The evaluation of the clinical utility of urocortin 1 and adrenomedullin versus proBNP in systolic heart failureErkan Yıldırım1, Mahir Cengiz2, Nilgün Yıldırım3, Kürşat Aslan1, Emrah İpek1, Ali Fuat Korkmaz1, Fatih Rıfat Ulusoy1, Engin Hatem1
1Clinic of Cardiology, Erzurum Research and Training Hosppital; Erzurum-Turkey
2Department of Internal Medicine, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
3Department of Internal Medicine, Faculty of Medicine Atatürk University; Erzurum-Turkey
Objective: Urocortin 1 (UCN1) has vasodilator, diuretic, and natriuretic effects, and its expression increases in heart failure (HF). Adrenomedullin (ADM) increases cardiac output and lowers blood pressure in healthy men and in patients with heart failure. The aim of the study was to determine UCN1 and ADM levels in patients with HF, to evaluate the relationship of UCN1 and ADM with various clinical parameters, and to assess UCN1 and ADM as diagnostic markers in HF, in comparison with pro-brain natriuretic peptide (pro-BNP).Keywords: urocortin 1, adrenomedullin, heart failure, pro-brain natriuretic peptide
Methods: We investigated serum levels of UCN1, ADM, and pro-BNP in 86 consecutive patients with systolic HF [ejection fraction (EF) ≤45%] and 85 healthy controls. Serum UCN1, ADM, and pro-BNP levels were measured with the ELISA method. Transthoracic echocardiography was performed to determine left ventricular EF and pulmonary artery systolic pressure.
Results: UCN1 and ADM levels were higher in HF patients (446.2±145.7 pg/mL, p<0.001; 87.9±4.2 pg/mL, p<0.001 respectively). UCN1 was posi- tively correlated with pro-BNP (r=0.963, p<0.001), ADM (r=0.915, p<0.001), and NYHA (r=0.879, p<0.001); ADM was positively correlated with pro-BNP (r=0.956, p<0.001) and NYHA (r=0.944, p<0.001). Receiver operating characteristic curves yielded an area under the curve of 1.00 (p<0.001) for UCN1, 1.00 (p<0.001) for ADM, and 0.99 (p<0.001) for pro-BNP in the diagnosis of HF.
Conclusion: UCN1 and ADM increase with worsening HF and left ventricular dysfunction. They may be used as diagnostic biomarkers in sys- tolic HF, but the incremental value of measuring UCN1 and ADM in patients tested for pro-BNP is questionable. (Anatol J Cardiol 2015; 15(0): 000-000)
Corresponding Author: Mahir Cengiz, Türkiye