Sahin Irfan, Gungor Baris, Ozkaynak Berk, Uzun Fatih, Küçük Suat Hayri, Avci Ilhan Iker, Ozal Ender, Ayça Burak, Cetın Sukru, Okuyan Ertugrul, Dinckal Mustafa Hakan
Department of Cardiology, Bagcilar Research and Education Hospital, Istanbul, Turkey.
Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Clin Cardiol. 2017 Jan;40(1):32-37. doi: 10.1002/clc.22602. Epub 2016 Oct 21.
Correlation of increased copeptin levels with various cardiovascular diseases has been described. The clinical use of copeptin levels in patients with hypertrophic cardiomyopathy (HCM) has not been investigated before.
In this study, we aimed to investigate the prognostic value of copeptin levels in patients with hypertrophic cardiomyopathy (HCM).
HCM was defined as presence of left ventricular wall thickness ≥15 mm in a subject without any concomitant disease that may cause left ventricular hypertrophy. Levels of copeptin and plasma N-terminal probrain natriuretic peptide (NT-proBNP) were evaluated prospectively in 24 obstructive HCM patients, 36 nonobstructive HCM patients, and 36 age- and sex-matched control subjects. Blood samples were collected in the morning between 7 and 9 am after overnight fasting. Patients were followed for 24 months. Hospitalization with diagnosis of heart failure/arrhythmia, implantable cardioverter-defibrillator implantation, and cardiac mortality were accepted as adverse cardiac events.
Copeptin and NT-proBNP levels were higher in the HCM group compared with controls (14.1 vs 8.4 pmol/L, P < 0.01; and 383 vs 44 pg/mL, P < 0.01, respectively). Copeptin and NT-proBNP levels were higher in the obstructive HCM subgroup compared with the nonobstructive HCM subgroup (18.3 vs 13.1 pmol/L, P < 0.01; and 717 vs 223 pg/mL, P < 0.01, respectively). In multivariable logistic regression analysis, copeptin and NT-proBNP levels remained as independent predictors of heart failure (P < 0.01 for both) and adverse cardiac events (P < 0.01 for both).
Copeptin and NT-proBNP levels were significantly higher in patients with obstructive HCM, and higher levels were associated with worse outcome.
已描述了copeptin水平升高与各种心血管疾病之间的相关性。此前尚未研究过copeptin水平在肥厚型心肌病（HCM）患者中的临床应用。
在本研究中，我们旨在调查copeptin水平在肥厚型心肌病（HCM）患者中的预后价值。
肥厚型心肌病定义为在无任何可能导致左心室肥厚的伴随疾病的受试者中左心室壁厚度≥15mm。对24例梗阻性HCM患者、36例非梗阻性HCM患者和36例年龄及性别匹配的对照受试者进行了copeptin和血浆N末端脑钠肽前体（NT-proBNP）水平的前瞻性评估。在过夜禁食后的上午7点至9点之间采集血样。对患者进行了24个月的随访。诊断为心力衰竭/心律失常的住院治疗、植入式心脏复律除颤器植入和心脏死亡被视为不良心脏事件。
与对照组相比，HCM组的copeptin和NT-proBNP水平更高（分别为14.1 vs 8.4 pmol/L，P<0.01；383 vs 44 pg/mL，P<0.01）。与非梗阻性HCM亚组相比，梗阻性HCM亚组的copeptin和NT-proBNP水平更高（分别为18.3 vs 13.1 pmol/L，P<0.01；717 vs 223 pg/mL，P<0.01）。在多变量逻辑回归分析中，copeptin和NT-proBNP水平仍然是心力衰竭（两者P<0.01）和不良心脏事件（两者P<0.01）的独立预测因素。
梗阻性HCM患者的copeptin和NT-proBNP水平显著更高，且更高水平与更差的预后相关。
