Objective
Correlation of increased copeptin levels with various cardiovascular diseases has been described. The correlation of copeptin levels with presence of HCM and echocardiographic indices of LV has not been investigated in the literature, yet. In this study, we investigated the relation between copeptin levels and presence of HCM and the potential use of this biomarker in diagnosis of HCM.
Methods
HCM was defined as presence of left ventricular (LV) wall thickness ≥15 mm in a subject without any concomitant disease that may cause LV hypertrophy. LV outflow tract obstruction was defined by a peak instantaneous outflow gradient of ≥30mmHg. Clinical characteristics, echocardiographic parameters and levels of copeptin and plasma B-type natriuretic peptide (BNP) were evaluated prospectively in 24 obstructive HCM, 36 non obstructive HCM and 36 control subjects.
Methods
HCM was defined as presence of left ventricular (LV) wall thickness ≥15 mm in a subject without any concomitant disease that may cause LV hypertrophy. LV outflow tract obstruction was defined by a peak instantaneous outflow gradient of ≥30mmHg. Clinical characteristics, echocardiographic parameters and levels of copeptin and plasma B-type natriuretic peptide (BNP) were evaluated prospectively in 24 obstructive HCM, 36 non obstructive HCM and 36 control subjects.
Results
The groups were comparable regarding age, gender, and frequency of HT, DM and HL. The mean thickness of IVS was 20.5±4.7 mm, PW was 14.6±3.6 mm which were significantly higher in the HCM group. The LVD, LVS were smaller and left atrial antero-posterior diameter was larger in HCM group compared to the controls. In addition, E/A ratio was lower and and E/e’ was higher in the HCM group. The clinical and echocardiographic parameters of subjects with obstructive and non-obstructive HCM groups are summarized in Table 1. The mean IVS diameter and E/e’ ratio were significantly higher in obstructive HCM group. Whereas, the other echocardiographic parameters were similar between the two groups. Copeptin and NT-proBNP levels were higher in the HCM group compared to the controls (14.1 [10.7] vs. 8.4 [1.5] pmol/L, p=0.01 and 383 [719] vs. 44 [94] pg/mL, p=0.01, respectively). In subgroup analysis, copeptin and NT-proBNP levels were higher in the obstructive HCM subgroup compared to the non-obstructive HCM subgroup (18.3 [10.1] vs. 13.1 [8.6] pmol/L, p=0.01 and 717 [781] vs. 223 [585] pg/mL, p=0.01, respectively). In ROC analysis; copeptin levels >10.1 pmol/L (sensitivity 80%, specificity 94.4% AUC=0.895, p=0.01) and NT-proBNP levels > 114 pg/mL (sensitivity 90%, specificity 80.6% AUC=0.920, p=0.01) predicted HCM in the study population.
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