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Urocortin-2 as a novel biomarker of clinical deterioration in HFpEF: A prospective cohort study
Session:
Comunicações Orais - Sessão 17 - Miscelânea
Speaker:
Inês Vasconcelos
Congress:
CPC 2024
Topic:
P. Other
Theme:
37. Miscellanea
Subtheme:
10.2 Chronic Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Inês Vasconcelos; Rui Adão; Francisco Vasques-Nóvoa; Adelino Leite-Moreira; António S. Barros; Carmen Brás-Silva
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> With an increased understanding of the pathophysiology of heart failure (HF), many molecules have emerged as possible diagnostic and prognostic biomarkers. Although circulating urocortin levels in healthy humans are low, serum Urocortin-2 (Ucn2) levels have been found to be elevated in HF patients with reduced ejection fraction and in patients with hypertension and have been positively correlated with left ventricular hypertrophy. These findings suggest a potential value of serum Ucn2 concentration in HF with preserved ejection fraction (HFpEF).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Objectives:</strong> The study aims to explore the possibility that circulating levels of Ucn2 may serve as indicators of the severity and prognosis of HFpEF.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> Urocortin-2 serum levels were measured in 101 serum samples from patients with chronic HFpEF in a prospective cohort study (NETDiamond). Clinical, imaging, and analytical data were compared for a cutoff value of 1203 pg/mL. The primary outcome was a composite of the time to cardiovascular death or HF hospitalization. A univariable Cox regression model was utilized to explore the relationship between urocortin-2 and various clinical characteristics.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Higher Ucn2 levels were associated with an increased risk of primary outcomes. Echocardiographic parameters such as left atrial diameter and e/e’ ratio were positively associated with Ucn2 serum levels (HR = 1.10, 95%CI 1.01-1.19, p = 0.024 and HR = 1.36, 95%CI 1.14-1.64, p < 0.001, respectively). Additionally, Ucn2 concentration was positively associated with clinical congestive signs, such as bibasilar pulmonary congestion (HR = 3.59, 95%CI 1.2–10.7, p = 0.022), peripheral edema, particularly if present above the knee (HR = 30.3, 95%CI 1.89-486, p = 0.016), and increased jugular venous pressure (HR = 4.74, 95%CI 1.11-20.3, p = 0.036). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> In patients with HFpEF, it was observed that serum Ucn2 levels were correlated with left chamber remodeling and adverse prognosis, particularly with clinical signs of congestion. These findings provide evidence for the potential pathophysiological role of this peptide and suggest its usefulness as a circulating biomarker for HFpEF.</span></span></p>
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