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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Predictive Value of Plasma Copeptin Level in Children with Acute Heart Failure
Doaa El Amrousy1, Dina Abdelhai2, Mohammed Nassar3
1Pediatric Department, Faculty of Medicine, Tanta University, Tanta, Egypt. doaa.moha@med.tanta.edu.eg.
Insights
Elevated copeptin levels in children with heart failure (HF) indicate a higher risk of adverse outcomes. This biomarker correlates with HF severity and can predict poor prognosis in pediatric patients.
Area of Science:
- Cardiology
- Biomarkers
- Pediatric Medicine
Background:
- Pediatric heart failure (HF) presents a significant clinical challenge.
- Identifying reliable prognostic markers is crucial for managing pediatric HF.
- Copeptin, a marker of arginine vasopressin release, has shown potential in adult HF but requires investigation in children.
Purpose of the Study:
- To evaluate the predictive ability of copeptin levels for adverse outcomes in pediatric heart failure.
- To correlate copeptin levels with clinical and echocardiographic parameters in children with HF.
- To assess the prognostic value of copeptin in pediatric HF patients.
Main Methods:
- A cohort study included 40 children with acute HF and 40 healthy controls.
- Echocardiography and plasma copeptin levels were measured at admission.
- Patients were followed for 6 months for mortality or readmission.
Main Results:
- Plasma copeptin levels were significantly higher in pediatric HF patients (16.2 ± 5 pmol/L) compared to controls (4.1 ± 2.3 pmol/L).
- Copeptin levels positively correlated with HF severity (Ross classification) and indicators of poor prognosis.
- A copeptin cut-off of ≥19.5 pmol/L predicted adverse outcomes with 75% sensitivity and 93% specificity.
Conclusions:
- Plasma copeptin is a valuable prognostic biomarker for adverse outcomes in pediatric heart failure.
- Copeptin levels correlate with the severity of pediatric HF and clinical parameters.
- This study supports the use of copeptin for risk stratification in children with HF.
Abstract:
We investigated the ability of copeptin level to predict adverse outcome in pediatric heart failure (HF) and correlated copeptin level with various clinical and echocardiographic data. This cohort study was carried out on forty children with clinical picture of acute HF as the patient group and forty healthy children of matched age and sex as the control group. Echocardiographic examination and plasma copeptin level were performed for all included children at admission. Patients were followed up for 6 months for mortality or readmission. Plasma copeptin level was significantly higher in the patient group (16.2 ± 5) pmol/L compared to the control group (4.1 ± 2.3) pmol/L, P ˂0.001. Moreover, copeptin level was positively correlated with Ross classification, being the highest in patients with class IV (19.6 ± 3.9) pmol/L compared to those with class III (15.2 ± 4) pmol/L and class II (10.4 ± 1.5) pmol/L. Copeptin levels were significantly higher in patients with bad prognosis (21.2 ± 4.1) pmol/L compared to those with good prognosis (14.5 ± 4.1) pmol/L, P ˂0.001. Copeptin level had a significant positive correlation with age, heart rate, respiratory rate, and ROSS classification. On the contrary, copeptin level had a significant negative correlation with left ventricular fraction shortening and diastolic function. Copeptin at cut-off value of ≥ 19.5 pmol/L yielded a sensitivity of 75% and a specificity of 93% to predict adverse outcome in children with HF. Plasma copeptin level has a good prognostic value to predict adverse outcome in pediatric heart failure. Moreover, copeptin correlate well with the severity of pediatric HF.
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