Copeptin levels in patients with vasovagal syncope

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• 作者：Panayota Flevari^a ; ¹ ; ^{pflevari@yahoo.com} ; Dionyssios Leftheriotis^a ; ¹ ; Christos Kroupis^b ; ¹ ; George Antonakos^b ; ¹ ; John Lekakis^a ; ¹ ; Kleanthi Dima^b ; ¹
• 关键词：Copeptin ; Arginine-vasopressin ; Vasoconstriction ; Syncope
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 March 2017
• 年：2017
• 卷：230
• 期：Complete
• 页码：642-645
• 全文大小：336 K
• 卷排序：230

文摘

Vasovagal syncope (VVS) is linked to more than one pathophysiologic mechanisms. Copeptin, an emerging cardiovascular marker, is a surrogate for arginine-vasopressin, which increases following VVS. We aimed to assess the dynamic pattern of copeptin levels in typical VVS, categorized by the degree of vasoconstriction during orthostasis, and healthy controls.MethodsThe following groups were studied: Group A (n = 21), with adequate limb vasoconstriction during the first min. of tilt, assessed by limb plethysmography (at least 30% flow reduction); Group B (n = 15), showing impaired vasoconstriction during orthostasis (< 10% reduction); Group C (n = 18), history of VVS and negative tilt test result; Group D (n = 18), healthy controls. Copeptin plasma levels were assessed before and 5 min following tilt test positivity or termination.ResultsBaseline copeptin values were similar in all groups (8.3 ± 6.4 in Group A, 5.7 ± 2.3 pmol/l in B, 6.0 ± 1.9 in C, and 6.9 ± 2.6 in D, p: 0.41). Significant increases in copeptin during tilt were observed in all Groups of VVS patients (A, B, C), including those with negative tilt (Group C: from 6.0 ± 1.9 to 27.7 ± 12.6 pmol/l, p: 0.001), but not in controls. Following tilt termination, a greater increase was observed in copeptin values in Group B vs all other Groups A, C, and D (111.6 ± 63.5 vs 29.5 ± 51.3, 27.7 ± 12.6, and 8.3 ± 2.9, respectively).ConclusionsCopeptin increases following tilt not only in VVS with a positive response, but also in typical history patients with a negative test. Increased copeptin levels following orthostasis may be useful for diagnosing VVS.