Higher copeptin levels are associated with worse outcome in patients with hypertrophic cardiomyopathy

Abstract

Background Correlation of increased copeptin levels with various cardiovascular diseases has been described. The clinical use of copeptin levels in patients with hypertrophic cardiomyopathy (HCM) has not been investigated before. Hypothesis In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM). Methods HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N‐terminal probrain natriuretic peptide (NT‐proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age‐ and sex‐matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fasting. Patients were followed for 24 months. Hospitalization with diagnosis of heart failure/arrhythmia, implantable cardioverter‐defibrillator implantation, and cardiac mortality were accepted as adverse cardiac events. Results Copeptin and NT‐proBNP levels were higher in the HCM group compared with controls (14.1 vs 8.4 pmol/L, P < 0.01; and 383 vs 44 pg/mL, P < 0.01, respectively). Copeptin and NT‐proBNP levels were higher in the obstructive HCM subgroup compared with the nonobstructive HCM subgroup (18.3 vs 13.1 pmol/L, P < 0.01; and 717 vs 223 pg/mL, P < 0.01, respectively). In multivariable logistic regression analysis, copeptin and NT‐proBNP levels remained as independent predictors of heart failure (P < 0.01 for both) and adverse cardiac events (P < 0.01 for both). Conclusions Copeptin and NT‐proBNP levels were significantly higher in patients with obstructive HCM, and higher levels were associated with worse outcome.

The role of oxytocin and vasopressin in the pathophysiology of heart failure in pregnancy and in fetal and neonatal life

“…Clinical and experimental studies provide evidence that cardiovascular diseases have a significant impact on the function of the central and peripheral VPS and OTS. In patients with hypertension and heart failure, blood AVP and/or copeptin concentrations are elevated (5, 44,60,109,150,157,164). The release of AVP is promoted by the unloading of the cardiopulmonary receptors and hypoxia.…”

Up-to-date clinical approaches of biomarkers’ use in heart failure

“…Unfortunately, there are large body of evidence regarding that the level of copeptin might relate closely to some metabolic abnormalities including hyperglycemia that sufficiently limits the predictive power of the biomarker in serial measurements especially in patients with diabetes mellitus and abdominal obesity (Savic-Radojevic et al, 2017). However, the improvement of diagnostic reliability of copeptin may achieve by means use of combined biomarker strategy, in particular it might be based on copeptin and NPs Sahin et al, 2016;Smaradottir et al, 2017). Finally, circulating level of copeptin has now recognized a promising biomarker with better discriminative value for both all-cause mortality and HF-related outcomes general population and individuals with established CV disease.…”

Novel Biomarkers in Prediction of Heart Failure Related Outcomes: From Bench to Bedside

“…Unfortunately, there are large body of evidence regarding that the level of copeptin might relate closely to some metabolic abnormalities including hyperglycemia that sufficiently limits the predictive power of the biomarker in serial measurements especially in patients with diabetes and obesity [17,19]. However, the improvement of diagnostic reliability of copeptin may achieve by means use of combined biomarker strategy, in particular it might be based on copeptin and natriuretic peptides (N-terminal pro-brain natriuretic peptide, mid-regional pro-atrial natriuretic peptide) [20,21]. Finally, circulating level of copeptin is now recognized a promising biomarker with better discriminative value for both allcause mortality and HF-related outcomes general population and individuals with established CV disease.…”