Przybylowski P, Malyszko J, Malyszko J S
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University, John Paul II Hospital, Cracow, Poland.
Transplant Proc. 2010 Jun;42(5):1808-11. doi: 10.1016/j.transproceed.2010.03.138.
Copeptin is cosynthesized with vasopressin, also known as antidiuretic hormone, with plasma levels similar to vasopressin. In the past 2 years, copeptin has been studied as a diagnostic and prognostic marker in infections and other diseases. In patients with destabilized heart failure, copeptin is an accurate prognostic marker for mortality. The aim of this study was to assess copeptin in orthotopic heart recipients in relation to New York Heart Association class and kidney function. The studies were performed on 139 prevalent patients after orthotopic heart transplantation-(OHT) including 105 males and 34 females. Glomerular filtration rate (GFR) was estimated using simplified Modification of Diet in Renal Disease (MDRD), Cockcroft-Gault, and new the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. In addition 24-hour creatinine clearances were performed on each patient. Complete blood count, urea, serum lipids, fasting glucose, creatinine, BNP were studied by standard laboratory method in the hospital central laboratory. Plasma copeptin was measured using a commercially available kit. Copeptin correlated with parameters of kidney function: creatinine (r = .39, P < .001), estimated GFR by MDRD (r = -.24, P < .01), estimated GFR by CKD-EPI (r = -.25, P < .01), creatinine clearance by Cockcroft-Gault (r = -.27, P < .01), 24-hour creatinine clearance (r = -.21, P < .05), cystatin C (r = .45, P < .001), and high-density lipoprotein (r = .18, P < .05), BNP (r = .25, P < .01), intraventricular septal diameter/thickness (IVS); r = -.30, P < .01), ejection fraction (r = -.17, P < .05), ferritin (r = .21, P < .05). Upon multiple regression analysis, predictors of copeptin were cystatin C and IVS, which explained 51% of copeptin variations (F = 3.21, P < .03 and Standard error of estimate was 0.57). Beta value for cystatin C was 0.51 (P = .024) and for IVS was -0.59 (P = .018). Copeptin in a heart transplant population was independently associated with kidney function and IVS.
copeptin与抗利尿激素（又称血管加压素）共同合成，其血浆水平与血管加压素相似。在过去两年中，copeptin已被作为感染及其他疾病的诊断和预后标志物进行研究。在失代偿性心力衰竭患者中，copeptin是死亡率的准确预后标志物。本研究的目的是评估原位心脏移植受者中copeptin与纽约心脏协会分级及肾功能的关系。研究对象为139例原位心脏移植术后的现患患者，其中男性105例，女性34例。采用简化的肾脏病饮食改良（MDRD）公式、Cockcroft - Gault公式以及新的慢性肾脏病流行病学协作组（CKD - EPI）公式估算肾小球滤过率（GFR）。此外，还对每位患者进行了24小时肌酐清除率检测。采用医院中心实验室的标准实验室方法检测全血细胞计数、尿素、血脂、空腹血糖、肌酐、脑钠肽（BNP）。使用市售试剂盒检测血浆copeptin。copeptin与肾功能参数相关：肌酐（r = 0.39，P < 0.001）、MDRD估算的GFR（r = -0.24，P < 0.01）、CKD - EPI估算的GFR（r = -0.25，P < 0.01）、Cockcroft - Gault法计算的肌酐清除率（r = -0.27，P < 0.01）、24小时肌酐清除率（r = -0.21，P < 0.05）、胱抑素C（r = 0.45，P < 0.001）、高密度脂蛋白（r = 0.18，P < 0.05）、BNP（r = 0.25，P < 0.01）、室间隔直径/厚度（IVS；r = -0.30，P < 0.01）、射血分数（r = -0.
