Copeptin constitutes a novel biomarker of degenerative aortic stenosis

Abstract

Copeptin is a new biomarker of cardiovascular diseases. Its diagnostic value in degenerative aortic valve stenosis (AS) with preserved left ventricle systolic function is unknown. We aimed to assess the association of serum copeptin levels with AS severity and coexistence of coronary artery disease (CAD). Sixty-four patients with AS and preserved left ventricle systolic function including 40 with severe degenerative AS (group sAS, effective orifice area EOA = 0.67 cm(2)) and 24 with moderate degenerative AS (group mAS, EOA = 1.40 cm(2)) were enrolled into the study. Twenty-three patients without AS and heart failure, matched for age, sex, and CAD occurrence served as the control group (group C). Serum levels of copeptin and N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using enzyme-linked immunosorbent assay. The mean serum copeptin concentrations were significantly higher in patients with AS: sAS (405 pg/ml) and mAS (351 pg/ml; sAS vs mAS P< 0.05), compared with group C (302 pg/ml, P < 0.05). Serum copeptin levels correlated inversely with EOA (r = -0.55; P < 0.001) in AS patients. There was no correlation between copeptin and NT-proBNP or association with the coexisting CAD. Receiver-operating characteristics analysis showed that copeptin was a good marker of severe/moderate AS (sensitivity 71 %; specificity 87 %), with the optimized cut-off value of 354 pg/ml. Serum copeptin concentration constitutes a novel biomarker of degenerative AS. Coexisting CAD does not interfere with copeptin level.

Prosthesis-patient mismatch and left ventricle systolic strain in patients with severe degenerative aortic stenosis, who are undergoing surgical valve replacement

“…The standard techniques as described previously [11] were used to assess the LV geometry and function.…”

“…Peak early diastolic (E') mitral annular velocities were measured at the lateral side of the mitral annulus using pulsed wave tissue Doppler imaging. The E/E' ratio was calculated [11].…”

Copeptin in heart failure

“…31 The importance of copeptin was documented in severe aortic stenosis, with preserved left ventricular systolic function regardless of the copresence of coronary artery disease. 32 The importance of AVP has also been described in cardiovascular shock states. 15,33,34 It should be noted that the significance of the role of the concentration of copeptin has also been observed in other diseases that worsen the prognosis of cardiovascular events, namely: chronic obstructive pulmonary disease; 35 40 and the prediction of mortality after injury of the central nervous system.…”

“…32 Although both markers grew along with the progression of the disease, there was no correlation between serum concentrations of copeptin and NT-proBNP. It seems, therefore, that the two biomarkers may reflect the potentially different pathomechanisms of the disease.…”

Copeptin in Severe Mitral Regurgitation Caused by Degenerative Mitral Disease

“…Copeptin has been shown to be increased in cardiovascular diseases, especially in acute coronary syndromes and CHF. Copeptin is also associated with ventricular remodeling because of changes in LV ejection fraction (LVEF) and volumes (6) . It was found to be the strongest predictor of mortality especially in patients NYHA classes II and III (1,2,4,7) .…”