Prognostic Value of Emerging Neurohormones in Chronic Heart Failure during Optimization of Heart Failure–Specific Therapy

Neuhold, Stephanie; Huelsmann, M; Strunk, Guido; Struck, Joachim; Adlbrecht, Christopher; Gouya, Ghazaleh; Elhenicky, Marie; Pacher, Richard

doi:10.1373/clinchem.2009.125856

Cited by 48 publications

(37 citation statements)

References 32 publications

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“…29,30 In line with this, cortisol is associated with mortality in chronic heart failure patients, 31 and antagonists of the mineralocorticoid receptor lower the incidence of sudden cardiac death in patients with heart failure. 32,33 Although in patients with CHF, copeptin has been described to be a predictor of all-cause mortality and worsening of heart failure, 2,34,35 no association was found between copeptin and the risk of death caused by CHF in this analysis. Most likely, this is explained by the low incidence of events (n ϭ 40).…”

Section: Clinical Researchcontrasting

confidence: 55%

“…Patient characteristics according to quartiles of baseline copeptin ing copeptin, the N-terminal pro B-type natriuretic peptide (NT-pro-BNP) levels were increasing also, and treatment with diuretics became less frequent. Significant correlation coefficients were found for copeptin and time since start of maintenance hemodialysis treatment (correlation coefficient, 0.304; Figure 1A), NT-pro-BNP (0.265) ( Figure 1B 884751 ϫ log copeptin ϩ 1.277041 ϫ (log copeptin) 2 and log NT-pro-BNP ϭ 6.936637 Ϫ 0.003649 ϫ log copeptin ϩ 0.065427 ϫ (log copeptin) 2 . cause of the limited number of hemorrhagic strokes (n ϭ 13), no separate analysis was performed.…”

Section: Resultsmentioning

confidence: 99%

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Copeptin Levels Associate with Cardiovascular Events in Patients with ESRD and Type 2 Diabetes Mellitus

Fenske

Wanner

Allolio

et al. 2011

Journal of the American Society of Nephrology

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In ESRD, the neurohormone arginine vasopressin (AVP) may act primarily through V1a and V1b receptors, which promote vasoconstriction, myocardial hypertrophy, and release of adrenocorticotropic hormone. The preanalytical instability of AVP limits the investigation of whether this hormone associates with cardiovascular events, but the stable glycopeptide copeptin may serve as a surrogate because it is co-secreted with AVP from the posterior pituitary. Here, we studied whether copeptin predicts cardiovascular risk and mortality in ESRD. We measured copeptin at baseline in 1241 hemodialysis patients with type 2 diabetes participating in the German Diabetes and Dialysis Study. The median copeptin level was 81 pmol/L (interquartile range, 81 to 122 pmol/L). In Cox regression analyses, compared with patients with copeptin levels in the lowest quartile (Յ51 pmol/L), patients with copeptin levels in the highest quartile (Ͼ122 pmol/L) had a 3.5-fold increased risk for stroke (HR, 3.48; 95% CI: 1.71 to 7.09), a 73% higher risk for sudden death (HR, 1.73; 95% CI: 1.01 to 2.95), a 42% higher risk for combined cardiovascular events (HR, 1.42; 95% CI: 1.06 to 1.90), and a 48% higher risk for all-cause mortality (HR, 1.48; 95% CI: 1.15 to 1.90). In contrast, we did not detect significant associations between copeptin levels and risks for myocardial infarction or death caused by congestive heart failure. In conclusion, copeptin levels strongly associate with stroke, sudden death, combined cardiovascular events, and mortality in hemodialysis patients with type 2 diabetes. Whether vasopressin receptor antagonists will improve these outcomes requires further studies. 22: 782-790, 201122: 782-790, . doi: 10.1681 Arginine vasopressin (AVP) is a key neurohormone in the human body, with numerous important physiologic activities including regulation of BP, fluid volume, and serum osmolality. AVP acts via three G protein-coupled receptors, namely the V1a (vasoconstriction and myocardial hypertrophy), the V1b (release of adrenocorticotropic hormone), and the V2 receptor (water retention in the renal collecting duct). Despite its suggested importance in the pathogenesis of cardiovascular disorders, 1,2 the evaluation of AVP secretion is difficult because of its preanalytical instability. Copeptin, a 39-amino acid glycopeptide that comprises the Cterminal part of the AVP precursor, is co-secreted with AVP from the neurohypophysis and is a stable and sensitive surrogate marker for AVP release, making it much easier to measure. 3 Dialysis patients are at a very high risk of death (about 20% per year) 4 . Thus, the identification of new risk factors with the potential of applying inter- J Am Soc Nephrol

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Section: Clinical Researchcontrasting

confidence: 55%

Section: Resultsmentioning

confidence: 99%

Copeptin Levels Associate with Cardiovascular Events in Patients with ESRD and Type 2 Diabetes Mellitus

Fenske

Wanner

Allolio

et al. 2011

Journal of the American Society of Nephrology

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“…So, although the total cardiac function and exercise tolerance improved and serum concentrations of the assessed plasma biomarkers signifi cantly decreased there was a distinct diversity in biomarkers' predictive properties. In concordance with previous reports [16][17][18], baseline BNP level was a strong predictor of all-cause mortality but in contrast to them it was not prognostic of subsequent cardiovascular hospitalizations. Further, on-treatment changes in BNP had no role in prediction of mortality, hospitalizations, or therapeutic response to carvedilol.…”

Section: Discussionsupporting

confidence: 90%

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Nessler¹,

Nessler²,

Gołębiowska-Wiatrak³

et al. 2013

Cardiol J.

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Background:The role of infl ammatory and hemodynamic stress biomarkers in heart failure (HF) patients treated de novo with beta-blockers has been poorly studied. Methods: A total of 86 patients (age 56 ± 9 years, 81 men) with left ventricular ejection fraction (LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol. At baseline and 12 months later we performed echocardiography, cardiopulmonary exercise testing, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1), C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF -a). Patientswere followed up over a total period of 9 ± 3 years from baseline. Results: Increased baseline CRP and its on-treatment decrease were associated with improvement of LVEF (est. coeffi cient per one SD: 1.6; 95% CI : -0.05,3.28; p = 0.056, and -1.80; -3.43, -0.18; p = 0.030, respectively) (-6.83; -11.32; -2.34; p = 0.003, and 5.85; 1.23; -10.46; p = 0.014, respectively). Higher baseline ET-1 and on-treatment increase in TNF-a predicted frequent admissions (> 1) for cardiac complications (odds ratio per one SD: 1.98; p = 0.025, and 2.07, p = 0.021, respectively) (Cardiol J 2013; 20, 2: 144-151)

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“…ADM is elevated in cardiac failure proportionally to the severity of the disease assessed by NYHA class and to the degree of left ventricular impairment (9,12). ADM also has diagnostic and prognostic value alongside the natriuretic peptides in acute dyspnoea and in chronic heart failure (12)(13)(14)(15)(16)(17)(18)(19)(20), and in diastolic dysfunction (21). In post-AMI patients with new heart failure (9), patients with established heart failure (12,22), and patients presenting with acute dyspnoea in emergency settings (13)(14)(15)23), MRproADM has been shown to have independent prognostic significance for major adverse cardiovascular outcomes.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

Yuyun

Narayan

2015

The American Journal of Cardiology

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Highlights-This systematic review shows that adrenomedullin is an independent predictor of death in patients with heart failure, as well as MACE and death in patients who have suffered an acute myocardial infarction.-Quantification of this peptide might contribute to improved risk stratification in settings of heart failure and myocardial infarction. ABSTRACTWe undertook this systematic review to determine the prognostic significance of adrenomedullin (ADM) in heart failure and acute myocardial infarction (AMI) patients.Given the difficulty in measuring mature ADM, its surrogate, mid-regional proadrenomedullin (MRproADM), has been used in most studies. 1 nmol/l increase in MRproADM was associated with HR for MACE ranging from 1.78 to 4.10 (CI 1.20 -10.12), while log10 of MRproADM had hazard ratios of 3.63 to 9.75 ) for death across studies in AMI patients. In conclusion, adrenomedullin is an independent predictor of death in patients with heart failure, as well as MACE and death in patients who have suffered an AMI. Quantification of this peptide might contribute to improved risk stratification in settings of heart failure and myocardial infarction.

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Prognostic Value of Emerging Neurohormones in Chronic Heart Failure during Optimization of Heart Failure–Specific Therapy

Cited by 48 publications

References 32 publications

Copeptin Levels Associate with Cardiovascular Events in Patients with ESRD and Type 2 Diabetes Mellitus

Copeptin Levels Associate with Cardiovascular Events in Patients with ESRD and Type 2 Diabetes Mellitus

Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

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