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McCord J. Identification and definition of type 2 myocardial infarction: Where do we go from here? Int J Cardiol 2024; 405:131941. [PMID: 38460733 DOI: 10.1016/j.ijcard.2024.131941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Affiliation(s)
- James McCord
- Henry Ford Heart and Vascular Institute, 2799 West Grand Blvd, Detroit 48202, USA.
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2
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Davidson LT, Engvall J, Chisalita SI, Östgren CJ, Nyström FH. Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study. Cardiovasc Diabetol 2024; 23:200. [PMID: 38867292 PMCID: PMC11170787 DOI: 10.1186/s12933-024-02291-2] [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: 10/26/2023] [Accepted: 05/29/2024] [Indexed: 06/14/2024] Open
Abstract
OBJECTIVES There is currently limited understanding of the relationship between copeptin, the midregional portion of proadrenomedullin (MRproADM) and the midregional fragment of the N-terminal of proatrial natriuretic peptide (MRproANP), and arterial disorders. Toe brachial index (TBI) and aortic pulse wave velocity (aPWV) are established parameters for detecting arterial disorders. This study evaluated whether copeptin, MRproADM, and MRproANP were associated with TBI and aPWV in patients with type 2 diabetes with no history of cardiovascular disease (CVD). METHODS In the CARDIPP study, a cross-sectional analysis of 519 patients with type 2 diabetes aged 55-65 years with no history of CVD at baseline, had complete data on copeptin, MRproADM, MRproANP, TBI, and aPWV was performed. Linear regression analysis was used to investigate the associations between conventional CVD risk factors, copeptin, MRproADM, MRproANP, TBI, and aPWV. RESULTS Copeptin was associated with TBI (β-0.0020, CI-0.0035- (-0.0005), p = 0.010) and aPWV (β 0.023, CI 0.002-0.044, p = 0.035). These associations were independent of age, sex, diabetes duration, mean 24-hour ambulatory systolic blood pressure, glycated hemoglobin A1c, total cholesterol, estimated glomerular filtration rate, body mass index, and active smoking. CONCLUSIONS Plasma copeptin may be a helpful surrogate for identifying individuals at higher risk for arterial disorders. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT010497377.
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Affiliation(s)
- Lee Ti Davidson
- Department of Emergency Medicine in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, 581 83, Linköping, Sweden.
| | - Jan Engvall
- Department of Clinical Physiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Simona I Chisalita
- Department of Endocrinology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Carl Johan Östgren
- Division of Prevention, Rehabilitation and Community Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Fredrik H Nyström
- Division of Diagnostics and Specialist Medicine, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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3
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Kassem M, Ayala PL, Andric-Cancarevic T, Tajsic M, Vargas KG, Bendik D, Kaufmann C, Wojta J, Mueller C, Huber K. Copeptin for the differentiation of type 1 versus type 2 myocardial infarction or myocardial injury. Int J Cardiol 2024; 403:131879. [PMID: 38369132 DOI: 10.1016/j.ijcard.2024.131879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND The rapid and reliable differentiation of myocardial infarction (MI) due to atherothrombosis (T1MI) from MI due to supply-demand mismatch (T2MI) or acute myocardial injury is of major clinical relevance due to very different treatments, but still a major unmet clinical need. This study aimed to investigate whether copeptin, a stress hormone produced in the hypothalamus, helps to differentiate between T1MI versus T2MI or injury. METHODS In a retrospective analysis, 1271 unselected consecutive patients presenting with symptoms suggestive of MI to the emergency department were evaluated. Patients diagnosed with ST-elevation MI were excluded. All patients with elevated cardiac troponin I (cTnI) concentration possibly indicating MI were classified into T1MI, T2MI, or acute myocardial injury using detailed clinical assessment and coronary imaging. Copeptin plasma concentration was measured in a blinded fashion. A multicenter diagnostic study with central adjudication of the final diagnosis served as external validation cohort (n = 1390). RESULTS Among 1161 patients, 154 patients had increased cTnI concentration. Of these, 78 patients (51%) were classified as T1MI and 76 (49%) as T2MI or myocardial injury. Patients with T2MI or myocardial injury had significantly higher copeptin plasma concentration between patients versus T1MI (21,4 pmol/l versus 8,1 pmol/l, p = 0,001). A multivariable regression analysis revealed that higher concentrations of copeptin and C-reactive protein, higher heart rate at presentation and lower frequency of smoking remained significantly associated with T2MI and myocardial injury. Findings were largely confirmed in the external validation cohort. CONCLUSION In patients without ST-segment elevation, copeptin concentration was higher in T2MI and myocardial Injury versus T1MI and may help in their differential diagnosis.
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Affiliation(s)
- Mona Kassem
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.
| | - Pedro Lopez Ayala
- Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland
| | - Tijana Andric-Cancarevic
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Milos Tajsic
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Kris G Vargas
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Dimitri Bendik
- Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland
| | - Christoph Kaufmann
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria
| | - Johann Wojta
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
| | - Christian Mueller
- Department of Cardiology and Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Switzerland
| | - Kurt Huber
- 3rd Medical Department with Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria; Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria; Sigmund Freud University, Medical School, Vienna, Austria
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4
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Yalta K, Palabıyık O, Gurdogan M, Yetkın E. Hyponatremia and takotsubo syndrome: a review of pathogenetic and clinical implications. Heart Fail Rev 2024; 29:27-44. [PMID: 37698728 DOI: 10.1007/s10741-023-10344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 09/13/2023]
Abstract
Hyponatremia is a common electrolyte abnormality with important prognostic and therapeutic implications. It might exert detrimental effects on various organ systems including the central nervous system (CNS), bone, and heart along with its potential association with poor quality of life. These adverse effects might be largely mediated through a variety of mechanisms including osmotic stress, dysfunctional transmembrane exchangers, and enhanced oxidative stress.Interestingly, hyponatremia might also have an important association with takotsubo syndrome (TTS) that has been universally considered as a reversible form of cardiomyopathy usually emerging in response to various stressors. In this context, severe hyponatremia was previously reported to serve as a direct trigger of TTS evolution largely through its potential impact on CNS and heart. However, pathogenetic and clinical implications of hyponatremia still need to be thoroughly evaluated in patients with TTS. This paper aims to analyze the clinical features of published cases with TTS primarily triggered by hyponatremia and also aims to discuss the association between hyponatremia and TTS from a broader perspective.
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Affiliation(s)
- Kenan Yalta
- Cardiology Department, School of Medicine, TrakyaUniversity, Balkan Yerleşkesi, 22030, Edirne, Turkey.
| | - Orkide Palabıyık
- Trakya University, Vocational Collage of Health Services, Edirne, Turkey
| | - Muhammet Gurdogan
- Cardiology Department, School of Medicine, TrakyaUniversity, Balkan Yerleşkesi, 22030, Edirne, Turkey
| | - Ertan Yetkın
- Türkiye Hastanesi, Cardiology Department, Istanbul, Turkey
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Shi Z, Qian C. Copeptin and the prognosis of patients with coronary artery disease: a meta-analysis. Ir J Med Sci 2023; 192:2129-2141. [PMID: 36719516 DOI: 10.1007/s11845-023-03276-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/03/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Copeptin, the C-terminal portion of provasopressin, has been regarded as a marker of non-specific stress response and a potentially prognostic biomarker of cardiovascular diseases. This systematic review and meta-analysis was conducted to summarize the predictive role of baseline copeptin for the prognosis of patients with coronary artery disease (CAD). METHODS Relevant observational studies with longitudinal follow-up were obtained by comprehensive search of PubMed, Embase, and Web of Science databases. A random-effects model was used to pool the results. RESULTS Twenty-two studies with 19,821 patients with CAD were enrolled. Results of the meta-analyses revealed that a high copeptin at baseline was associated with a higher mortality risk (risk ratio [RR]: 1.76, 95% confidence interval [CI]: 1.49 to 2.09, p < 0.001; I2 = 70%) and an increased incidence of major adverse cardiovascular events (MACEs, RR: 1.49, 95% CI: 1.34 to 1.65, p < 0.001; I2 = 28%) in patients with CAD. Further results of sensitivity and subgroup analyses showed consistent associations between high copeptin with increased risks of mortality and MACEs in studies of patients with different ages, proportion of men, subtypes of CAD, study design, follow-up durations, and quality scores (p for subgroup effect all < 0.05). CONCLUSIONS A high plasma level of copeptin is associated with higher risks of mortality and MACEs in patients with CAD. Measuring copeptin may be helpful for risk stratification in patients with CAD.
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Affiliation(s)
- Zhewei Shi
- Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, 311800, China.
| | - Caizhen Qian
- Department of Cardiology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, 311800, China
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Selective Serotonin Reuptake Inhibitor Use in Pregnancy and Protective Mechanisms in Preeclampsia. Reprod Sci 2023; 30:701-712. [PMID: 35984571 PMCID: PMC9944568 DOI: 10.1007/s43032-022-01065-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/11/2022] [Indexed: 01/25/2023]
Abstract
Depression and preeclampsia share risk factors and are bi-directionally associated with increased risk for each other. Despite epidemiological evidence linking selective serotonin reuptake inhibitors (SSRIs) in pregnancy to preeclampsia, serotonin (5-HT) and vasopressin (AVP) secretion mechanisms suggest that SSRIs may attenuate preeclampsia risk. However, there is a need to clarify the relationship between SSRIs and preeclampsia in humans to determine therapeutic potential. This retrospective cohort study included clinical data from 9558 SSRI-untreated and 9046 SSRI-treated pregnancies. In a subcohort of 233 pregnancies, early pregnancy (< 20 weeks) maternal plasma copeptin, an inert and stable AVP prosegment secreted 1:1 with AVP, was measured by enzyme-linked immunosorbent assay. Diagnoses and depression symptoms (Patient Health Questionnaire-9 [PHQ-9]) were identified via medical records review. Descriptive, univariate, and multivariate regression analyses were conducted (α = 0.05). SSRI use was associated with decreased preeclampsia after controlling for clinical confounders (depression severity, chronic hypertension, diabetes, body mass index, age) (OR = 0.9 [0.7-1.0], p = 0.05). Moderate-to-severe depression symptoms were associated with significantly higher copeptin secretion than mild-to-no depression symptoms (240 ± 29 vs. 142 ± 10 ng/mL, p < 0.001). SSRIs significantly attenuated first trimester plasma copeptin (78 ± 22 users vs. 240 ± 29 ng/ml non-users, p < 0.001). In preeclampsia, SSRI treatment was associated with significantly lower copeptin levels (657 ± 164 vs. 175 ± 134 ng/mL, p = 0.04). Interaction between SSRI treatment and preeclampsia was also significant (p = 0.04). SSRIs may modulate preeclampsia risk and mechanisms, although further studies are needed to investigate the relationships between 5-HT and AVP in depression and preeclampsia.
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Haba MȘC, Tudorancea I, Miftode RȘ, Popa IP, Mitu O, Mihai CT, Haba RM, Onofrei VA, Petris AO, Costache II, Haba D, Șorodoc L. Pulmonary Embolism Risk Assessment Using Blood Copeptin Concentration and Pulmonary Arteries Thrombotic Burden Evaluated by Computer Tomography. J Pers Med 2022; 12:jpm12122084. [PMID: 36556304 PMCID: PMC9786201 DOI: 10.3390/jpm12122084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/06/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: Pulmonary embolism (PE) represents the third most important cardiovascular cause of death after myocardial infarction and stroke. The proper management of this condition is dependent on adequate risk stratification, due to the life-threatening complications of more aggressive therapies such as thrombolysis. Copeptin is a surrogate marker of vasopressin which is found increased in several cardiovascular conditions. The Mastora score is an imagistic evaluation of the degree of pulmonary arteries thrombotic burden based on computed tomography angiography. In this study, we aimed to evaluate the diagnostic and prognostic role of copeptin in patients with acute PE. Furthermore, we analyzed the relationship between copeptin and Mastora score and their role in PE risk profiling. (2) Methods: We conducted a single center prospective study that included 112 patients with PE and 53 healthy volunteers. Clinical and paraclinical parameters, together with plasma levels of copeptin and the Mastora score, were evaluated in all patients after admission. (3) Results: Copeptin levels were significantly increased in PE patients compared with the general population (26.05 vs. 9.5 pmol/L, p < 0.001), while receiver operating characteristic (ROC) analysis revealed an AUC of 0.800 (95% CI 0.728−0.873, p < 0.001). Copeptin directly correlated with the Mastora score (r = 0.535, p = 0.011) and both parameters were strong predictors for adverse clinical events and death. Receiver operating characteristic (ROC) analysis for death within 30 days revealed a copeptin cut-off of 38.36 pmol/L, which presented a specificity of 79.6% and a sensitivity of 88.9%, and a Mastora score cut-off of 82 points, which presented a specificity of 74.8% and a sensitivity of 77.8%. (4) Conclusions: Our results showed that copeptin and the Mastora score are both correlated with adverse cardiovascular events and mortality in PE patients, and this may pave the way for their use in clinical practice, helping physicians to select the best therapeutical management.
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Affiliation(s)
- Mihai Ștefan Cristian Haba
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Ionut Tudorancea
- Department of Morpho-Functional Sciences II-Physiology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
- Correspondence: ; Tel.: +40-232-301-603
| | - Radu Ștefan Miftode
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Irene Paula Popa
- Department of Morpho-Functional Sciences II-Physiology, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Ovidiu Mitu
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Cosmin Teodor Mihai
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Raluca Maria Haba
- Faculty of General Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Viviana Aursulesei Onofrei
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Antoniu Octavian Petris
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Irina Iuliana Costache
- Department of Internal Medicine I, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
| | - Danisia Haba
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, “Gr. T. Popa” University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania
| | - Laurentiu Șorodoc
- Department of Internal Medicine III, Faculty of Medicine, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iasi, Romania
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Deniz M, Doğan M, Gül Ö, Özhan B, Agladıoğlu SY, Enli Y, Şenol H. Evaluation of cardiovascular system and determination of cardiometabolic risk using novel biomarkers in childhood obesity. PROGRESS IN PEDIATRIC CARDIOLOGY 2022. [DOI: 10.1016/j.ppedcard.2022.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Ullmo J, Cruz-Lemini M, Sánchez-García O, Bos-Real L, Fernandez De La Llama P, Calero F, Domínguez-Gallardo C, Garrido-Gimenez C, Trilla C, Carreras-Costa F, Sionis A, Mora J, García-Osuna Á, Ordoñez-Llanos J, Llurba E. Cardiac dysfunction and remodeling regulated by anti-angiogenic environment in patients with preeclampsia: the ANGIOCOR prospective cohort study protocol. BMC Pregnancy Childbirth 2021; 21:816. [PMID: 34879854 PMCID: PMC8653611 DOI: 10.1186/s12884-021-04263-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Background Cardiovascular diseases (CVD) are cause of increased morbidity and mortality in spite of advances for diagnosis and treatment. Changes during pregnancy affect importantly the maternal CV system. Pregnant women that develop preeclampsia (PE) have higher risk (up to 4 times) of clinical CVD in the short- and long-term. Predominance of an anti-angiogenic environment during pregnancy is known as main cause of PE, but its relationship with CV complications is still under research. We hypothesize that angiogenic factors are associated to maternal cardiac dysfunction/remodeling and that these may be detected by new cardiac biomarkers and maternal echocardiography. Methods Prospective cohort study of pregnant women with high-risk of PE in first trimester screening, established diagnosis of PE during gestation, and healthy pregnant women (total intended sample size n = 440). Placental biochemical and biophysical cardiovascular markers will be assessed in the first and third trimesters of pregnancy, along with maternal echocardiographic parameters. Fetal cardiac function at third trimester of pregnancy will be also evaluated and correlated with maternal variables. Maternal cardiac function assessment will be determined 12 months after delivery, and correlation with CV and PE risk variables obtained during pregnancy will be evaluated. Discussion The study will contribute to characterize the relationship between anti-angiogenic environment and maternal CV dysfunction/remodeling, during and after pregnancy, as well as its impact on future CVD risk in patients with PE. The ultimate goal is to improve CV health of women with high-risk or previous PE, and thus, reduce the burden of the disease. Trial registration NCT04162236
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Affiliation(s)
- Johana Ullmo
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain
| | - Monica Cruz-Lemini
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Madrid, Spain
| | - Olga Sánchez-García
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Madrid, Spain
| | - Lidia Bos-Real
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Cardiology Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - Patricia Fernandez De La Llama
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Nephrology Department, Hypertension and Prevention of Kidney Damage Unit, Fundació Puigvert, Barcelona, Spain
| | - Francesca Calero
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Nephrology Department, Hypertension and Prevention of Kidney Damage Unit, Fundació Puigvert, Barcelona, Spain
| | - Carla Domínguez-Gallardo
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain
| | - Carmen Garrido-Gimenez
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain
| | - Cristina Trilla
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain
| | | | - Alessandro Sionis
- Cardiology Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - Josefina Mora
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Biochemistry Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain
| | - Álvaro García-Osuna
- Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain.,Fundació per la Bioquímica i la Patología Molecular, Biochemistry Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain
| | - Jordi Ordoñez-Llanos
- Biochemistry Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain.,Fundació per la Bioquímica i la Patología Molecular, Biochemistry Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain
| | - Elisa Llurba
- Obstetrics and Gynecology Department, Santa Creu i Sant Pau University Hospital & Universitat Autònoma, Barcelona, Spain. .,Woman and Perinatal Health Research Group, Sant Pau Biomedical Research Institute (IIB-Sant Pau), Sant Pau University Hospital, Barcelona, Spain. .,Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Madrid, Spain.
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Gembillo G, Visconti L, Giusti MA, Siligato R, Gallo A, Santoro D, Mattina A. Cardiorenal Syndrome: New Pathways and Novel Biomarkers. Biomolecules 2021; 11:1581. [PMID: 34827580 PMCID: PMC8615764 DOI: 10.3390/biom11111581] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/22/2021] [Accepted: 10/22/2021] [Indexed: 12/15/2022] Open
Abstract
Cardiorenal syndrome (CRS) is a multi-organ disease characterized by the complex interaction between heart and kidney during acute or chronic injury. The pathogenesis of CRS involves metabolic, hemodynamic, neurohormonal, and inflammatory mechanisms, and atherosclerotic degeneration. In the process of better understanding the bi-directional pathophysiological aspects of CRS, the need to find precise and easy-to-use markers has also evolved. Based on the new pathophysiological standpoints and an overall vision of the CRS, the literature on renal, cardiac, metabolic, oxidative, and vascular circulating biomarkers was evaluated. Though the effectiveness of different extensively applied biomarkers remains controversial, evidence for several indicators, particularly when combined, has increased in recent years. From new aspects of classic biomarkers to microRNAs, this review aimed at a 360-degree analysis of the pathways that balance the kidney and the heart physiologies. In this delicate system, different markers and their combination can shed light on the diagnosis, risk, and prognosis of CRS.
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Affiliation(s)
- Guido Gembillo
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Luca Visconti
- Unit of Nephrology and Dialysis, Ospedali Riuniti Villa Sofia Cervello, University of Palermo, 90146 Palermo, Italy;
| | - Maria Ausilia Giusti
- Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), UPMC Italy, 90127 Palermo, Italy; (M.A.G.); (A.M.)
| | - Rossella Siligato
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
- Department of Biomedical and Dental Sciences and Morpho-Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Alessia Gallo
- Department of Research, IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), UPMC Italy, 90127 Palermo, Italy;
| | - Domenico Santoro
- Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy;
| | - Alessandro Mattina
- Diabetes and Islet Transplantation Unit, Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad alta Specializzazione), UPMC Italy, 90127 Palermo, Italy; (M.A.G.); (A.M.)
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Ozmen C, Deveci OS, Tepe O, Yesildas C, Ünal İ, Yıldız İ, Eker Akıllı R, Deniz A, Demir M, Kanadaşı M, Usal A. Prognostic performance of copeptin among patients with acute decompensated heart failure. Acta Cardiol 2021; 76:842-851. [PMID: 32666903 DOI: 10.1080/00015385.2020.1786624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND In heart failure (HF), various biomarkers have been established for prognosis. However, little is known about the relevance of copeptin measurements to HF. This study aimed to explore the prognostic value of copeptin for predicting cardiovascular (CV) death or HF-related re-hospitalisation in patients with acute decompensated HF. MATERIALS AND METHODS We prospectively enrolled 155 consecutive patients with acute signs and symptoms of HF. Plasma copeptin and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were measured at admission. Patients were monitored for 90 days regarding the composite endpoint of CV death or acute HF-related re-hospitalisation. RESULTS Of the 155 patients enrolled, 40 reached the endpoint, and 115 were in a stable condition during follow-up. Patients who reached an adverse endpoint showed higher NT-proBNP and copeptin levels compared to patients in stable condition. Receiver operating characteristic curve analysis revealed that the area under curve of copeptin 0.844 (95% CI, 0.753-0.935) was superior to that of NT-proBNP 0.809 (95% CI, 0.729-0.890) for the prediction of adverse events within 90 days. Meanwhile, compared to the group with lower copeptin levels (<34 pmol/L), patients with higher copeptin levels (≥34 pmol/L) were at a 10.672-times higher risk of CV death or acute HF-related re-hospitalisation. Multivariate Cox proportional hazards regression analysis revealed that increased copeptin level was a significantly independent predictor of adverse events (risk ratio, 1.051; 95% CI, 1.020-1.083; p < 0.001). CONCLUSION Copeptin was found to be a strong, novel marker for predicting CV death or HF-related re-hospitalisation in patients with acute decompensated HF.
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Affiliation(s)
- Caglar Ozmen
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Onur Sinan Deveci
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Omer Tepe
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Cuma Yesildas
- Faculty of Medicine, Department of Cardiology, Mersin University, Mersin, Turkey
| | - İlker Ünal
- Faculty of Medicine, Department of Biostatistics, Cukurova University, Adana, Turkey
| | - İbrahim Yıldız
- Department of Cardiology, Osmaniye State Hospital, Osmaniye, Turkey
| | - Rabia Eker Akıllı
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Ali Deniz
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Mesut Demir
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Mehmet Kanadaşı
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
| | - Ayhan Usal
- Faculty of Medicine, Department of Cardiology, Cukurova University, Adana, Turkey
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12
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Aguiló Mir S, García Pagès E, López Barbeito B, Ribeiro TC, Garzón-Rey JM, Aguiló Llobet J. Design and validation of an electrophysiological based tool to assess chronic stress. Case study: burnout syndrome in caregivers. Stress 2021; 24:384-393. [PMID: 32865469 DOI: 10.1080/10253890.2020.1807512] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Caregiver burnout syndrome is an increasingly seen condition, although the subjective nature of self-administered psychometric tests and the lack of a consensual diagnostic tool might hinder a proper diagnosis. The availability of objective psychosomatic measures of stress might facilitate the early diagnosis and clinical management of these patients. For this reason, the aim of this work was to develop a quantitative tool to evaluate the stress level of caregivers in a noninvasive and repeatable manner. An observational, controlled, matched study was designed including a group of 38 principal caregivers of chronic patients and a control group of 38 non-caregivers. Psychometric, biochemical, and electrophysiological data were analyzed along with sociodemographic data. A quantitative chronic stress reference scale (CSRs) was constructed based on the weighted contribution of several psychometric and biochemical variables and afterwards, a predictive psychosomatic model (ESBSm) correlated with CSRs was elaborated from extracted variables of several electrophysiological signals monitored for 10 min. The resulting CSR scale shows a high power to discriminate caregivers from the control group while the ESBSm shows a 79% correlation with the CSR scale validated through a 5-fold process. Therefore, the results demonstrate that the ESBS model is an objective and validated tool to diagnose the degree of stress linked to burnout in caregivers of chronic patients from a 10-min session of noninvasive monitoring with a reliability equivalent to the questionnaires currently used to quantify stress in caregivers.
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Affiliation(s)
- Sira Aguiló Mir
- Emergency Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Esther García Pagès
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona, Bellaterra, Spain
| | | | - Thais Castro Ribeiro
- Microelectronics and Electronic Systems Department, Autonomous University of Barcelona (UAB), Barcelona, Spain
| | - Jorge M Garzón-Rey
- Aragon Institute of Engineering Research (I3A), IIS Aragón, University of Zaragoza, Zaragoza, Spain
| | - Jordi Aguiló Llobet
- Networking Biomedical Research Center: Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Universitat Autònoma de Barcelona, Bellaterra, Spain
- Microelectronics and Electronic Systems Department, Autonomous University of Barcelona (UAB), Barcelona, Spain
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Gogakos AI, Gogakos T, Kita M, Efstathiadou ZA. Pituitary Dysfunction as a Cause of Cardiovascular Disease. Curr Pharm Des 2021; 26:5573-5583. [PMID: 33155896 DOI: 10.2174/1381612824999201105165351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 08/16/2020] [Indexed: 11/22/2022]
Abstract
The hypothalamic-pituitary axis is responsible for the neuroendocrine control of several organ systems. The anterior pituitary directly affects the functions of the thyroid gland, the adrenal glands, and gonads, and regulates growth and milk production. The posterior hypophysis, through nerve connections with the hypothalamic nuclei, releases vasopressin and oxytocin responsible for water balance and social bonding, sexual reproduction and childbirth, respectively. Pituitary gland hormonal excess or deficiency results in dysregulation of metabolic pathways and mechanisms that are important for the homeostasis of the organism and are associated with increased morbidity and mortality. Cardiovascular (CV) disorders are common in pituitary disease and have a significant impact on survival. Hormonal imbalance is associated with CV complications either through direct effects on the heart structure and function and vasculature or indirectly by altering the metabolic profile. Optimal endocrine control can prevent or reverse CV defects and preserve survival and quality of life. In this review, we discuss the effects of pituitary hormone excess and deficiency on the CV system. Specifically, we assess the impact of Somatotroph, Corticotroph, Gonadotroph, and Lactotroph anterior pituitary axes on the CV system. The effect of posterior pituitary function on the CV system is also explored.
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Affiliation(s)
- Apostolos I Gogakos
- Department of Endocrinology, "Hippokration" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Tasos Gogakos
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Marina Kita
- Department of Endocrinology, "Hippokration" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Zoe A Efstathiadou
- Department of Endocrinology, "Hippokration" General Hospital of Thessaloniki, Thessaloniki, Greece
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Dyhl‐Polk A, Schou M, Vistisen KK, Sillesen A, Serup‐Hansen E, Faber J, Klausen TW, Bojesen SE, Vaage‐Nilsen M, Nielsen DL. Myocardial Ischemia Induced by 5-Fluorouracil: A Prospective Electrocardiographic and Cardiac Biomarker Study. Oncologist 2021; 26:e403-e413. [PMID: 32959474 PMCID: PMC7930422 DOI: 10.1002/onco.13536] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 09/04/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Cardiotoxicity induced by 5-fluorouracil (5-FU) is well known but poorly understood. In this study, we undertook ECG recording (Holter) and analyses of the biomarkers troponin and copeptin in patients receiving 5-FU to increase our understanding of the cardiotoxicity. SUBJECTS, MATERIALS, AND METHODS Patients with colorectal or anal cancer that received first-time treatment with 5-FU-based chemotherapy were prospectively included. Holter recording, clinical evaluation, 12-lead electrocardiogram, and assessment of plasma concentrations of troponin I and copeptin were performed before (control) and during 5-FU treatment (intervention). RESULTS A total of 108 patients were included, 82 with colorectal and 26 with anal cancer. The proportion of patients with myocardial ischemia on Holter recording was significantly higher during the first 5-FU infusion (14.1%) than before (3.7%; p = .001). The ischemic burden per day (p = .001), the number of ST depression episodes per day (p = .003), and the total duration of ischemic episodes per day (p = .003) were higher during the first 5-FU infusion than before, as was plasma copeptin (p < .001), whereas plasma troponin I was similar (p > 0.999). Six patients (5.6%) developed acute coronary syndromes and two (1.8%) developed symptomatic arrhythmias during 5-FU treatment. CONCLUSION 5-FU infusion is associated with an increase in the number of patients with myocardial ischemia on Holter recording. According to biomarker analyses, 5-FU is associated with an increase in copeptin, but rarely with increases in cardiac troponin I. However, 5%-6% of the patients developed acute coronary syndromes during treatment with 5-FU. IMPLICATIONS FOR PRACTICE Symptomatic 5-fluorouracil (5-FU) cardiotoxicity occurs in 0.6%-19% of patients treated with this drug, but a small electrocardiographic (Holter) study has revealed silent myocardial ischemia in asymptomatic patients, suggesting a more prevalent subclinical cardiac influence. This study demonstrated a significant increase in the number of patients with myocardial ischemia on Holter recording during 5-FU treatment and an increase in ischemic burden. Cardiac biomarker analyses suggested that 5-FU infusion results in endogenous stress (increased copeptin) but rarely induces myocyte injury (no change in troponin). These findings suggest a more prevalent cardiac influence from 5-FU and that Holter recording is an important tool in the evaluation of patients with suspected cardiotoxicity from 5-FU.
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Affiliation(s)
- Anne Dyhl‐Polk
- Departments of Oncology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
- Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Morten Schou
- Departments of Cardiology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
- Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Kirsten K. Vistisen
- Departments of Oncology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
| | - Anne‐Sophie Sillesen
- Departments of Cardiology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
| | - Eva Serup‐Hansen
- Departments of Oncology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
| | - Jens Faber
- Departments of Medicine, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
- Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Tobias W. Klausen
- Departments of Hematology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
| | - Stig E. Bojesen
- Departments of Clinical Biochemistry, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
- Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
| | - Merete Vaage‐Nilsen
- Departments of Cardiology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
| | - Dorte L. Nielsen
- Departments of Oncology, Herlev‐Gentofte Hospital, University of CopenhagenHerlevDenmark
- Faculty of Health and Medical Sciences, University of CopenhagenCopenhagenDenmark
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15
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Waldsperger H, Biener M, Stoyanov KM, Vafaie M, Katus HA, Giannitsis E, Mueller-Hennessen M. Prognostic Value of Elevated Copeptin and High-Sensitivity Cardiac Troponin T in Patients with and without Acute Coronary Syndrome: The ConTrACS Study. J Clin Med 2020; 9:E3627. [PMID: 33187192 PMCID: PMC7696893 DOI: 10.3390/jcm9113627] [Citation(s) in RCA: 5] [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: 09/30/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 01/03/2023] Open
Abstract
AIMS We aimed to assess the prognostic role of copeptin in patients presenting to the emergency department with acute symptoms and increased high-sensitivity cardiac troponin T. METHODS A total of 3890 patients presenting with acute symptoms to the emergency department of Heidelberg University Hospital were assessed for increased hs-cTnT (>14 ng/L) from three cohorts: the Heidelberg Acute Coronary Syndrome (ACS) Registry (n = 2477), the BIOPS Registry (n = 320), and the ACS OMICS Registry (n = 1093). In a pooled analysis, 1956 patients remained, comprising of 1600 patients with ACS and 356 patients with non-ACS. RESULTS Median follow-up was 1468 days in the ACS cohort and 709 days in the non-ACS cohort. Elevated copeptin levels (>10 pmol/L) were found in 1174 patients (60.0%) in the entire cohort (58.1% in ACS and 68.5% in non-ACS, respectively) and mortality rates were significantly higher than in patients with normal copeptin levels (29.0% vs. 10.7%, p < 0.001). In a multivariate Cox regression, elevated copeptin was independently associated with all-cause death in the ACS (HR = 1.7, 1.3-2.3, p = 0.002) and non-ACS cohort (HR = 2.7, 1.4-5.0, p = 0.0018). CONCLUSION Copeptin may aid in identifying patients at risk for adverse outcomes in patients with increased levels of hs-cTnT in ACS patients and in non-ACS conditions.
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Affiliation(s)
- Hanna Waldsperger
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
| | - Moritz Biener
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, 69120 Heidelberg, Germany
| | - Kiril M. Stoyanov
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
| | - Mehrshad Vafaie
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
| | - Hugo A. Katus
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, 69120 Heidelberg, Germany
| | - Evangelos Giannitsis
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
| | - Matthias Mueller-Hennessen
- Department of Internal Medicine III, Heidelberg University Hospital, 69120 Heidelberg, Germany; (H.W.); (M.B.); (K.M.S.); (M.V.); (H.A.K.); (E.G.)
- DZHK (German Centre for Cardiovascular Research), partner site Heidelberg/Mannheim, 69120 Heidelberg, Germany
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16
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Sellmer A, Hjortdal VE, Bjerre JV, Schmidt MR, Bech BH, Henriksen TB. Cardiovascular biomarkers in the evaluation of patent ductus arteriosus in very preterm neonates: A cohort study. Early Hum Dev 2020; 149:105142. [PMID: 32861196 DOI: 10.1016/j.earlhumdev.2020.105142] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 07/08/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The evaluation of the patent ductus arteriosus (PDA) in the very premature neonate is a challenge. Echocardiography provides an interpretation of the hemodynamic condition. It is however, only a snapshot. Biomarkers may represent a physiological response to the hemodynamic alterations brought on by the PDA and may add to the identification of the clinical significant PDA. AIM To investigate the association between mid regional proadrenomodulin (MR-proADM), N-terminal pro b-type natriuretic peptide (NT-proBNP), mid regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro endothelin-1 (CT-proET1) and copeptin and echocardiographic measures of PDA. STUDY DESIGN Cohort study with echocardiography performed on day 3 and 6. Blood samples from day 3. SUBJECT 139 consecutive neonates born at a gestational age <32 weeks. OUTCOME MEASURES The main outcomes were presence of a PDA day 3 and 6, PDA diameter, left atrium to aorta ratio (LA:Ao-ratio), and descending aorta diastolic flow (DADF). RESULTS Adjusted plasma levels of all investigated biomarkers, except CT-proET1, were found to be associated with both PDA diameter and LA:Ao-ratio, and also the presence of a large PDA. CT-proET1 and copeptin was found to be associated with abnormal DADF. Using pre-specified cut-off values NT-proBNP and MR-proANP day 3 seemed to be of value in identifying a large PDA day 3 and 6 in very preterm neonates. CONCLUSION Among the investigated biomarkers NT-proBNP and MR-proANP performed best in relation to echocardiographic markers of PDA severity in very preterm neonates.
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Affiliation(s)
- Anna Sellmer
- Department of Cardiothoracic Surgery, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.
| | - Vibeke E Hjortdal
- Department of Cardiothoracic Surgery, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Jesper V Bjerre
- Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.
| | - Michael R Schmidt
- Department of Cardiology, Rishospitalet Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Bodil H Bech
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000 Aarhus, Denmark.
| | - Tine B Henriksen
- Perinatal Epidemiology Research Unit, Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark; Department of Pediatrics, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark.
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Chang JF, Chou YS, Wu CC, Chen PC, Ko WC, Liou JC, Hsieh CY, Lin WN, Wen LL, Chang SW, Tung TH, Wang TM. A Joint Evaluation of Neurohormone Vasopressin-Neurophysin II-Copeptin and Aortic Arch Calcification on Mortality Risks in Hemodialysis Patients. Front Med (Lausanne) 2020; 7:102. [PMID: 32296707 PMCID: PMC7136408 DOI: 10.3389/fmed.2020.00102] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 03/09/2020] [Indexed: 01/05/2023] Open
Abstract
Objective: Systemic hypoperfusion is intricately involved in neurohormone secretion, vascular calcification (VC) related impaired vasodilation, and luminal stenosis. We aimed to conduct a joint evaluation of vasopressin-neurophysin II-copeptin peptide (VP) and advanced aortic arch calcification (AAC) on all-cause and cardiovascular (CV) mortality in maintenance hemodialysis (MHD) patients. Methods: Unadjusted and adjusted hazard ratios (aHRs) of mortality risks were analyzed for different groups of VP and AAC in 167 MHD patients. The modification effect between higher VP and advanced AAC on mortality risk was examined using an interaction product term. Results: Interactions between VP and AAC with respect to all-cause and CV mortality were statistically significant. In multivariable analysis, higher VP predicted all-cause and CV mortality [aHR: 2.2 (95% confidence interval (CI): 1.1-4.5)] and 2.6 (95% CI: 1.1-4.6), respectively. Advanced AAC was associated with incremental risks of all-cause and CV mortality [aHR: 2.1 (95% CI: 1.1-4.0)and 2.5 (95% CI: 1.0-4.3), respectively]. Patients with combined higher VP (>101.5 ng/mL) and advanced AAC were at the greatest risk of all-cause and CV mortality [aHR: 4.7 (95% CI: 1.2-16.2)and 4.9 (95% CI: 1.1-18.9), respectively]. Conclusion: Combined VP and advanced AAC predict not only all-cause but also CV death in MHD patients, and a joint evaluation is more comprehensive than single marker. In light of hypoperfusion and ischemic events in vital organs, VP and AAC could act as more robust dual marker for prognostic assessment.
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Affiliation(s)
- Jia-Feng Chang
- Division of Nephrology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Graduate Institute of Aerospace and Undersea Medicine, Academy of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu, Taiwan
- Division of Nephrology, Department of Internal Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
- Renal Care Joint Foundation, New Taipei City, Taiwan
- College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Yu-Shao Chou
- Department of Emergency Medicine, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Chang-Chin Wu
- Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
- Department of Orthopedics, En Chu Kong Hospital, New Taipei City, Taiwan
- Department of Biomedical Engineering, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Po-Cheng Chen
- Department of Urology, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Wen-Chin Ko
- College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
- Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
| | - Jian-Chiun Liou
- School of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Chih-Yu Hsieh
- School of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
- Department of Pathology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Wei-Ning Lin
- Graduate Institution of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Li-Li Wen
- Department of Medical Laboratory Science and Biotechnology, Yuanpei University, Hsinchu, Taiwan
- Department of Clinical Laboratory, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Shu-Wei Chang
- Department of Civil Engineering, National Taiwan University, Taipei, Taiwan
| | - Tao-Hsin Tung
- Department of Medical Research and Education, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Ting-Ming Wang
- Department of Orthopaedic Surgery, School of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Orthopaedic Surgery, National Taiwan University Hospital, Taipei, Taiwan
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Yildirim E, Cabbar AT. Association between copeptin and contrast-induced nephropathy in patients with ST-elevation myocardial infarction. Rev Port Cardiol 2020; 38:873-879. [PMID: 32165078 DOI: 10.1016/j.repc.2019.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 06/16/2019] [Accepted: 06/22/2019] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the predictive value of copeptin levels in the development of contrast-induced nephropathy (CIN). METHODS A total of 274 patients diagnosed with ST-elevation myocardial infarction (STEMI) and who had undergone primary percutaneous coronary intervention were included in the study. The patients were divided into two groups according to the presence (CIN+) or absence (CIN-) of CIN. These groups were compared in terms of demographic characteristics, laboratory findings and risk factors. RESULTS Copeptin levels (10.68±6.43 vs. 7.07±05.53 pmol/l; p<0.001) and peak creatinine (1.46±1.20 vs. 1.03±0.20 mg/dl; p=0.005) were significantly higher in the CIN+ group than in the CIN- group. Female gender was significantly more prevalent in the CIN- group compared to the CIN+ group (19% vs. 8.6%; p<0.05). Copeptin level at hospital admission (OR: 2.36, p=0.005) was found to be an independent predictor for CIN development. CONCLUSION Copeptin level is an independent predictor of CIN development in patients with acute STEMI that can be detected rapidly and easily. This result indicates that physicians should be aware of the possibility of CIN development in patients with high copeptin levels and preventive measures should start early.
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Affiliation(s)
- Ersin Yildirim
- Istanbul Umraniye Education and Research Hospital, University of Health Sciences, Department of Cardiology, Turkey.
| | - Ayca Turer Cabbar
- Yeditepe University Faculty of Medicine, Department of Cardiology, Turkey
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19
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Almeida MDS. Predicting contrast-induced nephropathy in patients with acute myocardial infarction: Can it be avoided? Rev Port Cardiol 2020; 38:881-882. [PMID: 32094010 DOI: 10.1016/j.repc.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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20
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Wang XY, Zhang F, Zhang C, Zheng LR, Yang J. The Biomarkers for Acute Myocardial Infarction and Heart Failure. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2018035. [PMID: 32016113 PMCID: PMC6988690 DOI: 10.1155/2020/2018035] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/05/2019] [Accepted: 12/04/2019] [Indexed: 01/06/2023]
Abstract
The use of a large number of cardiovascular biomarkers, meant to complement the use of the electrocardiogram, echocardiography cardiac imaging, and clinical symptom assessment, has become a routine in clinical diagnosis, differential diagnosis, risk stratification, and prognosis and guides the management of patients with suspected cardiovascular diseases. There is a broad consensus that cardiac troponin and natriuretic peptides are the preferred biomarkers in clinical practice for the diagnosis of the acute coronary syndrome and heart failure, respectively, while the roles and possible clinical applications of several other potential biomarkers are still under study. This review mainly focuses on the recent studies of the roles and clinical applications of troponin and natriuretic peptides, which seem to be the best-validated markers in distinguishing and predicting the future cardiac events of patients with suspected cardiovascular diseases. Additionally, the review briefly discusses some of the large number of potential markers that may play a more prominent role in the future.
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Affiliation(s)
- Xi-Ying Wang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Fen Zhang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chi Zhang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Liang-Rong Zheng
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Yang
- Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Yildirim E, Cabbar AT. Association between copeptin and contrast-induced nephropathy in patients with ST-elevation myocardial infarction. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2019.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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22
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Almeida MDS. Predicting contrast-induced nephropathy in patients with acute myocardial infarction: Can it be avoided? REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2019. [DOI: 10.1016/j.repce.2020.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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23
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Zelenak C, Chavanon ML, Tahirovic E, Trippel TD, Tscholl V, Stroux A, Veskovic J, Apostolovic S, Obradovic D, Zdravkovic M, Loncar G, Störk S, Herrmann-Lingen C, Düngen HD. Early NT-proBNP and MR-proANP associated with QoL 1 year after acutely decompensated heart failure: secondary analysis from the MOLITOR trial. Biomark Med 2019; 13:1493-1507. [PMID: 31659915 DOI: 10.2217/bmm-2019-0083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aim: Heart failure negatively impacts quality of life (QoL), which in turn contributes to an adverse long-term prognosis. We aimed at identifying biomarker trajectories after an episode of acutely decompensated heart failure (ADHF) that differ between patients showing average versus impaired QoL 1 year later, thus allowing to predict impaired QoL. Methods: Biomarkers were repeatedly measured throughout the year in 104 ADHF patients. QoL was assessed at discharge and 1 year after ADHF. Logistic regression and receiver operating characteristic analyses were used to identify predictors of impaired QoL while controlling psychosocial confounders. Results: MR-proANP predicted impaired physical and mental QoL. NT-proBNP measurements were important predictors for poor physical QoL. Conclusion: MR-proANP and NT-proBNP predict poor QoL after an epidode of ADHF. The trial is registered at http://clinicaltrials.gov as MOLITOR (IMpact of therapy optimisation On the Level of biomarkers in paTients with Acute and Decompensated ChrOnic HeaRt Failure) with unique identifier: NCT01501981.
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Affiliation(s)
- Christine Zelenak
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Mira-Lynn Chavanon
- Department of Psychology, Philipps Universität Marburg, Marburg, Germany
| | - Elvis Tahirovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Tobias Daniel Trippel
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Verena Tscholl
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Andrea Stroux
- Department for Biometry & Clinical Epidemiology, CBF, Charité University Medicine Berlin, Berlin, Germany
| | - Jovan Veskovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
| | - Svetlana Apostolovic
- Department for Cardiovascular Diseases, Clinical Centre Niš, University of Niš, Niš, Serbia
| | - Danilo Obradovic
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany
| | - Marija Zdravkovic
- Department of Cardiology, University Clinical Hospital Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Goran Loncar
- Institute for Cardiovascular Diseases Dedinje, Department of Cardioloy, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Stefan Störk
- Comprehensive Heart Failure Center, University Hospital Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Germany
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine & Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Hans-Dirk Düngen
- Department of Internal Medicine, Cardiology, CVK, Charité University Medicine Berlin, Berlin, Germany.,German Centre for Cardiovascular Research (DZHK), Partner Site Berlin, Berlin, Germany
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24
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Rouatbi H, Zigabe S, Gkiougki E, Vranken L, Van Linthout C, Seghaye MC. Biomarkers of neonatal stress assessment: A prospective study. Early Hum Dev 2019; 137:104826. [PMID: 31362253 DOI: 10.1016/j.earlhumdev.2019.104826] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/19/2019] [Accepted: 07/23/2019] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Early diagnosis of perinatal asphyxia, the major cause of neonatal mortality and morbidity, might be improved by the detection of neonatal stress biomarkers such as cardiac troponin (CTn)T, CTnI, NT-Terminal-pro-Brain Natriuretic Peptide (NT-pro-BNP), copeptin, and high sensitivity C-reactive protein (hs-CRP). However, reference values in neonates are lacking. The objective of our study was therefore to establish a reference range of these biomarkers in healthy full term newborns and to analyze the influence of delivery mode on their cord blood concentrations. PATIENTS AND METHODS CTnT, CTnI, NT-pro-BNP, Copeptin and hs-CRP levels were determined in 201 neonates enrolled in this prospective study and correlated to the delivery mode and post-natal outcome. RESULTS Using the 99th percentile, the upper reference limit in healthy newborns was established for all biomarkers. Neonates born after complicated delivery had significantly higher values of CTnT, CTnI and Copeptin than those born after uncomplicated delivery. In the multiple regression models with CTnT as dependent variable, the delivery mode was the statistically significant independent variable. CONCLUSION In this study, we established reference values of cord blood concentrations of cardiac stress biomarkers in healthy newborns. We showed that cardiac-related birth stress is dependent on delivery mode.
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Affiliation(s)
- H Rouatbi
- Department of Pediatrics, University Hospital Liège, Belgium.
| | - S Zigabe
- Department of Pediatrics, University Hospital Liège, Belgium
| | - E Gkiougki
- Department of Pediatrics, University Hospital Liège, Belgium
| | - L Vranken
- Department of Medical Chemistry, University Hospital Liège, Belgium
| | - C Van Linthout
- Department of Gynecology & Obstetrics, University Hospital Liège, Belgium
| | - M-C Seghaye
- Department of Pediatrics, University Hospital Liège, Belgium
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25
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Yalta K, Yilmaz MB, Yalta T, Palabiyik O, Taylan G, Zorkun C. Late Versus Early Myocardial Remodeling After Acute Myocardial Infarction: A Comparative Review on Mechanistic Insights and Clinical Implications. J Cardiovasc Pharmacol Ther 2019; 25:15-26. [DOI: 10.1177/1074248419869618] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In the setting of acute myocardial infarction (AMI), adverse myocardial remodeling (AMR) has been universally regarded as an early-onset phenomenon generally arising within the first few weeks (usually within days in the infarct zone) following myocardial injury. On the other hand, onset of cardiac morphological changes in this setting may potentially extend far beyond this time frame (usually beyond several months after the index AMI), suggesting a prolonged latent period in certain cases. In clinical practice, this delayed form of post-AMI remodeling, namely late AMR, has emerged as an interesting and underrecognized phenomenon with poorly understood mechanisms. Notably, systemic inflammation and associated growth factors seem to play a pivotal role in this setting. Accordingly, the present article primarily aims to discuss potential mechanisms and clinical implications of late AMR (in a comparative manner with its classical early counterpart) among AMI survivors along with a particular emphasis on potential benefits of certain anti-inflammatory strategies in this setting.
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Affiliation(s)
- Kenan Yalta
- Cardiology Department, Trakya University, Edirne, Turkey
| | | | - Tulin Yalta
- Pathology Department, Trakya University, Edirne, Turkey
| | | | - Gokay Taylan
- Cardiology Department, Trakya University, Edirne, Turkey
| | - Cafer Zorkun
- Cardiology Department, Trakya University, Edirne, Turkey
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26
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Myburgh CE, Malan L, Möller M, Magnusson M, Melander O, Rauch HGL, Steyn F, Malan NT. Coping facilitated troponin T increases and hypo-responsivity in the copeptin-HPA-axis during acute mental stress in a black cohort: The SABPA study. Physiol Behav 2019; 207:159-166. [PMID: 31095930 DOI: 10.1016/j.physbeh.2019.05.012] [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] [Received: 01/17/2019] [Revised: 04/24/2019] [Accepted: 05/10/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Defensive coping (DefS) was associated with a vulnerable cardiovascular profile in blacks. The copeptin/vasopressin system is a manifestation of hypothalamic-pituitary-adrenal-axis activity and may act as an acute compensatory mechanism when there is a disruption in volume-loading homeostasis, i.e. when cardiac stress is evident. Whether DefS will influence associations between copeptin and cardiac stress markers, remains unclear. Here we aimed to determine associations between acute mental stress responses of copeptin, vascular responsiveness and biomarkers of cardiomyocyte injury [cardiac troponin T (cTnT)] and cardiac wall-stress [N-terminal pro-brain natriuretic peptide (NT-proBNP)] in DefS race groups. METHODS South African black and white teachers (n = 378) of both sexes, participated in this target population study. Cases with a history of myocardial infarction, stroke and atrial fibrillation were excluded. We obtained coping scores (Coping Strategy Indicator), beat-to-beat blood pressure and fasting blood samples at rest and after 1-min exposure to the Stroop-Colour-Word-Conflict-test. RESULTS Interaction effects (p < .05) for copeptin percentage change (%) during the Stroop-Colour-Word-Conflict-test determined stratification of participants into race and DefS (≥26, above-median score) groups. In DefS blacks, Stroop-Colour-Word-Conflict-test exposure elicited increases in cTnT%, NT-proBNP% and diastolic-blood pressure%. Again, in these individuals, multiple regression analyses showed positive associations between copeptin% and total peripheral resistance%; with inverse associations between copeptin% and cTnT% (p < .05). None of these associations were found in DefS whites. CONCLUSIONS Utilisation of DefS in blacks provoked vascular hyper-responsiveness and cardiac wall stress (elevated cTnT and NT-proBNP); possibly mediated via the copeptin/vasopressin system. However, a presumably hypo-responsive hypothalamic-pituitary-adrenal-axis during stress exposure could not counteract coronary perfusion deficits via additional copeptin/vasopressin release. The presence of defensiveness may have clinical implications in preventive cardiology.
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Affiliation(s)
- Catharina Elizabeth Myburgh
- Hypertension in Africa Research Team (HART), Centre of Excellence, North-West University, Potchefstroom Campus, South Africa
| | - Leoné Malan
- Hypertension in Africa Research Team (HART), Centre of Excellence, North-West University, Potchefstroom Campus, South Africa.
| | - Marisa Möller
- Centre of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University, Potchefstroom, South Africa
| | - Martin Magnusson
- Department of Clinical Sciences, Lund University, Clinical Research Center, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Henri Guise Laurie Rauch
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Faans Steyn
- Statistical Consultation Services, North-West University, Potchefstroom 2520, South Africa
| | - Nicolaas Theodor Malan
- Hypertension in Africa Research Team (HART), Centre of Excellence, North-West University, Potchefstroom Campus, South Africa
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Gille J, Schmidt J, Kremer T, Sablotzki A. Evaluation of MR-proANP and copeptin for sepsis diagnosis after burn injury. J Crit Care 2019; 52:149-155. [DOI: 10.1016/j.jcrc.2019.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 04/11/2019] [Accepted: 04/29/2019] [Indexed: 01/02/2023]
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Govender N, Moodley J, Naicker T. Copeptin in Preeclampsia Development. CURRENT WOMEN S HEALTH REVIEWS 2019. [DOI: 10.2174/1573404815666190110094636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background:
Preeclampsia complicates 2-8% of all pregnancies worldwide and is one of
the leading causes of maternal and neonatal morbidity and mortality. It occurs after the 20th week of
gestation and is characterized by high blood pressure, proteinuria or end-organ disease. The heterogeneous
and multi-systemic nature of this disease has led to the elusive pathophysiology which
delays timely diagnoses and the clinical treatment of those affected.
Objective:
Despite the extensive investigations surrounding the inclusion of various potential markers
for PE prediction, early diagnosis remains unresolved. Quantification of copeptin, a stable component
of the arginine vasopressin (AVP) precursor is shown to be relatively reliable in confirming
the circulating levels of AVP.
Conclusion:
Elevated copeptin levels confirmed in pregnant women have also provided clinical
support for its role in PE development. However, its clinical use in predicting disease severity in
early-onset pre-eclampsia has been debatable. This review thus recapitulates the current literature
surrounding copeptin and its potential as a risk indicator for PE development.</P>
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Affiliation(s)
- Nalini Govender
- Department of Basic Medical Sciences, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, College of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa
| | - Thajasvarie Naicker
- Discipline of Optics and Imaging, College of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa
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29
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la Cour JL, Christensen HM, Köhrle J, Lehmphul I, Kistorp C, Nygaard B, Faber J. Association Between 3-Iodothyronamine (T1am) Concentrations and Left Ventricular Function in Chronic Heart Failure. J Clin Endocrinol Metab 2019; 104:1232-1238. [PMID: 30383216 DOI: 10.1210/jc.2018-01466] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/26/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Thyroid hormone metabolites might affect the heart. The endogenous aminergic metabolite 3-iodothyronamine (T1am) reduces left ventricular ejection fraction (LVEF) in rodents. OBJECTIVE To investigate concentration of T1am and its association with LVEF and biomarkers of heart function in patients with chronic heart failure (CHF) without thyroid disease, including patients with cardiac cachexia (nonedematous weight loss >5% over 6 months). METHODS Cross-sectional study. CHF was characterized by LVEF <45% and symptoms. Three groups were included (n = 19 in each group, matched on age, sex, and kidney function): patients with cachexia (CAC), patients without (non-CAC), and control (C) patients with prior myocardial infarction and LVEF >45%. T1am was measured by a monoclonal antibody-based chemiluminescence immunoassay. N-amino terminal pro-BNP (NT-proBNP) concentrations were also analyzed. RESULTS Mean (SD) LVEF: CAC, 32 ± 9%; non-CAC, 38 ± 8%; and C, 60 ± 8% (P < 0.0001). TSH, T4, and T3 levels did not differ between groups and did not correlate to T1am. Serum T1am (nmol/L) concentrations were higher in CHF: CAC (mean ± SD), 12.4 ± 6.6; non-CAC, 9.1 ± 5; and C, 7.3 ± 2.9. A negative association between T1am and LVEF was present after adjusting for sex, age, T3, and estimated glomerular filtration rate (P = 0.03). Further, serum T1am levels tended to be associated with NT-proBNP (P = 0.053). CONCLUSION Serum T1am levels were increased in patients with CHF and numerically highest (although nonsignificant) in patients with cardiac cachexia. Increasing T1am concentrations were independently associated with reduced LVEF, suggesting a direct effect on the human heart.
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Affiliation(s)
| | - Heidi M Christensen
- Department of Endocrinology, Herlev University Hospital, Herlev, Denmark
- Department of Gynecology and Obstetrics, Herlev University Hospital, Herlev, Denmark
| | - Josef Köhrle
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ina Lehmphul
- Institut für Experimentelle Endokrinologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Caroline Kistorp
- Department of Endocrinology, Herlev University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Birte Nygaard
- Department of Endocrinology, Herlev University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | - Jens Faber
- Department of Endocrinology, Herlev University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
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Yalta K, Palabiyik O, Gurdogan M, Gurlertop Y. Serum copeptin might improve risk stratification and management of aortic valve stenosis: a review of pathophysiological insights and practical implications. Ther Adv Cardiovasc Dis 2019; 13:1753944719826420. [PMID: 30803406 PMCID: PMC6376527 DOI: 10.1177/1753944719826420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Over recent decades, the prevalence of aortic valve stenosis (AVS) has been constantly increasing possibly owing to the aging of general population. Severe AVS as determined by an aortic valve area (AVA) of <1 cm2 has been regarded as a serious clinical condition potentially associated with a variety of adverse outcomes, including sudden cardiac death (SCD). However, patients with severe AVS (in the absence of overt high-risk features) are usually evaluated and managed exclusively based on symptomatology or imperfect prognostic tools including exercise testing and biomarkers, with a potential risk of mismanagement, suggesting the need for further objective risk stratifiers in this setting. Within this context, copeptin (C-terminal pro-vasopressin), a novel neurohormone widely considered as the surrogate marker of the arginine–vasopressin (AVP) system, may potentially serve as a reliable prognostic and therapeutic guide (e.g. timing of aortic valvular intervention) in patients with severe AVS largely based on its hemodynamic, fibrogenic as well as autonomic implications in these patients. Accordingly, the present paper aims to discuss clinical and pathophysiological implications of copeptin in the setting of AVS along with a summary of biomarkers and other prognostic tools used in this setting.
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Affiliation(s)
- Kenan Yalta
- Trakya University, School of Medicine, Cardiology Department, 22030 Edirne, Turkey
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31
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Yalta K, Gurdogan M, Kaya C, Zeybey U. Serum copeptin: a potential guide to clinical decision-making for congenital shunt closure. BRITISH HEART JOURNAL 2019; 105:499-500. [DOI: 10.1136/heartjnl-2018-314598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gavaldà-Manso M, Jimenez-Marrero S, Cainzos-Achirica M, Garay A, Enjuanes C, Yun S, Diez C, Gonzalez-Costello J, Tajes M, Farre N, Duran X, Comin-Colet J. Reduced levels of vasopressin, an independent mechanism in the obesity paradox in patients with chronic heart failure: Insights from the DAMOCLES study. Int J Cardiol 2019; 276:171-176. [DOI: 10.1016/j.ijcard.2018.10.094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/19/2018] [Accepted: 10/26/2018] [Indexed: 01/13/2023]
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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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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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35
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Düngen HD, Tscholl V, Obradovic D, Radenovic S, Matic D, Musial Bright L, Tahirovic E, Marx A, Inkrot S, Hashemi D, Veskovic J, Apostolovic S, von Haehling S, Doehner W, Cvetinovic N, Lainscak M, Pieske B, Edelmann F, Trippel T, Loncar G. Prognostic performance of serial in-hospital measurements of copeptin and multiple novel biomarkers among patients with worsening heart failure: results from the MOLITOR study. ESC Heart Fail 2018; 5:288-296. [PMID: 29476612 PMCID: PMC5880673 DOI: 10.1002/ehf2.12231] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/10/2017] [Accepted: 09/27/2017] [Indexed: 01/08/2023] Open
Abstract
Aims In heart failure, various biomarkers are established for diagnosis and risk stratification; however, little is known about the relevance of serial measurements during an episode worsening heart failure (WHF). This study sought to investigate the trajectory of natriuretic peptides and multiple novel biomarkers during hospitalization for WHF and to determine the best time point to predict outcome. Methods and results MOLITOR (Impact of Therapy Optimisation on the Level of Biomarkers in Patients with Acute and Decompensated Chronic Heart Failure) was an eight‐centre prospective study of 164 patients hospitalized with a primary diagnosis of WHF. C‐terminal fragment of pre‐pro‐vasopressin (copeptin), N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), mid‐regional pro‐atrial natriuretic peptide (MR‐proANP), mid‐regional pro‐adrenomedullin (MR‐proADM), and C‐terminal pro‐endothelin‐1 (CT‐proET1) were measured on admission, after 24, 48, and 72 h, and every 72 h thereafter, at discharge and follow‐up visits. Their performance to predict all‐cause mortality and rehospitalization at 90 days was compared. All biomarkers decreased during recompensation (P < 0.05) except MR‐proADM. Copeptin at admission was the best predictor of 90 day mortality or rehospitalization (χ2 = 16.63, C‐index = 0.724, P < 0.001), followed by NT‐proBNP (χ2 = 10.53, C‐index = 0.646, P = 0.001), MR‐proADM (χ2 = 9.29, C‐index = 0.686, P = 0.002), MR‐proANP (χ2 = 8.75, C‐index = 0.631, P = 0.003), and CT‐proET1 (χ2 = 6.60, C‐index = 0.64, P = 0.010). Re‐measurement of copeptin at 72 h and of NT‐proBNP at 48 h increased prognostic value (χ2 = 23.48, C‐index = 0.718, P = 0.00001; χ2 = 14.23, C‐index = 0.650, P = 0.00081, respectively). Conclusions This largest sample of serial measurements of multiple biomarkers in WHF found copeptin at admission with re‐measurement at 72 h to be the best predictor of 90 day mortality and rehospitalization.
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Affiliation(s)
- Hans-Dirk Düngen
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Verena Tscholl
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Danilo Obradovic
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Sara Radenovic
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Dragan Matic
- Emergency Department, Clinic for Cardiology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Lindy Musial Bright
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany
| | - Elvis Tahirovic
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | | | - Simone Inkrot
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,Department of Cardiology, Waikato Hospital, Hamilton, New Zealand
| | - Djawid Hashemi
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Jovan Veskovic
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | | | - Stephan von Haehling
- Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany.,Division of Innovative Trials, University Medical Center Göttingen, Göttingen, Germany
| | - Wolfram Doehner
- Center for Stroke Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Natasa Cvetinovic
- Department of Cardiology, Clinical Hospital Zvezdara, Belgrade, Serbia
| | - Mitja Lainscak
- Department of Cardiology, General Hospital Celje, Celje, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Burkert Pieske
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Frank Edelmann
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Tobias Trippel
- Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow Klinikum, Medizinische Klinik m. S. Kardiologie, Augustenburger Platz 1, D-13353, Berlin, Germany.,German Centre for Cardiovascular Research DZHK, Partner Site Berlin, Berlin, Germany
| | - Goran Loncar
- Department of Cardiology, Clinical Hospital Zvezdara, Belgrade, Serbia.,School of Medicine, University of Belgrade, Belgrade, Serbia
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Yalta K. Copeptin and its clinical implications in the setting of vasovagal syncope. Int J Cardiol 2017; 242:28. [DOI: 10.1016/j.ijcard.2017.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 10/19/2022]
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Abstract
Copeptin is derived from the cleavage of the precursor of arginine vasopressin (AVP), produced in an equimolar ratio in hypothalamus and processed during axonal transport AVP is an unstable peptide and has a short half-life of 5-20 min. Unlike AVP, copeptin is a stable molecule and can easily be measured. Recent evidence suggest that increased copeptin levels have been associated with worse outcomes in various clinical conditions including chronic kidney disease (CKD) and hypertension. In this review, the data regarding copeptin with kidney function (evaluated as glomerular filtration rate, increased albumin/protein excretion or both) and hypertension with regard to performed studies, prognosis and pathogenesis was summarised.
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Effect of increased water intake on plasma copeptin in healthy adults. Eur J Nutr 2017; 57:1883-1890. [PMID: 28578535 PMCID: PMC6060834 DOI: 10.1007/s00394-017-1471-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 05/06/2017] [Indexed: 01/12/2023]
Abstract
PURPOSE Inter-individual variation in median plasma copeptin is associated with incident type 2 diabetes mellitus, progression of chronic kidney disease, and cardiovascular events. In this study, we examined whether 24-h urine osmolality was associated with plasma copeptin and whether increasing daily water intake could impact circulating plasma copeptin. METHODS This trial was a prospective study conducted at a single investigating center. Eighty-two healthy adults (age 23.6 ± 2.9 years, BMI 22.2 ± 1.5 kg/m2, 50% female) were stratified based upon habitual daily fluid intake volumes: arm A (50-80% of EFSA dietary reference values), arm B (81-120%), and arm C (121-200%). Following a baseline visit, arms A and B increased their water intake to match arm C for a period of 6 consecutive weeks. RESULTS At baseline, plasma copeptin was positively and significantly associated with 24-h urine osmolality (p = 0.002) and 24-h urine specific gravity (p = 0.003) but not with plasma osmolality (p = 0.18), 24-h urine creatinine (p = 0.09), and total fluid intake (p = 0.52). Over the 6-week follow-up, copeptin decreased significantly from 5.18 (3.3;7.4) to 3.90 (2.7;5.7) pmol/L (p = 0.012), while urine osmolality and urine specific gravity decreased from 591 ± 206 to 364 ± 117 mOsm/kg (p < 0.001) and from 1.016 ± 0.005 to 1.010 ± 0.004 (p < 0.001), respectively. CONCLUSIONS At baseline, circulating levels of copeptin were positively associated with 24-h urine concentration in healthy young subjects with various fluid intakes. Moreover, this study shows, for the first time, that increased water intake over 6 weeks results in an attenuation of circulating copeptin. CLINICAL TRIAL REGISTRATION NUMBER NCT02044679.
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Niizuma S, Iwanaga Y, Yahata T, Miyazaki S. Renocardiovascular Biomarkers: from the Perspective of Managing Chronic Kidney Disease and Cardiovascular Disease. Front Cardiovasc Med 2017; 4:10. [PMID: 28321399 PMCID: PMC5337832 DOI: 10.3389/fcvm.2017.00010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Accepted: 02/16/2017] [Indexed: 12/17/2022] Open
Abstract
Mortality among the patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) remains high because of the very high incidence of cardiovascular disease (CVD) such as coronary artery disease, cardiac hypertrophy, and heart failure. Identifying CVD in patients with CKD/ESRD remains a significant hurdle and the early diagnosis and therapy for CVD is crucial in these patients. Therefore, it is necessary for the better management to identify and utilize cardiovascular (CV) biomarkers in profiling CVD risk and enabling stratification of early mortality. This review summarizes current evidence about renocardiovascular biomarkers: CV biomarkers in patients with CKD as well as with ESRD, emphasizing on the emerging biomarkers: B-type natriuretic peptide, cardiac troponins, copeptin, the biomarker of renal injury (neutrophil gelatinase-associated lipocalin), and the mineral and bone disorder hormone/marker (fibroblast growth factor-23). Furthermore, it discusses their potential roles especially in ESRD and in future diagnostic and therapeutic strategies for CVD in the context of managing cardiorenal syndrome.
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Affiliation(s)
| | - Yoshitaka Iwanaga
- Division of Cardiology, Kindai University Faculty of Medicine , Osakasayama , Japan
| | - Takaharu Yahata
- Department of Cardiology, Yokohama Chuo Hospital , Yokohama , Japan
| | - Shunichi Miyazaki
- Division of Cardiology, Kindai University Faculty of Medicine , Osakasayama , Japan
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Flevari P, Leftheriotis D, Kroupis C, Antonakos G, Lekakis J, Dima K. Copeptin levels in patients with vasovagal syncope. Int J Cardiol 2017; 230:642-645. [DOI: 10.1016/j.ijcard.2017.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Revised: 12/31/2016] [Accepted: 01/03/2017] [Indexed: 12/25/2022]
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Zhang R, Liu J, Zhang Y, Liu Q, Li T, Cheng L. Association Between Circulating Copeptin Level and Mortality Risk in Patients with Intracerebral Hemorrhage: a Systemic Review and Meta-Analysis. Mol Neurobiol 2017; 54:169-174. [PMID: 26732599 DOI: 10.1007/s12035-015-9626-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 12/08/2015] [Indexed: 10/25/2022]
Abstract
Copeptin has been identified as a biomarker of disease severity and is associated with mortality risk in several common diseases. This study sought to determine the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. PubMed, Web of Science, and Wanfang Medicine Database were searched for studies assessing the association between circulating copeptin level and mortality risk in patients with intracerebral hemorrhage. The pooled hazard ratio (HR) of mortality was calculated and presented with 95 % confidence interval (95 % CI). Data from 1332 intracerebral hemorrhage patients were derived from 9 studies. Meta-analysis showed that intracerebral hemorrhage patients with poor prognosis had much higher copeptin levels than those survivors (standardized mean difference = 1.68, 95 % CI 1.26-2.11, P < 0.00001). Meta-analysis of 8 studies with HRs showed that high circulating copeptin level was associated with higher risk of mortality in patients with intracerebral hemorrhage (HR = 2.42, 95 % CI 1.60-3.65, P < 0.0001). Meta-analysis of 6 studies with adjusted HRs showed that high circulating copeptin level was independently associated with higher risk of mortality in patients with intracerebral hemorrhage (HR = 1.67, 95 % CI 1.26-2.22, P = 0.0003). Our study suggests that there is an obvious association between circulating copeptin level and mortality in patients with intracerebral hemorrhage. High circulating copeptin level is independently associated with higher risk of mortality in patients with intracerebral hemorrhage.
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Affiliation(s)
- Ruoyu Zhang
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China.
| | - Jin Liu
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Ying Zhang
- Neuroscience Care Unit, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Qiang Liu
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Tianlang Li
- Department of Geriatrics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, People's Republic of China
| | - Lei Cheng
- Department of Neurosurgery, The Affiliated Hospital of Shandong University, Jinan, 250019, China
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Frøssing S, Nylander M, Aziz M, Skouby SO, Kistorp C, Faber J. Atrial natriuretic peptide, copeptin and adrenomedullin levels in polycystic ovary syndrome: a case-control study. Gynecol Endocrinol 2017; 33:30-33. [PMID: 27424881 DOI: 10.1080/09513590.2016.1202915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) defined by the Rotterdam criteria does not take into account the unhealthy metabolic profile of the syndrome with increased insulin resistance (IR) and overweight favoring development of type 2 diabetes, hypertension and cardiovascular disease (CVD). We assess three vasoactive peptides associated with CVD in women with PCOS. METHOD Plasma levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin and mid-regional pro-adrenomedullin (MR-proADM) were measured in 98 PCOS patients and 46 age- and BMI-matched healthy women. RESULTS We found no difference in levels of MR-proANP, copeptin and MR-proADM between the PCOS and control group. Multiple regression analyses on a combined group of PCOS and control subjects demonstrated an inverse correlation between MR-proANP and IR (measured by fasting C-peptide) and a positive correlations between copeptin and IR as well as MR-proADM and BMI. We found no association between peptide levels and different Rotterdam phenotypes. CONCLUSION Plasma concentrations of MR-proANP, copeptin and MR-proADM were not increased in PCOS compared to age- and BMI-matched controls. Thus, these peptides cannot be used to detect increased risk of CVD in a young PCOS cohort.
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Affiliation(s)
- Signe Frøssing
- a Department of Internal Medicine , Division of Endocrinology , and
| | - Malin Nylander
- b Department of Gynecology and Obstetrics , Herlev University Hospital , Copenhagen , Denmark , and
- c Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Mubeena Aziz
- b Department of Gynecology and Obstetrics , Herlev University Hospital , Copenhagen , Denmark , and
| | - Sven O Skouby
- b Department of Gynecology and Obstetrics , Herlev University Hospital , Copenhagen , Denmark , and
- c Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Caroline Kistorp
- a Department of Internal Medicine , Division of Endocrinology , and
- c Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Jens Faber
- a Department of Internal Medicine , Division of Endocrinology , and
- c Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
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Rothermel J, Kulle A, Holterhus PM, Toschke C, Lass N, Reinehr T. Copeptin in obese children and adolescents: relationships to body mass index, cortisol and gender. Clin Endocrinol (Oxf) 2016; 85:868-873. [PMID: 27624976 DOI: 10.1111/cen.13235] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 08/22/2016] [Accepted: 09/09/2016] [Indexed: 01/29/2023]
Abstract
OBJECTIVE Copeptin has been reported to be associated with stress, obesity and the metabolic syndrome (MetS) in adults. However, data in childhood are scarce. Therefore, we studied the relationships between copeptin, cortisol, puberty and parameters of the MetS in children. DESIGN Cross-sectional study. PATIENTS A total of 51 obese children (10·8 ± 3·2 years, 39% male, 45% prepubertal, body mass index standard deviation score (BMI-SDS) 2·77 ± 0·56) and 24 lean children of similar age, gender and pubertal stage. MEASUREMENTS Copeptin, serum cortisol, 24-h urinary free cortisol, BMI-SDS and, as parameters of the MetS, insulin resistance index (HOMA), HbA1c, uric acids, blood pressure and lipids. RESULTS Copeptin levels were significantly (P = 0·047) higher in obese children (5·8 ± 2·8pmol/l) compared to lean children (4·6 ± 2·2pmol/l). BMI-SDS (β-coefficient 0·38 ± 0·35, P =0·033), but not any parameter of the MetS, was significantly related to copeptin in multiple linear regression analyses adjusted for age, gender and pubertal stage. A 24-h urinary free cortisol (β-coefficient 0·13 ± 0·06, P < 0·001), but not serum cortisol, was significantly related to copeptin in multiple linear regression analyses adjusted for age, gender, pubertal stage and BMI-SDS. Pubertal boys (6·6 ± 2·8pmol/l) demonstrated significantly (P = 0·042) higher copeptin levels compared to pubertal girls (4·8 ± 2·6pmol/l), while copeptin concentrations did not differ between prepubertal girls and boys. CONCLUSIONS Copeptin levels are related to 24-h urinary free cortisol in obese children. Pubertal boys, but not prepubertal boys, demonstrated higher copeptin levels than girls, suggesting that sex hormones are involved in the regulation of copeptin levels. Further studies are necessary to understand the relationship between obesity, cortisol, gender, pubertal stage and copeptin levels.
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Affiliation(s)
- Juliane Rothermel
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Alexandra Kulle
- Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig Holstein, UKSH, Campus Kiel/Christian-Albrechts-University, CAU, Kiel, Germany
| | - Paul-Martin Holterhus
- Division of Pediatric Endocrinology and Diabetes, University Hospital of Schleswig Holstein, UKSH, Campus Kiel/Christian-Albrechts-University, CAU, Kiel, Germany
| | - Christina Toschke
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Nina Lass
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Thomas Reinehr
- Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
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Asociación de valores elevados de péptido natriurético auricular y copeptina con riesgo de mortalidad. An Pediatr (Barc) 2016; 85:284-290. [DOI: 10.1016/j.anpedi.2016.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 02/02/2016] [Accepted: 02/03/2016] [Indexed: 11/22/2022] Open
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Rey C, García-Cendón C, Martínez-Camblor P, López-Herce J, Concha-Torre A, Medina A, Vivanco-Allende A, Mayordomo-Colunga J. High levels of atrial natriuretic peptide and copeptin and mortality risk. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpede.2016.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Schiel R, Perenthaler TJ, Steveling A, Stein G. Plasma copeptin in children and adolescents with type 1 diabetes mellitus in comparison to healthy controls. Diabetes Res Clin Pract 2016; 118:156-61. [PMID: 27371782 DOI: 10.1016/j.diabres.2016.06.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/25/2016] [Accepted: 06/05/2016] [Indexed: 12/12/2022]
Abstract
UNLABELLED In a cohort of children and adolescents with type 1 diabetes mellitus the trial tested the hypothesis that copeptin levels are associated with kidney function, biometrical data and quality of diabetes control. PATIENTS AND METHODS A total of 141 subjects were recruited to participate in the trial: 80 patients with type 1 diabetes (13.0±3.4years, HbA1c 7.85±1.42%) and 61 healthy controls (12.4±2.8years). Clinical and socio-economic data were assessed. A sandwich immunoassay (B.R.A.H.M.S. GmbH/Thermo Fisher Scientific, Hennigsdorf/Berlin, Germany) was used for measuring plasma copeptin levels. RESULTS The mean concentration of copeptin in the diabetic patients was 4.75±3.46pmol/l. There was a strong inverse correlation between copeptin and GFR (r=-0.86, p=0.021), as well as with total cholesterol (r=-0.23, p=0.041), LDL-cholesterol (r=-0.24, p=0.036), but not with serum creatinine, albuminuria, HbA1c, blood glucose, MAGE, CRP, systolic or diastolic blood pressure or age, diabetes duration, weight, height and BMI. Comparing patients with a diabetes duration of ⩾7years (n=45) with those with a diabetes duration <7years (n=35), patients with a longer duration of diabetes had higher copeptin levels (5.24±2.26 vs 4.13±2.86, p=0.045). Performing multivariate analyses only GFR could be identified as a parameter associated with copeptin (R-square=0.05, β=-0.23, p=0.032). In the healthy controls mean copeptin concentration was 5.56±3.15pmol/l. The copeptin concentration and GFR were inversely correlated as well (r=-0.61, p=0.034). However, other correlation and multivariate analyses revealed no further significant results. Comparing patients with type 1 diabetes mellitus with the healthy controls, the diabetes patients revealed no significant difference with respect to copeptin (p=0.24), serum creatinine (49.8±11.9 vs 50.4±11.0μmol/l, p=0.53) or GFR (102.4±23.3 vs 104.5±19.1ml/min, p=0.47). On the other hand, patients with type 1 diabetes had lower concentrations of CRP (1.66±3.91 vs 3.21±3.04μg/ml, p=0,013), triglycerides (0.88±0.53 vs 1.13±0.60mmol/l, p=0.010), and a lower ratio of LDL-/HLD-cholesterol (1.73±0.69 vs 2.32±0.80, p<0.001), as well as lower body weight (51.3±18.0 vs 60.3±15.7kg, p=0.002) and BMI (19.7±3.8 vs 23.2±2.9kg/m(2), p<0.001). In contrast to the controls, the diabetes patients had higher blood glucose levels at the time of examination (8.2±3.8 vs 4.7±0.5mmol/l, p<0.001), higher HDL-cholesterol levels (1.59±0.34 vs 1.26±0.24mmol/l, p<0.001), as well as higher education and higher educational levels of the mothers. CONCLUSIONS The present trial revealed a clear association between GFR and copeptin in children and adolescents with type 1 diabetes mellitus. Hence, copeptin can be considered as a marker of renal function.
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Affiliation(s)
- Ralf Schiel
- MEDIGREIF-Inselklinik Heringsdorf GmbH, Department of Diabetes and Metabolic Diseases, Ostseebad Heringsdorf, Germany.
| | - Thomas Johannes Perenthaler
- MEDIGREIF-Inselklinik Heringsdorf GmbH, Department of Diabetes and Metabolic Diseases, Ostseebad Heringsdorf, Germany
| | - Antje Steveling
- Ernst-Moritz-Arndt-University, School of Medicine, Internal Medicine A, Greifswald, Germany
| | - Günter Stein
- Friedrich-Schiller-University, School of Medicine, Internal Medicine, Nephrology, Jena, Germany
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Sontrop JM, Huang SH, Garg AX, Moist L, House AA, Gallo K, Clark WF. Effect of increased water intake on plasma copeptin in patients with chronic kidney disease: results from a pilot randomised controlled trial. BMJ Open 2015; 5:e008634. [PMID: 26603245 PMCID: PMC4663439 DOI: 10.1136/bmjopen-2015-008634] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Increased water intake may have a beneficial effect on the kidney through suppression of plasma vasopressin. We examined the effect of increased water intake on plasma copeptin (a marker of vasopressin) over 6 weeks in patients with chronic kidney disease. DESIGN Secondary analysis of a randomised controlled parallel-group pilot trial. SETTING Canada, 2012-2013. PARTICIPANTS 28 patients with stage 3 chronic kidney disease randomised (2:1) to a hydration (n=17) or control group (n=11). INTERVENTION The hydration group was coached to increase water intake by up to 1.5 L/day for 6 weeks. The control group was asked to maintain regular water intake. MEASURES AND OUTCOMES Participants provided blood and 24 h urine samples at baseline and 6 weeks. Change in plasma copeptin was compared within and between study groups. RESULTS Participants were 64% male with a mean age of 62 years and an estimated glomerular filtration rate of 40 mL/min/1.73 m(2). Between baseline and 6 weeks, 24 h urine volume increased by 0.7 L/day in the hydration group, rising from 2.3 to 3.0 L/day (p=0.01), while decreasing by 0.3 L/day among controls, from 2.0 to 1.7 L/day (p=0.07); between-group difference: 0.9 L/day (95% CI 0.37 to 1.46; p=0.002). In the hydration group, median copeptin decreased by 3.6 pmol/L, from 15.0 to 10.8 pmol/L (p=0.005), while remaining stable among controls at 19 pmol/L (p=0.76; p=0.19 for the between-group difference in median change); the between-group difference in mean change was 5.4 pmol/L (95% CI -1.2 to 12.0; p=0.11). CONCLUSIONS Adults with stage 3 chronic kidney disease can be successfully randomised to drink approximately 1 L more per day than controls. This increased water intake caused a significant decrease in plasma copeptin concentration. Our larger 12-month trial will examine whether increased water intake can slow renal decline in patients with chronic kidney disease. TRIAL REGISTRATION NUMBER NCT01753466.
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Affiliation(s)
- Jessica M Sontrop
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Shi-Han Huang
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Amit X Garg
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Louise Moist
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, Western University, London, Ontario, Canada
| | - Andrew A House
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - Kerri Gallo
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
| | - William F Clark
- Division of Nephrology, Department of Medicine, London Health Sciences Centre, London, Ontario, Canada
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Greisenegger S, Segal HC, Burgess AI, Poole DL, Mehta Z, Rothwell PM. Copeptin and Long-Term Risk of Recurrent Vascular Events After Transient Ischemic Attack and Ischemic Stroke: Population-Based Study. Stroke 2015; 46:3117-23. [PMID: 26451023 DOI: 10.1161/strokeaha.115.011021] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 09/15/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Copeptin, the c-terminal portion of provasopressin, is a useful prognostic marker in patients after myocardial infarction and heart failure. More recently, high levels of copeptin have also been associated with worse functional outcome and increased mortality within the first year after ischemic stroke and transient ischemic attack (TIA). However, to date, there are no published data on whether copeptin predicts long-term risk of vascular events after TIA and stroke. METHODS We measured copeptin levels in consecutive patients with TIA or ischemic stroke in a population-based study (Oxford Vascular Study) recruited from 2002 to 2007 and followed up to 2014. Associations with risk of recurrent vascular events were determined by Cox-regression. RESULTS During ≈6000 patient-years in 1076 patients, there were 357 recurrent vascular events, including 174 ischemic strokes. After adjustment for age, sex, and risk factors, copeptin was predictive of recurrent vascular events (adjusted hazard ratio per SD, 1.47; 95% confidence interval, 1.31-1.64; P=0.0001), vascular death (1.85; 1.60-2.14; P<0.0001), all-cause death (1.75; 1.58-1.93; P<0.0001), and recurrent ischemic stroke (1.22; 1.04-1.44; P=0.017); and improved model-discrimination significantly: net reclassification improvement for recurrent vascular events (32%; P<0.0001), vascular death (55%; P<0.0001), death (66%; P<0.0001), and recurrent stroke (16%; P=0.044). The predictive value of copeptin was largest in patients with cardioembolic index events (adjusted hazard ratio, 1.84; 95% confidence interval, 1.53-2.20 versus 1.31, 1.14-1.50 in noncardioembolic stroke; P=0.0025). In patients with cardioembolic stroke, high copeptin levels were associated with a 4-fold increased risk of vascular events within the first year of follow-up (adjusted hazard ratio, 4.02; 95% confidence interval, 2.13-7.70). CONCLUSIONS In patients with TIA and ischemic stroke, copeptin predicted recurrent vascular events and death, particularly after cardioembolic TIA/stroke. Further validation is required, in particular, in studies using more extensive cardiac evaluation.
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Affiliation(s)
- Stefan Greisenegger
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.)
| | - Helen C Segal
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.)
| | - Annette I Burgess
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.)
| | - Debbie L Poole
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.)
| | - Ziyah Mehta
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.)
| | - Peter M Rothwell
- From the Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neuroscience, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom (S.G., H.C.S., A.I.B., D.L.P., Z.M., .M.R.); and Department of Neurology, Medical University of Vienna, Vienna, Austria (S.G.).
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Wannamethee SG, Welsh P, Papacosta O, Lennon L, Whincup PH, Sattar N. Copeptin, Insulin Resistance, and Risk of Incident Diabetes in Older Men. J Clin Endocrinol Metab 2015; 100:3332-9. [PMID: 26158609 PMCID: PMC4570154 DOI: 10.1210/jc.2015-2362] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Prior studies suggested a role for the arginine vasopressin (AVP) system in the pathogenesis of diabetes. Prospective studies on the association between copeptin (the C-terminal fragment of AVP hormone) and incident diabetes are limited. OBJECTIVE We have examined the association between plasma copeptin and the risk of incident diabetes in older men. DESIGN The British Regional Heart Study was a prospective study with an average of 13 years follow-up. SETTING General practices in the United Kingdom were studied. PARTICIPANTS Participants were 3226 men aged 60 to 79 years with no prevalent diabetes. OUTCOME We measured 253 patients with incident diabetes. RESULTS Copeptin was positively and significantly associated with renal dysfunction, insulin resistance (homeostasis model assessment of insulin resistance), metabolic risk factors (waist circumference, blood pressure, triglycerides, and liver function), C-reactive protein, tissue plasminogen activator, and von Willebrand factor (endothelial dysfunction) but not with plasma glucose. The risk of incident diabetes was significantly elevated only in men in the top fifth of the copeptin distribution (>6.79 pmol/L), and this risk persisted after adjustment for several diabetes risk factors including metabolic risk factors and C-reactive protein (adjusted hazard ratio in the top fifth vs the rest = 1.78 [95% confidence interval, 1.34-2.37]). Risk was markedly attenuated although it remained significant after further adjustment for homeostasis model assessment of insulin resistance and plasma glucose (adjusted hazard ratio = 1.47 [1.11-1.97]). The increased risk was seen even when the analysis was restricted to men with no chronic kidney disease or to men with no impaired fasting glucose (<6.1 mmol/L). CONCLUSION Copeptin is associated with a significantly increased risk of diabetes in older men. The association is partly mediated through lower insulin sensitivity. The findings suggest a potential role of the AVP system in diabetes.
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Affiliation(s)
- S Goya Wannamethee
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
| | - Paul Welsh
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
| | - Olia Papacosta
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
| | - Lucy Lennon
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
| | - Peter H Whincup
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
| | - Naveed Sattar
- Department of Primary Care and Population Health (S.G.W., O.P., L.L.), University College Medical School, Royal Free Campus, London NW3 2PF, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre (P.W., N.S.), Faculty of Medicine, University of Glasgow, G12 8TA Glasgow, United Kingdom; and Department of Community Health Sciences (P.H.W.), St George's, University of London SW17 ORE, London, United Kingdom
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Łukaszyk E, Małyszko J. Copeptin: Pathophysiology and potential clinical impact. Adv Med Sci 2015; 60:335-41. [PMID: 26233637 DOI: 10.1016/j.advms.2015.07.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 06/29/2015] [Accepted: 07/02/2015] [Indexed: 12/24/2022]
Abstract
Copeptin, a C-terminal part of the precursor pre-provasopressin is a novel biomarker of arginine-vasopressin (AVP) system. Measurements of AVP concentration are not used in clinical practice because of technical difficulties. Copeptin is synthesized in stoichiometric ratio with AVP, hence it reflects vasopressin concentration in human plasma and serum. This review outlines current research concerning the role of copeptin as a prognostic marker in different diseases and its potential clinical value.
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