activation of vasopressin secretion are both independently associated with 30-day mortality: results of a multicenter, observational study. J Intern Med 2018; 284:270-281. [PMID: 29664160 DOI: 10.1111/joim.12764] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Hyponatremia is a common feature of acute illness and associated with increased mortality. This may be explained by a stress-mediated activation of the vasopressin system with an increase in free-water reabsorption. OBJECTIVES To investigate whether the association between hyponatremia and mortality could be explained by activation of the vasopressin system. METHODS We prospectively enrolled adult, medical patients seeking emergency care in three centres in Switzerland, France and the United States. We investigated associations between admission plasma sodium and copeptin, a stable portion of the vasopressin-precursor peptide, with 30-day mortality. We performed uni- and multivariate regression analysis. RESULTS Of 6962 included patients, 18% had hyponatremia (sodium ≤135 mmol L-1 ), which doubled their risk for mortality compared to patients with normonatremia (8.3% vs. 3.8%). This association was confirmed in a multivariate-adjusted logistic regression analysis [adjusted odds ratio (OR) 1.47, 95% CI 1.12-1.93, P = 0.005]. Vasopressin levels, mirrored by copeptin, were also increased in nonsurvivors and strongly associated with mortality (adjusted OR 3.42, 95% CI 2.76-4.25, P < 0.001). The association between hyponatremia and mortality remained unchanged when adding copeptin levels to the regression model (fully adjusted OR 1.53, 95% CI 1.16-2.00, P = 0.002). CONCLUSION This prospective study including medical patients upon emergency room admission found hyponatremia as well as an activation of the vasopressin system to be independently associated with mortality. This suggests that stress- and vasopressin-independent mechanisms are responsible for the association of low sodium levels with mortality.
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Affiliation(s)
- A Eckart
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - P Hausfater
- Emergency Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.,Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHUC, ICAN, Paris, France
| | - D Amin
- Morton Plant Hospital, Clearwater, FL, USA
| | - A Amin
- Morton Plant Hospital, Clearwater, FL, USA
| | - S Haubitz
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - M Bernard
- Biochemistry Department, Hôpital Pitié-Salpêtrière and Univ-Paris Descartes, Paris, France
| | - A Baumgartner
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - T Struja
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - A Kutz
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - M Christ-Crain
- Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland
| | - A Huber
- Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - B Mueller
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - P Schuetz
- Division of General Internal and Emergency Medicine, University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
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Balling L, Goetze JP, Jung MH, Rossing K, Boesgaard S, Gustafsson F. Copeptin levels and invasive hemodynamics in patients with advanced heart failure. Biomark Med 2018; 12:861-870. [DOI: 10.2217/bmm-2017-0439] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Aim: Arginine vasopressin is a potent vasoconstrictory hormone and arginine vasopressin release is upregulated in heart failure (HF). The aim of this study was to evaluate if copeptin (the C-terminal part of provasopressin) is related to invasive hemodynamics in HF. Methods & results: Right heart catheterization was performed in patients with advanced HF referred for evaluation for heart transplantation. Sixty-five patients (mean age 54 ± 12 years, left ventricular ejection fraction 19 ± 8% and median copeptin levels of 16.7 pmol/l (interquartile range: 11–30 pmol/l) were included. In multivariate analysis, increased levels of log (copeptin) were associated with a reduced CI (r = 0.65 and p = 0.04). Conclusion: Increased copeptin levels in plasma are associated with hemodynamic parameters obtained at right heart catheterization in patients with HF, in particular-reduced cardiac index. Copeptin could be a useful biomarker for abnormal resting hemodynamics in HF.
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Affiliation(s)
- Louise Balling
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Jens Peter Goetze
- Department of Clinical Biochemistry, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Mette Holme Jung
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Kasper Rossing
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Soeren Boesgaard
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Finn Gustafsson
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
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38
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Crespo-Leiro MG, Metra M, Lund LH, Milicic D, Costanzo MR, Filippatos G, Gustafsson F, Tsui S, Barge-Caballero E, De Jonge N, Frigerio M, Hamdan R, Hasin T, Hülsmann M, Nalbantgil S, Potena L, Bauersachs J, Gkouziouta A, Ruhparwar A, Ristic AD, Straburzynska-Migaj E, McDonagh T, Seferovic P, Ruschitzka F. Advanced heart failure: a position statement of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2018; 20:1505-1535. [DOI: 10.1002/ejhf.1236] [Citation(s) in RCA: 373] [Impact Index Per Article: 62.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 05/17/2018] [Accepted: 05/21/2018] [Indexed: 12/28/2022] Open
Affiliation(s)
- Maria G. Crespo-Leiro
- Complexo Hospitalario Universitario A Coruña (CHUAC); Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, UDC; La Coruña Spain
| | - Marco Metra
- Cardiology; University of Brescia; Brescia Italy
| | - Lars H. Lund
- Department of Medicine, Unit of Cardiology; Karolinska Institute; Stockholm Sweden
| | - Davor Milicic
- Department for Cardiovascular Diseases; University Hospital Center Zagreb, University of Zagreb; Zagreb Croatia
| | | | | | - Finn Gustafsson
- Department of Cardiology; Rigshospitalet; Copenhagen Denmark
| | - Steven Tsui
- Transplant Unit; Royal Papworth Hospital; Cambridge UK
| | - Eduardo Barge-Caballero
- Complexo Hospitalario Universitario A Coruña (CHUAC); Instituto de Investigación Biomédica de A Coruña (INIBIC), CIBERCV, UDC; La Coruña Spain
| | - Nicolaas De Jonge
- Department of Cardiology; University Medical Center Utrecht; Utrecht The Netherlands
| | - Maria Frigerio
- Transplant Center and De Gasperis Cardio Center; Niguarda Hospital; Milan Italy
| | - Righab Hamdan
- Department of Cardiology; Beirut Cardiac Institute; Beirut Lebanon
| | - Tal Hasin
- Jesselson Integrated Heart Center; Shaare Zedek Medical Center; Jerusalem Israel
| | - Martin Hülsmann
- Department of Internal Medicine II; Medical University of Vienna; Vienna Austria
| | | | - Luciano Potena
- Heart and Lung Transplant Program; Bologna University Hospital; Bologna Italy
| | - Johann Bauersachs
- Department of Cardiology and Angiology; Medical School Hannover; Hannover Germany
| | - Aggeliki Gkouziouta
- Heart Failure and Transplant Unit; Onassis Cardiac Surgery Centre; Athens Greece
| | - Arjang Ruhparwar
- Department of Cardiac Surgery; University of Heidelberg; Heidelberg Germany
| | - Arsen D. Ristic
- Department of Cardiology of the Clinical Center of Serbia; Belgrade University School of Medicine; Belgrade Serbia
| | | | | | - Petar Seferovic
- Department of Internal Medicine; Belgrade University School of Medicine and Heart Failure Center, Belgrade University Medical Center; Belgrade Serbia
| | - Frank Ruschitzka
- University Heart Center; University Hospital Zurich; Zurich Switzerland
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Parizadeh SM, Ghandehari M, Parizadeh MR, Ferns GA, Ghayour‐Mobarhan M, Avan A, Hassanian SM. The diagnostic and prognostic value of copeptin in cardiovascular disease, current status, and prospective. J Cell Biochem 2018; 119:7913-7923. [DOI: 10.1002/jcb.27093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/26/2018] [Indexed: 11/10/2022]
Affiliation(s)
| | - Maryam Ghandehari
- Student Research Committee, Faculty of Medicine Islamic Azad University, Mashhad Branch Mashhad Iran
| | - Mohammad Reza Parizadeh
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Medical Biochemistry, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
| | - Gordon A. Ferns
- Division of Medical Education Brighton & Sussex Medical School Brighton UK
| | - Majid Ghayour‐Mobarhan
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Modern Sciences and Technologies Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran
| | - Amir Avan
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Modern Sciences and Technologies Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran
| | - Seyed Mahdi Hassanian
- Metabolic Syndrome Research Center Mashhad University of Medical Sciences Mashhad Iran
- Department of Medical Biochemistry, Faculty of Medicine Mashhad University of Medical Sciences Mashhad Iran
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40
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Topaloglu Tuac S, Ozben S, Koseoglu Bitnel M, Koksal A, Kucuksayan E, Hanikoğlu A, Ozben T. Plasma copeptin levels in patients with restless legs syndrome. Acta Neurol Scand 2018; 137:316-320. [PMID: 29148047 DOI: 10.1111/ane.12866] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Copeptin, the C-terminal fragment of antidiuretic hormone, is a new biomarker that has been found to be elevated in several disorders and could be related with prognosis. This study aimed to compare plasma copeptin levels in patients with restless legs syndrome (RLS) with healthy individuals and to investigate whether plasma copeptin levels were associated with the severity of disease. MATERIAL AND METHODS 41 patients with primary RLS, who were followed in Bakirkoy Psychiatry and Neurology Research and Training Hospital and 41 age- and sex-matched healthy individuals were included into the study. RLS patients were divided into subgroups as mild-moderate, severe, and very severe according to the severity of symptoms. Sleep quality and excessive daytime sleepiness were determined according to Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale, respectively, and sleep quality scores were analyzed statistically among the groups divided according to disease severity. Copeptin levels in all the patients were compared to the controls. RLS subgroups were compared with each other to evaluate association between copeptin levels and disease severity. RESULTS Plasma copeptin levels in RLS patients were significantly higher than controls (P < .001). However, there was no association between copeptin levels and disease severity. Excessive daytime sleepiness was found as 14.63% and low sleep quality as 68.29% in patients. CONCLUSIONS Hypothalamic-pituitary-adrenal axis activation and sympathetic hyperactivity in RLS might be responsible for increased Antidiuretic hormone (ADH) and copeptin release. We think that copeptin might have a potential role in the pathogenesis of RLS and be a biomarker for this disease.
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Affiliation(s)
- S. Topaloglu Tuac
- Department of Neurology; Bakirkoy Psychiatry and Neurology Research and Training Hospital; Istanbul Turkey
| | - S. Ozben
- Department of Neurology; Antalya Training and Research Hospital; Antalya Turkey
| | - M. Koseoglu Bitnel
- Department of Neurology; Bakirkoy Psychiatry and Neurology Research and Training Hospital; Istanbul Turkey
| | - A. Koksal
- Department of Neurology; Bakirkoy Psychiatry and Neurology Research and Training Hospital; Istanbul Turkey
| | - E. Kucuksayan
- Department of Biochemistry; Medical Faculty; Akdeniz University; Antalya Turkey
| | - A. Hanikoğlu
- Department of Biochemistry; Medical Faculty; Akdeniz University; Antalya Turkey
| | - T. Ozben
- Department of Biochemistry; Medical Faculty; Akdeniz University; Antalya Turkey
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42
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Enhörning S, Tasevska I, Roussel R, Bouby N, Persson M, Burri P, Bankir L, Melander O. Effects of hydration on plasma copeptin, glycemia and gluco-regulatory hormones: a water intervention in humans. Eur J Nutr 2017; 58:315-324. [PMID: 29242971 PMCID: PMC6424930 DOI: 10.1007/s00394-017-1595-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/08/2017] [Indexed: 12/25/2022]
Abstract
Purpose High plasma copeptin, a marker of vasopressin, predicts diabetes mellitus. We tested if copeptin could be suppressed by increased water intake in healthy individuals, and if a water-induced change in copeptin was accompanied by altered concentrations of glucose, insulin or glucagon. Methods Thirty-nine healthy individuals underwent, in random order, 1 week of high water intake (3 L/day on top of habitual intake) and 1 week of normal (habitual) fluid intake (control). Fasting plasma concentrations of copeptin, glucose, insulin and glucagon were compared between the ends of both periods. Furthermore, acute copeptin kinetics were mapped for 4 h after ingestion of 1 L of water. Results After acute intake of 1 L water, copeptin was significantly reduced within 30 min, and reached maximum reduction within 90 min with on average 39% reduction (95% confidence interval (95 CI) 34–45) (p < 0.001) and remained low the entire test period (4 h). One week of increased water intake led to a 15% reduction (95 CI 5–25) (p = 0.003) of copeptin compared to control week. The greatest reduction occurred among subjects with habitually high copeptin and concentrated urine (“water-responders”). Water-responders had significant water-induced reduction of glucagon, but glucose and insulin were unaffected. Conclusions Both acute and 1 week extra water intake potently reduced copeptin concentration. In those with the greatest decline (water-responders), who are typically low drinkers with high baseline copeptin, water induced a reduction in fasting glucagon. Long-term trials assessing the effect of water on glucometabolic traits should focus on low-water drinkers with high copeptin concentration. Electronic supplementary material The online version of this article (10.1007/s00394-017-1595-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sofia Enhörning
- Department of Endocrinology, Skåne University Hospital, Lund University, Malmö, Sweden. .,Department of Clinical Sciences, Lund University, Malmö, Sweden. .,Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Jan Waldenströms gata 35, 91:12, 205 02, Malmö, Sweden.
| | - Irina Tasevska
- Department of Anesthesiology, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ronan Roussel
- INSERM, Unit 1138, Centre de Recherche des Cordeliers, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris, France.,Assistance Publique Hôpitaux de Paris, Hôpital Bichat, DHU FIRE, Paris, France
| | - Nadine Bouby
- INSERM, Unit 1138, Centre de Recherche des Cordeliers, Paris, France.,University Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France
| | - Margaretha Persson
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Philippe Burri
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Lise Bankir
- INSERM, Unit 1138, Centre de Recherche des Cordeliers, Paris, France.,University Pierre et Marie Curie, Centre de Recherche des Cordeliers, Paris, France
| | - Olle Melander
- Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden
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Prognostic and diagnostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from the ACE 2 study. Respir Res 2017; 18:184. [PMID: 29100503 PMCID: PMC5670515 DOI: 10.1186/s12931-017-0665-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 10/11/2017] [Indexed: 11/13/2022] Open
Abstract
Background Copeptin is a novel biomarker that predicts mortality in lower respiratory tract infections and heart failure (HF), but the diagnostic value of copeptin in acute dyspnea and the prognostic significance of copeptin in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is not clear. Method We determined copeptin and NT-proBNP concentrations at hospital admission in 314 patients with acute dyspnea who were categorized by diagnosis. Survival was registered after a median follow-up of 816 days, and the prognostic and diagnostic properties of copeptin and NT-proBNP were analyzed in acute HF (n = 143) and AECOPD (n = 84) separately. Results The median concentration of copeptin at admission was lower in AECOPD compared to acute HF (8.8 [5.2–19.7] vs. 22.2 [10.2–47.9]) pmol/L, p < 0.001), but NT-proBNP discriminated acute HF from non-HF related dyspnea more accurately than copeptin (ROC-AUC 0.85 [0.81–0.89] vs. 0.71 [0.66–0.77], p < 0.0001). Adjusted for basic risk factors, increased copeptin concentrations predicted mortality in AECOPD (HR per log (ln) unit 1.72 [95% CI 1.21–2.45], p = 0.003) and acute HF (1.61 [1.25–2.09], p < 0.001), whereas NT-proBNP concentrations predicted mortality only in acute HF (1.62 [1.27–2.06], p < 0.001). On top of a basic model copeptin reclassified a significant proportion of patients into a more accurate risk strata in AECOPD (NRI 0.60 [0.19–1.02], p = 0.004) and acute HF (0.39 [0.06–0.71], p = 0.020). Conclusion Copeptin is a strong prognostic marker in both AECOPD and acute HF, while NT-proBNP concentrations predict mortality only in patients with acute HF. NT-proBNP levels are superior to copeptin levels to diagnose acute HF in patients with acute dyspnea. Electronic supplementary material The online version of this article (10.1186/s12931-017-0665-z) contains supplementary material, which is available to authorized users.
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44
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Berezin AE. Cardiac biomarkers in diabetes mellitus: New dawn for risk stratification? Diabetes Metab Syndr 2017; 11 Suppl 1:S201-S208. [PMID: 28011232 DOI: 10.1016/j.dsx.2016.12.032] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 12/12/2016] [Indexed: 12/21/2022]
Abstract
Type 2 diabetes mellitus (T2DM) remains a leading cause of cardiovascular (CV) events and diseases worldwide. The aim of the review is to summarize our knowledge regarding clinical implementation of the biomarker-based strategy of the CV risk assessment in T2DM patient population. There is large body of evidence regarding use of the cardiac biomarkers to risk stratification at higher CV risk individuals who belongs to general population and cohort with established CV disease. Although T2DM patients have higher incidence of macrovascular and microvascular CV complications than the general population, whether cardiac biomarkers would be effective to risk stratification of the T2DM is not fully understood. The role of natriuretic peptides, galectin-3, interleukins, growth differentiation factor-15, as well as biomarkers of endothelial dysfunction are widely discussed. In conclusion, future directions, which associate with discovering of novel biomarkers and their best combinations to provide additional predictive information beyond other traditional CV risk factors, are discussed.
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Affiliation(s)
- Alexander E Berezin
- Private Hospital "Vita-Center", Zaporozhye, Ukraine; Internal Medicine Department, Medical University of Zaporozhye, Ukraine.
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45
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Stacey MJ, Delves SK, Britland SE, Allsopp AJ, Brett SJ, Fallowfield JL, Woods DR. Copeptin reflects physiological strain during thermal stress. Eur J Appl Physiol 2017; 118:75-84. [PMID: 29075863 PMCID: PMC5754412 DOI: 10.1007/s00421-017-3740-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 10/08/2017] [Indexed: 11/22/2022]
Abstract
Purpose To prevent heat-related illnesses, guidelines recommend limiting core body temperature (Tc) ≤ 38 °C during thermal stress. Copeptin, a surrogate for arginine vasopressin secretion, could provide useful information about fluid balance, thermal strain and health risks. It was hypothesised that plasma copeptin would rise with dehydration from occupational heat stress, concurrent with sympathoadrenal activation and reduced glomerular filtration, and that these changes would reflect Tc responses. Methods Volunteers (n = 15) were recruited from a British Army unit deployed to East Africa. During a simulated combat assault (3.5 h, final ambient temperature 27 °C), Tc was recorded by radiotelemetry to differentiate volunteers with maximum Tc > 38 °C versus ≤ 38 °C. Blood was sampled beforehand and afterwards, for measurement of copeptin, cortisol, free normetanephrine, osmolality and creatinine. Results There was a significant (P < 0.05) rise in copeptin from pre- to post-assault (10.0 ± 6.3 vs. 16.7 ± 9.6 pmol L−1, P < 0.001). Although osmolality did not increase, copeptin correlated strongly with osmolality after the exposure (r = 0.70, P = 0.004). In volunteers with maximum Tc > 38 °C (n = 8) vs ≤ 38 °C (n = 7) there were significantly greater elevations in copeptin (10.4 vs. 2.4 pmol L−1) and creatinine (10 vs. 2 μmol L−1), but no differences in cortisol, free normetanephrine or osmolality. Conclusions Changes in copeptin reflected Tc response more closely than sympathoadrenal markers or osmolality. Dynamic relationships with tonicity and kidney function may help to explain this finding. As a surrogate for integrated physiological strain during work in a field environment, copeptin assay could inform future measures to prevent heat-related illnesses.
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Affiliation(s)
- Michael John Stacey
- Department of Surgery and Cancer, Imperial College London, Care of General Intensive Care Unit, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK. .,Department of Military Medicine, Royal Centre for Defence Medicine, ICT Building, Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham, B15 2SQ, UK.
| | - Simon K Delves
- Institute of Naval Medicine, Alverstoke, Hampshire, PO12 2DL, UK
| | | | - Adrian J Allsopp
- Institute of Naval Medicine, Alverstoke, Hampshire, PO12 2DL, UK
| | - Stephen J Brett
- Department of Surgery and Cancer, Imperial College London, Care of General Intensive Care Unit, Hammersmith Hospital Campus, Du Cane Road, London, W12 0HS, UK
| | | | - David R Woods
- Department of Military Medicine, Royal Centre for Defence Medicine, ICT Building, Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham, B15 2SQ, UK.,Carnegie Research Institute, Leeds Beckett University, Leeds, LS6 3QS, UK
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46
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Copeptin in heart failure: Review and meta-analysis. Clin Chim Acta 2017; 475:36-43. [PMID: 28982590 DOI: 10.1016/j.cca.2017.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/28/2017] [Accepted: 10/01/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND The aim of this study was to explore the prognostic value of copeptin for predicting all-cause mortality in heart failure (HF). METHODS PubMed, Embase and Cochrane databases were systematically searched to identify if a 2×2 contingency table could be constructed based on both the copeptin level and the all-cause mortality in patients diagnosed with HF. The characteristics of test performance were summarized using forest plots and summary receiver operating characteristic curves (SROC). Q-test and I2 index were used to evaluate heterogeneity. RESULTS Ten prospective cohort studies comprising 4473 patients were eligible in this meta-analysis. An elevated copeptin level was associated with an increased risk of all-cause mortality in HF patients (Relative risk (RR) was 2.64 (95% CI, 2.09-3.32)). The pooled sensitivity (SEN) and specificity (SPE) of copeptin were 0.57 (95% CI, 0.50-0.63) and 0.74 (95% CI, 0.69-0.79), respectively. The positive likelihood ratio was 2.2 (95% CI, 1.90-2.60) and the negative likelihood ratio was 0.58 (95% CI, 0.52-0.66). Furthermore, the summary Diagnostic Odds Ratio (DOR) was 4.00 (95% CI, 3.00-5.00) and the AUC was 0.70 (95% CI, 0.66-0.74) similar to the AUC of NT-proBNP 0.71 (95% CI, 0.67-0.75). CONCLUSIONS Elevated levels of copeptin are associated with all-cause mortality in HF patients. The predictive value of copeptin is comparable with NT-proBNP for all-cause mortality in HF patients. Further studies are warranted to explore the prognostic value of copeptin in conjunction with other biomarkers and to determine an optimal cut-off level.
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Advances in heart failure: a review of biomarkers, emerging pharmacological therapies, durable mechanical support and telemonitoring. Clin Sci (Lond) 2017; 131:553-566. [PMID: 28302916 DOI: 10.1042/cs20160196] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 12/14/2016] [Accepted: 01/05/2017] [Indexed: 01/14/2023]
Abstract
The purpose of this review is to provide an overview of diagnosis, prognosis and management of heart failure (HF) with reduced ejection fraction (HFrEF). Specifically, this review is divided into three sections. The first section will address biomarkers. The discovery of biomarkers has allowed further understanding of the pathophysiology of HF and provides insight into potential therapeutic targets. This review will focus on novel applications of natriuretic peptides (NPs) in clinical trials. Next, emerging biomarkers of HF, such as ST2, galectin-3 and copeptin, will be discussed. The second section aims to highlight HF therapies, including novel drugs and durable devices. The last section will review home haemodynamic monitoring and mobile health. We aim to provide context for the understanding of novel diagnostic and therapeutic advances in HF that are still in phase II or III trials, and have yet to become widely available.
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Johar D, Bernstein L. A targeted approach toward more accurate assessment of hypertension. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2017. [DOI: 10.1016/j.ejcdt.2017.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Jia J, Chang GL, Qin S, Chen J, He WY, Lu K, Li Y, Zhang DY. Comparative evaluation of copeptin and NT-proBNP in patients with severe acute decompensated heart failure, and prediction of adverse events in a 90-day follow-up period: A prospective clinical observation trial. Exp Ther Med 2017; 13:1554-1560. [PMID: 28413508 DOI: 10.3892/etm.2017.4111] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 10/21/2016] [Indexed: 11/05/2022] Open
Abstract
The present study compared the prognostic value of a marker, the C-terminal section of the arginine vasopressin prohormone (copeptin), with N-terminal B-type natriuretic peptide (NT-proBNP) in patients with severe acute decompensated heart failure. A prospective, observational cohort study was conducted in a tertiary care hospital and enrolled 129 patients with severe acute decompensated heart failure. Clinicians were blinded to investigational markers except NT-proBNP, and the study participants were followed up for 90 days. The end-point was a composite of cardiovascular death or re-hospitalization due to decompensated heart failure. Of the 129 patients enrolled, 47 reached the end-point and 82 were in a stable condition during follow-up. Receiver operating characteristic curve analysis revealed that the areas under curve for the prediction of adverse events within 90 days were similar for copeptin [0.602±0.052; 95% confidence interval (CI), 0.499-0.705], NT-proBNP (0.659±0.048; 95% CI, 0.565-0.753) and their combination (0.670±0.050; 95% CI, 0.573-0.767). Kaplan-Meier survival analysis showed that the predictive value of NT-proBNP regarding the probability of survival was superior compared with that of copeptin (log-rank test for trend, P=0.001 vs. 0.040). Furthermore, multivariate Cox proportional-hazards regression analysis revealed that increased NT-proBNP and copeptin plasma concentrations were significant independent predictors of adverse events. The present study provided evidence that copeptin has similar predictive properties compared with NT-proBNP regarding adverse events within 90-days in patients with severe acute decompensated heart failure, but that copeptin may not provide superior 90-day prediction compared to NT-proBNP.
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Affiliation(s)
- Jun Jia
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Guang-Lei Chang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Shu Qin
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Jia Chen
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Wen-Yan He
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Kai Lu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
| | - Yong Li
- Department of Basic Sciences, Center for Perinatal Biology, Division of Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Dong-Ying Zhang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Yuanjiagang, Yuzhong, Chongqing 400016, P.R. China
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Krane V, Genser B, Kleber ME, Drechsler C, März W, Delgado G, Allolio B, Wanner C, Fenske W. Copeptin Associates with Cause-Specific Mortality in Patients with Impaired Renal Function: Results from the LURIC and the 4D Study. Clin Chem 2017; 63:997-1007. [PMID: 28280053 DOI: 10.1373/clinchem.2016.266254] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 01/11/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND In chronic kidney disease (CKD) arginine vasopressin (AVP) cannot efficiently act via renal V2-receptors. AVP is upregulated leading to augmented activation of V1a- and V1b-receptors, which might contribute to the increase in cardiovascular and infectious complications in CKD. Here, we evaluate copeptin, a surrogate of AVP, and its association with cause specific mortality among patients within the whole spectrum of renal function. METHODS Copeptin was measured in baseline samples from the LURIC (n = 3131 patients with coronary angiograms) and the 4D-Study (n = 1241 type 2 diabetic hemodialysis patients). Patients were stratified into 4 groups: estimated glomerular filtration rate (eGFR) ≥90 mL/min/1.73 m2, 60-89 mL/min/1.73 m2, <60 mL/min/1.73 m2, and hemodialysis. The association of copeptin with mortality was assessed by Cox proportional hazards regression during 9.9 years of median follow-up in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study and 4 years of median follow-up in the German Diabetes Dialysis Study (4D-Study). RESULTS Median copeptin increased with decreasing eGFR: 5.6 [interquartile range (IQR), 3.1-8.1] pmol/L (eGFR ≥90 mL/min/1.73 m2), 6.7 (2.9-10.5) pmol/L (eGFR 60-89 mL/min/1.73 m2), 15.3 (6.7-23.9) pmol/L (eGFR <60 mL/min/1.73 m2), and 80.8 (51.2-122) pmol/L (hemodialysis), respectively. Per SD increase in copeptin, the risk of coronary, infectious, and all-cause mortality increased by 25, 30, and 15% [hazard ratios (HR), 1.25; 95% CI, 1.13-1.39; HR, 1.30; 95% CI, 0.98-1.71; and HR, 1.15; 95% CI, 1.05-1.25], respectively, in patients with eGFR 60-89 mL/min/1.73 m2. Except for coronary death, results were similar among patients with more advanced renal disease. No significant association was found in patients with normal renal function. CONCLUSIONS Copeptin concentrations were independently associated with coronary, infectious, and all-cause mortality in patients with renal impairment. In patients with normal renal function no significant association was found.
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Affiliation(s)
- Vera Krane
- Department of Medicine 1, Division of Nephrology, and .,Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany
| | - Bernd Genser
- Instituto de Saúde Coletiva, Federal University of Bahia, Salvador, Brazil.,BGStats Consulting, Vienna, Austria
| | - Marcus E Kleber
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Christiane Drechsler
- Department of Medicine 1, Division of Nephrology, and.,Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Synlab Academy, Synlab Services GmbH, Mannheim, Germany
| | - Graciela Delgado
- Medical Clinic V (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Bruno Allolio
- Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany.,Department of Internal Medicine 1, Division of Endocrinology, University of Würzburg, Würzburg, Germany
| | - Christoph Wanner
- Department of Medicine 1, Division of Nephrology, and.,Comprehensive Heart Failure Centre, University Hospital of Würzburg, Würzburg, Germany
| | - Wiebke Fenske
- Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany
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