Abstract 11217: Copeptin: A Novel Biomarker in Pediatric Heart Failure Due to Cardiomyopathies

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A11217
• Main Authors: Karki, Karan B, Towbin, Jeffrey A, Philip, Ranjit R, Harrell, Camden, Tadphale, Sachin, Shah, Samir, Saini, Arun
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19.11.2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.11217

IntroductionCardiomyopathies are common causes of Pediatric Heart Failure (HF). Biomarkers are often used to assess the severity of HF. B-type natriuretic peptide (BNP) is the only commonly used prognostic biomarker available for these patients, which is imperfect. Copeptin is emerging as a useful marker for risk stratification, therapeutic implications and predicting all-cause mortality in adults with HF. No data is available in children with HF due to cardiomyopathies. The objective of this study is to determine the copeptin level in children with HF and correlate with clinical HF grading, BNP level, and echocardiographic measurements.MethodsA prospective case-control study of children of ages 1 month to 18 years with HF compared with age- and sex-matched control group of healthy children. A subgroup analysis was done in children with HF due to cardiomyopathies.ResultsA total of 54 children (66% males) with HF and 33(57% males) healthy controls were enrolled. Among them 44 (81.4%) had cardiomyopathies. The median(IQR) age of the cardiomyopathy group was 13.6 years (2.7-17.46). The different types of cardiomyopathies including LVNC in 24 (54.5%), Dilated in 11 (25%), Hypertrophic in 4(9%), Restrictive in 2 (4.5%), acute myocarditis in 3(6.8%), and mixed cardiomyopathies in 3 (6.8%) children. The distribution of children based on NYHA/Ross heart failure grading was Class I in 21 (47.3%), Class II in13 (29.55 %), Class III in 3 (6.8%) and class IV in 7 (15.9%) children. The median(IQR) copeptin level in the cardiomyopathy group was elevated 27pg/ml (11- 449) compared to the control group 6.2pg/ml (5.8-6.8) (p <0.001). The copeptin had strong correlation with BNP level (r =0.93, p <0.0001) and moderate correlation with HF grading (r =0.56, p <0.001). The copeptin level had moderate correlation with left atrial(LA) volume (r =0.62, p <0.001) and weak negative correlation with Left ventricular ejection fraction(LVEF) (r =-0.30, p =0.07).ConclusionsThis is the first study to report copeptin levels in children with HF due to cardiomyopathies. Copeptin level is elevated in children with HF due to cardiomyopathies. It has a strong correlation with the BNP level, a moderate correlation with the clinical grading of HF and LA volume and a weak correlation with LVEF.