Copeptin in Heart Failure, Post-Left Ventricular Assist Device and Post-Heart Transplantation

详细信息    查看全文

• 作者：Stanislava Zabarovskaja ; MD ; PhD^a ; ^b ; ^{stasia.zab@gmail.com} ; Camilla Hage ; RN ; PhD^a ; ^b ; Anders Gabrielsen ; MD ; PhD^a ; Linda Mellbin ; MD ; PhD^a ; ^b ; Lars H. Lund ; MD ; PhD^a ; ^b
• 关键词：Copeptin ; Heart failure ; Heart assist device ; Heart transplantation
• 刊名：Heart, Lung and Circulation
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：26
• 期：2
• 页码：143-149
• 全文大小：535 K
• 卷排序：26

文摘

Heart failure (HF) is associated with pathological activation of arginine vasopressin, measured in plasma by the pre-hormone fragment copeptin. We hypothesised that copeptin is elevated and associated with worse prognosis in HF, and that left ventricular assist device (LVAD) therapy and heart transplantation (HTx) are associated with lower levels of copeptin.MethodsWe measured copeptin in groups of 49 patients with advanced HF, 13 patients one year post-LVAD and 22 patients one year post-HTx and correlated with clinical data and cardiac output. In HF we also assessed the prognostic role of copeptin with Kaplan-Meier analysis and multivariate Cox regression.ResultsIn HF, median (interquartile range) copeptin was 28 (18-45) pmol/L, after LVAD 16 (6-27) pmol/L, and after HTx 12 (5-20) pmol/L (p overall <0.001). In HF, copeptin was an independent predictor of death, LVAD or HTx (hazard ratio for log copeptin, 3.28 [95% confidence interval: 1.66-6.50], p=0.001).ConclusionsCopeptin was elevated in, and independently predicted prognosis in, HF. Copeptin was progressively lower after LVAD and HTx. This suggests that improvement in cardiac output with LVAD and HTx may induce progressively reduced activation of vasopressin, which may be a marker for the beneficial effects of LVAD and HTx.