Cardiology Letters 2022, 31(3):178-183

The relationship between cardiac resynchronization therapy and serum levels of copeptin

Kerekanic M, Jakubova M, Komanova E, Sedlak J, Stancak B

East-Slovak Institute of Cardiovascular Diseases, Department of Arrhythmias, Kosice, Slovakia

Background: Chronic heart failure (CHF) is a complex syndrome characterized by an abnormal neurohormonal activation, including arginine vasopressin (AVP). Copeptin is an indicator of AVP activation, which levels are elevated in CHF and have prognostic importance. Cardiac resynchronization therapy (CRT) is an important device therapy for patients with advanced CHF, left ventricular (LV) systolic dysfunction and evidence of electromechanical dyssynchrony. The aim of the present study was to determine the possible relationship between CRT and serum copeptin levels.

Methods: We included CRT patients with ischemic as well as nonischemic etiology of CHF. The levels of copeptin were measured at baseline and 12 months respectively after CRT implantation. Echocardiography was also performed pre and 12 months post CRT implantation. A CRT response was defined as a ≥ 15% reduction in LV end-systolic volume (LVESV).

Results: The study population consisted of 41 patients. The mean copeptin level was 20.50 ± 15.77 pmol/l. Copeptin levels positively correlated with New York Heart Association class, left atrial diameter, creatinine levels and NT-proBNP levels. CRT responders have significant reduction in copeptin levels from baseline to 12 months (from 16.96 ± 12.80 pmol/l to 6.20 ± 6.44 pmol/l, p < 0.001). No significant changes in copeptin levels were observed in CRT nonresponders. Reduction > 45% in copeptin levels was significantly associated with CRT-response (OR 6.72, 95% CI 1.01 - 18.11, p = 0.045). Fig. 1, Tab. 2, Ref. 23, on-line full text (Free, PDF) www.cardiologyletters.sk Conclusion: The copeptin serum levels can be a useful biomarker in the evaluation of the CRT response.

Keywords: heart failure; biomarker; copeptin; cardiac resynchronization; responder

Published: March 1, 2022  Show citation