Plasma copeptin levels in children with pulmonary arterial hypertension associated with congenital heart disease

Gaheen, Reem; Amrousy, Doaa El; Hodeib, Hossam; Elnemr, Shimaa

doi:10.1007/s00431-021-04060-9

Cited by 9 publications

(9 citation statements)

References 30 publications

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“…Hypovolemia and low blood pressure are detected by vascular volume- and baroreceptors and drive AVP and copeptin release in the posterior pituitary gland [ 43 , 44 ]. In the present study, the median copeptin concentration in all patients (hypotensive and normotensive) was calculated with a median of 47 pmol/L, five-fold higher compared to the published normal values in healthy children (<10 pmol/L) [ 27 , 39 , 40 , 41 ]. The median copeptin concentrations remained elevated in all patients over 168 h, a finding that mirrors increased AVP and copeptin values measured over 120 h in pediatric septic shock patients by Lee et al [ 24 ].…”

Section: Discussionmentioning

confidence: 66%

“…First, there is no internationally valid normal value for blood copeptin concentrations for children or adults. Using published studies, including healthy controls, we arbitrarily set the cut-off for normal blood copeptin at 10 pmol/L [ 27 , 39 , 40 , 41 ]. It may well be that this value was set too low and that the baseline copeptin concentration for children admitted to the intensive care unit is generally higher.…”

Section: Discussionmentioning

confidence: 99%

“…In adults, it has been shown to predict adverse outcomes in ischemic [ 45 ] and hemorrhagic stroke [ 46 ], heart failure [ 47 ], community-acquired pneumonia [ 48 ], COVID-19 [ 49 ] and many more [ 50 , 51 , 52 ]. In children, copeptin predicted an adverse outcome in community-acquired pneumonia [ 25 , 26 ], congenital heart disease and pulmonary arterial hypertension [ 27 ], perinatal asphyxia [ 28 ], traumatic brain injury [ 31 ] and severity of disease, as well as mortality, in PICU [ 53 ]. In the present study, high copeptin levels were associated with the length of ICU stay, length of mechanical ventilation, dose of vasoactive and inotropic support, additional fluids exceeding 100 mL/kg/d, PIM II Score and steroid administration in univariate analysis, while only vasoactive support remained significant in the adjusted (multivariate) analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Further, there is a growing body of literature for the association of plasma copeptin with severity of disease and adverse outcome in both adults and children. It has been shown that non-favorable outcomes could be predicted in a variety of pediatric pathologies, such as community-acquired pneumonia [ 25 , 26 ], congenital heart disease with pulmonary hypertension [ 27 ] or perinatal asphyxia [ 28 ]. However, longitudinal data on pediatric patients in intensive care settings are still sparse [ 26 , 29 , 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

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Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

et al. 2022

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Low copeptin levels may indicate inadequate arginine-vasopressin release promoting arterial hypotension, whereas high copeptin concentrations may reflect disease severity. This single-center prospective non-randomized clinical trial analyzed the course of blood copeptin in critically ill normo- and hypotensive children and its association with disease severity. In 164 patients (median age 0.5 years (interquartile range 0.1, 2.9)), the mean copeptin concentration at baseline was 43.5 pmol/L. Though not significantly different after 61 h (primary outcome, mean individual change: −12%, p = 0.36, paired t-test), we detected 1.47-fold higher copeptin concentrations during arterial hypotension when compared to normotension (mixed-effect ANOVA, p = 0.01). In total, 8 out of 34 patients (23.5%) with low copeptin concentrations <10 pmol/L were hypotensive. Copeptin was highest in the adjusted mixed-effect regression analysis within the first day (+20% at 14 h) and decreased significantly at 108 h (−27%) compared to baseline (p = 0.002). Moreover, we found a significant association with vasopressor-inotrope treatment intensity, infancy (1–12 months) and cardiopulmonary bypass (all p ≤ 0.001). In conclusion, high copeptin values were associated with arterial hypotension and severity of disease in critically ill children. This study does not support the hypothesis that low copeptin values might be indicative of arginine-vasopressin deficiency.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

et al. 2022

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“…Congenital heart disease (CHD) accounts for nearly one- third of all major congenital anomalies [ 1 ]. Pulmonary hypertension (PH) is a hemodynamic and pathophysiological disorder that defined as an increase in mean pulmonary arterial pressure (mPAP) ≥ 20 mmHg at rest as assessed by right heart catheterization [ 2 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet Activation Markers in Children with Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

et al. 2022

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The study aimed to evaluate mean platelet volume (MPV), platelet distribution width (PDW), and platecrit in children with pulmonary arterial hypertension associated with congenital heart disease (PAH-CHD), to assess the predictive value of these platelet activation markers for adverse outcomes, and to correlate their levels with various data in these patients. This prospective cohort study included 60 children with PAH-CHD as group I and 60 children with CHD and no PAH as group II. Another 60 healthy children of matched age and sex served as the control group. All included children were evaluated by echocardiography. MPV, PDW, and platecrit were also measured using an automated blood counter. All patients were followed up for death or readmission for 6 months. MPV, PDW, and platecrit were significantly higher in group I compared to group II and the control group and they correlated well with increasing severity of PAH. MPV, PDW, and platecrit positively correlated with right ventricular diameter and mean pulmonary artery pressure, however they correlated negatively with right ventricular systolic and diastolic function. The best cut-off of platelet activation markers levels to predict poor prognosis in group I was > 11.2 FL with 75% sensitivity and 96.6% specificity for MPV, > 12.7 FL with 75% sensitivity and 61.5% specificity for PDW, and > 0.505% with 75% sensitivity and 93.2% specificity for platecrit. MPV, PDW, and platecrit were elevated in children with PAH-CHD and found to be good predictive markers for poor prognosis in these children.

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Predictive Value of Plasma Copeptin Level in Children with Acute Heart Failure

Amrousy

Nassar

2022

Pediatr Cardiol

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We investigated the ability of copeptin level to predict adverse outcome in pediatric heart failure (HF) and correlated copeptin level with various clinical and echocardiographic data. This cohort study was carried out on forty children with clinical picture of acute HF as the patient group and forty healthy children of matched age and sex as the control group. Echocardiographic examination and plasma copeptin level were performed for all included children at admission. Patients were followed up for 6 months for mortality or readmission. Plasma copeptin level was significantly higher in the patient group (16.2 ± 5) pmol/L compared to the control group (4.1 ± 2.3) pmol/L, P ˂0.001. Moreover, copeptin level was positively correlated with Ross classification, being the highest in patients with class IV (19.6 ± 3.9) pmol/L compared to those with class III (15.2 ± 4) pmol/L and class II (10.4 ± 1.5) pmol/L. Copeptin levels were significantly higher in patients with bad prognosis (21.2 ± 4.1) pmol/L compared to those with good prognosis (14.5 ± 4.1) pmol/L, P ˂0.001. Copeptin level had a significant positive correlation with age, heart rate, respiratory rate, and ROSS classification. On the contrary, copeptin level had a significant negative correlation with left ventricular fraction shortening and diastolic function. Copeptin at cut-off value of ≥ 19.5 pmol/L yielded a sensitivity of 75% and a specificity of 93% to predict adverse outcome in children with HF. Plasma copeptin level has a good prognostic value to predict adverse outcome in pediatric heart failure. Moreover, copeptin correlate well with the severity of pediatric HF.

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Plasma copeptin levels in children with pulmonary arterial hypertension associated with congenital heart disease

Cited by 9 publications

References 30 publications

Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

Copeptin Release in Arterial Hypotension and Its Association with Severity of Disease in Critically Ill Children

Platelet Activation Markers in Children with Pulmonary Arterial Hypertension Associated with Congenital Heart Disease

Predictive Value of Plasma Copeptin Level in Children with Acute Heart Failure

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